NHA Practice Exams 1-2 WITH Rationale

Some pictures might be placed with the definition - use this for studying!

In which of the following locations should an EKG technician place the leads for a resting EKG tracing for a patient who is in immobile fetal position?

a. On the patient's back

b. On the patient's right side

C. On the standard sites

D. On the limbs only

Answer: a. on the patient's back

reason: The technician should place the electrodes on the patient's back if the patient cannot move from the fetal position

An EKG technician is obtaining a pulse rate for a 2-year-old patient. Which of the following pulse rates should the technician recognize as within the expected reference range for this patient?

a. 60/min

b. 75/min

c. 120/min

d. 150/min

Answer: C. 120/min

Reason: The technician should recognize that the expected reference range for a child who is 1 to 2 years of age is a pulse rate of 80 to 140/min.

An EKG technician should recognize that a rhythm strip should be at least how many seconds long to accurately identify rate and rhythm?

a. 2 seconds

b. 4 seconds

c. 6 seconds

d. 8 seconds

Answer: c. 6 seconds

Reason: The technician should recognize that a minimum of 6 seconds is required to accurately determine the heart rate for an irregular rhythm.

In which of the following locations should a EKG technician place the electrode for leads V7, V8, and V9?

a. Evenly spaced on the back between the axillary line and the vertebral column at the fifth intercostal space

b. Evenly spaced on the right chest between the sternum and the right axillary line at the fifth intercostal space

c. On the axillary place at the fifth intercostal space

d,. On the frontal plane at the sixth intercostal space

Answer: a. Evenly spaced on the back between the axillary line and the vertebral column at the fifth intercostal space

Reason:

- For answer choice B, this is used for lead 4 in a patient who has dextrocardia

- For answer choice C, this is the correct placement for V6

- For answer choice D, none of the electrodes are placed there

An EKG technician should follow which of the following recommendations regarding infection control practices in health care settings?

a. artificial nails should be no longer than 1.27 cm (0.5") in length

b. Use an alcohol- based hand rub if there is visible contamination on the hands.

c. Remove soiled gloves prior to touching uncontaminated surfaces

d. Wear the same gloves while performing different procedures on the same patient.

Answer: c. Remove soiled gloves prior to touching uncontaminated surfaces

Reason:

- For answer choice A, technicians should not wear artificial nails

- For answer choice B, technicians should only use alcohol if there is no visible contamination

An EKG technician working at a central monitoring station notes that a patient has a rhythm of ventricular tachycardia. Which of the following actions should the technician take first?

a. prepare for defibrillation of the patient

b. document the rhythm in the patient's medical record

c. notify a licensed practitioner to evaluate the patient

d. verify the time of the last dose of the patient's cardiac medication

Answer: c. notify a licensed practitioner to evaluate the patient

Reason: The technician should notify a licensed practitioner to evaluate the patient because ventricular tachycardia is a decrease in the patient's cardiac output that can result in the patient becoming unresponsive. The technician should recognize that the first step is to evaluate the patient before administering any medications or beginning defibrillation

An EKG technician obtains a pulse oximetry reading of 88% from a patient. Which of the following terms should the technician use to describe the patient's condition?

a. rales

b. hypoxemia

c. hemoptysis

d. orthopnea

Answer: b. hypoxemia

Reason: The technician should describe the patient's condition as hypoxemia because it refers to low oxygen levels in the blood. The expected reference range for a pulse oximetry reading is 95% or greater

An EKG technician notes that a patient is experiencing a variation in respirations that correlates with the EKG tracing. Which of the following irregularities does this indicate?

a. sinus arrest

b. sinus dysrhythmia

c. tachycardia

d. bradycardia

Correct: b. sinus dysrhythmia

Reason: sinus dysrhythmia is characterized by changes in the patient's respirations that correspond to an irregular rhythm seen on the EKG tracing

An EKG technician is reviewing the EKG tracing of a patient who has ventricular hypertrophy. Which of the following finding should the technician expect?

a. An ST segment depression of 2mm

b. Increased amplitude of the QRS complex

c. prolongation of the PR interval

d. irregularity of the P-P interval

Answer: b. Increased amplitude of the QRS complex

Reason: The EKG tracing for a patient who has ventricular hypertrophy will display an increased amplitude of the QRS complex. A patient who has ventricular hypertrophy has overdeveloped cardiac muscles, which causes a higher amplitude of the QRS complex.

An EKG technician is caring for a patient who is experiencing heart palpitations. Which of the following interventions should the technician expect the provider to prescribe?

a. vasodilator medication

b. Holter monitor

c. Cardiac inotropic medication

d. chemical stress test

Answer: b. Holter monitor

Reason: A Holter monitor is typically prescribed for patients who experience palpations, syncope, dizziness, chest pain, lightheadedness, or are taking antidysrhythmic.

Which of the following sites is the most appropriate for an EKG technician to use when taking the pulse of an infant?

a. brachial artery

b. carotid artery

c. radial artery

d. femoral artery

Answer: a. brachial artery

Reason: The brachial artery is the easiest site to obtain a pulse if an infant because of its proximity to the surface of the skin

Which of the following actions should an EKG technician take when preparing a patient for a standard 12-lead EKG?

a. encourages the patient to ask questions during the procedure

b. instruct the patient to hold their breath

c. place electrodes over the patient's chest hair

d. have the patient remove any jewelry

Answer: d. have the patient remove any jewelry

Reason: The technician should have the patient remove any jewelry prior to the EKG because jewelry will cause AC interference on the EKG tracing

An EKG technician should recognize that the smallest box on the EKG graph represents which of the following lengths of time?

a. 0.02 seconds

b. 0.04 seconds

c. 0.10 seconds

d. 0.40 seconds

Answer: b. 0.04 seconds

An EKG technician should recognize that which of the following signs are often present when a patient is experiencing ventricular tachycardia?

a. multiple premature ventricular contractions in a row

b. decreased heart rate

c. absence of R-R interval

d. narrow QRS complexes on the EKG tracing

Answer: a. multiple premature ventricular contractions in a row

Reasons: The technician should identify that three or more premature ventricular contractions in a row on the EKG tracing indicates that the patient is experiencing ventricular tachycardia

Which of the following methods can be used to calculate both regular and irregular rhythms?

a. 6- second method

b. p-p method

c. 1500 method

d. 300 method

Answer: a. 6- second method

Reason: This is the only method available for both regular and irregular rhythm.

An EKG technician is preparing to perform a 12-lead EKG for a patient who has dextrocardia. In which of the following locations should the technician place the electrode for lead V1?

a. right sternal border, fourth intercostal space

b. left sternal border, fourth intercostal space

c. left mid-clavicular line, fifth intercostal space

d. right mid-clavicular line, fifth intercostal space

Answer: b. left sternal border, fourth intercostal space

Reason: For a patient who has dextrocardia, the location of the electrode for lead V1 should be mirrored to its standard placement for a 12-lead EKG

Calculate the ventricular rate in the tracing below using the 1500 method.

a. 140/min

b. 150/min

c. 160/min

Answer: b. 150/min

Reason: Divide 1500 by the number of small boxes between complexes. 1500/10 = 150/min

An EKG technician is providing instructions to a patient who is to wear a cardiac event monitor at home. Which of the following statements by the patient indicates an understanding of the instructions?

a. "I can take showers while wearing this monitor."

b. "The monitor will keep track of all my daily activities."

c. "I can continue to use my electric blanket while wearing the monitor."

d. "I will continue to do my daily walk to the grocery store."

Answer: d. "I will continue to do my daily walk to the grocery store."

Reason: The technician should instruct the patient to continue with normal activities, including excercise

An EKG technician is performing an exercise stress test to evaluate a patient for coronary vascular disease. Which of the following actions should the technician take regarding this procedure?

a. report unexpected dysthymias during the test

b. evaluate the need for the patient to follow an exercise program

c. prescribe oxygen if the patient reports shortness of breath during the test

d. instruct the patient to cease cardiac medication after the test

Answer: a. report unexpected dysthymias during the test

reason: The technician should report changes in the EKG tracing during the stress test

In a healthy adult patient, which of the following is the expected shape and direction of the P wave in lead II?

a. peaked and upright

b. peaked and inverted

c. rounded and inverted

d. rounded and upright

Answer: d. rounded and upright

Reason: Normal atrial depolarization moves in the direction of the left leg, or the positive electrode, causing an upright and rounded wave. This is an expected finding in a healthy adult patient.

While performing an exercise stress test on a patient, a technician observes elevated ST segments. The technician should identify these findings as which of the following?

a. expected EKG changes as a result of running

b. expected EKG changes due to hypokalemia

c. signs of pulmonary embolism

d. signs of acute myocardial injury

Answer: d. signs of acute myocardial injury

Reason: elevated ST segments in multiple leads indicate that the patient is experiencing an acute myocardial infraction. The technician should notify the provider immediately.

An EKG technician is performing a posterior 12-lead EKG for a patient. Which of the following leads should the technician place along the paraspinous border?

a. lead v7

b. lead v8

c. lead v9

d. lead v7r

Answer: c. lead v9

reason: the technician should position lead v9 at the left paraspinous border

Which of the following activities should an EKG technician instruct a patient to record in the Holter monitor diary?

a. bike riding

b. swimming

c. driving

d. sleeping position

Answer: a. bike riding

reason: the technician should instruct the patient to record exercise in the diary

Which of the following EKG machine functions should an EKG technician use to control and regulate the height of the EKG waveforms on the tracing?

a. speed

b. output display

c. artifact filter

d. gain

Answer: d. gain

reason: The technician should use the gain control to adjust the height of the waveform

An EKG technician is preparing to obtain a standard 12-lead EKG tracing for a patient who is at 35 weeks of gestation. In which of the following positions should the technician place the patient?

a. supine with head elevated

b. partially upright with legs supported

c. slightly on the left side with a pillow supporting the right hip

d. supine with the feet flat on the table

Answer: c. slightly on the left side with a pillow supporting the right hip

reason: The technician should place the patient who is pregnant slightly on her left side with a small pillow supporting the right hip to promote comfort during an EKG tracing.

An EKG technician should recognize that which of the following blood pressure readings is within the expected reference range for an adolescent patient?

a. 60/40 mm Hg

b. 78/48 mm Hg

c. 86/60 mm Hg

d. 98/78 mm Hg

Answer: d. 98/78 mm Hg

Remember for adults it is 120/80 mm Hg.

An EKG technician is instructing a patient about a transtelephonic event monitor using a heart card monitoring device. To which of the following sites should the patient apply the card to activate it during an event?

a. Over the right side of the chest

b. over the left side of the chest

c. over the middle to lower part of the sternum

d. over the manubrium

Answer: c. over the middle to lower part of the sternum

An EKG technician is reviewing a tracing for a patient who has a ventricular pacemaker. Which of the following rhythm patterns should the technician expect after a pacing spike?

a. regular P waves

b. AV delay between 0.12 and 0.16 seconds

c. QRS interval between 0.06 and 0.10 seconds

d. Wide QRS interval

Answer: d. Wide QRS interval

Reason: after a pacing spike, the tracing of a wide QRS complex will appear. A ventricular pacemaker causes the ventricular contraction that results in a wide QRS complex

Which of the following positions is appropriate for a patient during a nuclear stress test while the camera is scanning?

a. supine with the arms at the side

b. supine with the arms above the head

c. right side-lying with the arms slightly extended

d. sitting upright with the head tilted back

Answer: b. supine with the arms above the head

Reason: This position is correct for the camera must be able to rotate around the patient to be able to produce a multidimensional image

An EKG technician is recording a patient's radial pulse and finds the pulse to be irregular. The provider then takes the patient's apical pulse. The technician should recognize that which of the following locations is used for this assessment.

a. between the larynx and the left sternocleidomastoid muscle

b. between the fifth and sixth ribs, at the left midclavicular line

c. the antecubital aspect of the left or right elbow

d. the thumbs side of the left wrist

Answer: b. between the fifth and sixth ribs, at the left midclavicular line

An EKG technician should recognize that which of the following situations is an allowable disclosure of patient information according to HIPAA guidelines?

a. patients write their names on a basic sign-in sheet at the registration desk

b. an employer calls the clinic to verify an employees excused absence

c. a patient can read the demographics screen of another patient's electronic chart while checking in at the desk

d. an employee gives a coworker access to their username and password to retrieve a patient's laboratory report

answer: a. patients write their names on a basic sign-in sheet at the registration desk

Which of the following patient findings indicates myocardial infraction?

a. cyanosis

b. facial drooping

c. arm weakness

d. aphasia

answer: a. cyanosis

reason: cyanosis occurs due to a lack of oxygen, which causes the patient's lips and fingernails to turn blue or cyanotic. This is a common manifestation of myocardial infraction.

An EKG technician is preparing to enter an inpatient room to perform a standard 12-lead EKG. Which of the following actions should the technician take for a patient who is prescribed contact precautions?

a. wear an N-95 mask if there is potential exposure to blood

b. disinfect the EKG machine immediately prior to entering the room

c. remove gloves before leaving the patient's room

d. keep the door to the patient's room closed

answer: c. remove gloves before leaving the patient's room

reason:

- A is incorrect for an N-95 mask is worn when someone is prescribed airborne precautions, not contact

- B is incorrect for the technician should disinfect immediately after leaving the room

- D is incorrect for it is a contact disease, not airborne

An EKG technician is performing an exercise stress test for a patient and observes the following rhythm on the monitor. Which of the following accurately describes the rhythm?

a. normal sinus rhythm

b. first-degree AV heart block

c. second-degree AV heart block Mobitz type II

d. junctional rhythm

Answer: c. second-degree AV heart block Mobitz type II

Reason: A second-degree AV heart block Mobitz type II has some P waves without a QRS Complex, but the PR interval is constant.

- A is incorrect for a normal sinus rhythm has a P wave followed by a normal QRS complex.

- B is incorrect for a first-degree AV heart block has a P wave, but it has a consistently prolonged PR interval, followed by the QRS complex.

- D is incorrect for a junctional rhythm has an inverted or absent P wave and can appear before or after the QRS complex.

An EKG technician is measuring the intervals on an EKG tracing. Which of the following is an expected finding of impaired conduction through the AV node?

a. decreased QT inerval

b. prolonged QRS interval

c. prolonged QR interval

d. Prolonged PR interval

Answer:d. Prolonged PR interval

Reason: The PR interval is a direct reflection of AV node conduction. The PR interval signifies the distance the electrical impulse travels from the start of atrial depolarization to the start of ventricular depolarization.

Note: Remember, the SA node is the primary pacemaker, while the AV node is the secondary.

Which of the following intervals should be used to determine the regularity of ventricular depolarization?

a. P-P wave interval

b. R-R wave interval

c. QT interval

d. PR interval

Answer: b. R-R wave interval

Reason: The R-R wave interval represents the amount of time that elapses between cycles of ventricular depolarization. The EKG technician should use this interval to determine the pattern of regularity of the ventricles.

An EKG technician is performing a standard 12-lead EKG for a patient. The technician should identify that which of the following information is recorded by lead I?

a. electrical activity between the right arm and left leg

b. electrical activity between the right arm and left arm

c. electrical activity between the left arm and left leg

d. electrical activity between the right leg and left leg

Answer: b. electrical activity between the right arm and left arm

Reason:

- A is recording Lead II

- C is recording lead III

- D: we do not use the right leg

An EKG technician is providing instructions for a patient who is going home with a Holter monitor for 48hrs. Which of the following statements indicates the patient understands the instructions?

a. "I am able to shower or bathe"

b. "I can use moisturizing lotion around the electrodes"

c. "I should activate the event marker if I have chest pain"

d. "I should only record activities that cause chest pain"

Answer: c. "I should activate the event marker if I have chest pain"

Reason: The technician should instruct the patient to record all usual and unusual activities

After completing a standard 12-lead EKG on a patient, which of the following actions should an EKG technician take next?

a. remove the electrodes and assist the patient to a sitting position

b. remove the EKG tracing from the machine and provide privacy for the patient to get dressed

c. check the tracing is free from artifacts and then disconnect the patient from the machine

d. tell the patient that the test is complete and the provider will be in shortly

Answer: c. check the tracing is free from artifacts and then disconnect the patient from the machine

Reason: Always check your work before removing electrodes

An EKG technician should recognize that which of the following is the most commonly used paper speed for an EKG?

a. 5 mm/second

b. 10 mm/second

c. 25 mm/second

d. 50 mm/second

c. 25 mm/second

Which of the following methods should an EKG technician use to calculate a patient's heart rate from the EKG tracing?

a. calculate the mean rate and divide 1,500 by that rate

b. count the number of small boxes in two cardiac cycles

c. Divide 300 by the number of large boxes between two R waves

d. Count the number of large boxes between P and T waves

Answer: c. Divide 300 by the number of large boxes between two R waves

Reason:

- A is used to calculate irregular

- B: Only one cardiac cycle is needed to calculate heart rate

- D represents a partial cardiac cycle, and the large boxes are used to calculate when using the memory method

Ab EKG technician is preparing to apply electrodes to a patient for a standard 12-lead EKG. Which of the following methods should the technician use to prepare the patient for application of the electrodes?

a. cleanse the patient's skin with chlorhexidine

b. Apply tape and remove in a quick motion to remove patient's hair

c. Use a razor or clippers to remove the patient's hair

d. cleanse the patients skin with povidone iodine

Answer: c. Use a razor or clippers to remove the patient's hair

An EKG technician notices an accelerated idioventricular rhythm on a tracing. Which of the following actions should the technician take next?

a. tell the patient the results show significant findings and ask if she feels any different

b. call for help and stay with the patient

c. ask another technician to run an EKG

d. upload the tracing to the EHR and notify the provider that the tracing is ready for interpretation

Answer: b. call for help and stay with the patient

Idioventricular rhythm is a heart rhythm in which your lower heart chambers beat more slowly than normal. With this type of rhythm, your heart's ventricles or lower chambers may start your heartbeat if your natural pacemaker located in the upper chambers is unable to pace the heart

Which of the following statements made by an EKG technician correctly prepares the patient for telemetry monitoring?

a. "I will clean your skin with an alcohol pad"

b. "You may feel a slight warming sensation after the electrodes are placed on the skin"

c. "A mild rash or skin redness should be expected around the electrodes after 24 hrs. "

d. "Electrodes will be replaced once per week while you're in the hospital"

Answer" a. "I will clean your skin with an alcohol pad"

Reason: The technician should cleanse the patient's skin with either soap and water or an alcohol pad

An EKG technician is monitoring a patient who is undergoing an exercise stress test. Which of the following findings should indicate to the technician that the patient is experiencing an adverse reaction?

a. increase in blood pressure from 110/70 to 120/78 mm Hg.

b. An oxygen saturation of 95%

c. Presence of sinus tachycardia with a regular R-R wave

d. Report of tinging sensations in the lower extremities

Answer: d. Report of tinging sensations in the lower extremities

Reason: Tingling sensations may indicate poor perfusion or lack of blood flow to the lower extremities. This can be a sign of cardiac distress and lead to tissue damage due to a lack of oxygen.

An EKG technician hears another staff member making derogatory comments about a patient's appearance. This is an example of which of the following torts?

a. libel

b. assault

c, slander

d. battery

Answer: c. slander

An EKG technician is performing a standard 12-lead EKG for a patient who is experiencing accelerated junction rhythm. Which of the following speed settings should the technician use?

a. 5mm/second

b. 10 mm/second

c. 25 mm/second

d. 50 mm/second

Answer: c. 25 mm/second

Using the tracing below, measure the PR interval

a. 0.10 seconds

b. 0.52 seconds

c. 0.16 seconds

d. 0.28 seconds

Answer: d. 0.28 seconds

Reason: There are seven small boxes from the beginning of the P waves to the beginning of the QRS complex. Because each small box equals 0.04 seconds, the seven small boxes are multiplied by the 0.04 seconds.

Which of the following statements should an EKG technician include when preparing a patient for an upcoming exercise stress test?

a. "Be sure to eat a light meal five to eight hours prior to the test"

b. "Wear tight clothing around your lower abdomen area so the electrodes stay in place"

c. "Refrain from caffeine, smoking, or alcohol for at least three hours prior to the test"

d. "The procedure should take about ten to fifteen minutes"

Answer: c. "Refrain from caffeine, smoking, or alcohol for at least three hours prior to the test"

Reason:

- A is incorrect for you are able to eat 2 hrs prior to the test

- B is incorrect for you should wear loose fitting clothing

- D is incorrect for the test takes around 45 minutes

Which of the following EKG findings differentiates accelerated idioventricular rhythm from junctional rhythm?

a. Accelerated idioventricular rhythm has P waves

b. The ventricular rate is accelerated atrioventricular rhythm is slower than junctional rhythm

c, accelerated idioventricular rhythm is indicated by an irregular rhythm

d. accelerated idioventricular rhythm has a wide QRS complex

Answer: d. accelerated idioventricular rhythm has a wide QRS complex

Reason:

- Both accelerated idioventricular rhythm and a junctional rhythm have regular rhythms

- The ventricular rate in accelerated idioventricular rhythm is equal to or greater than the rate of junctional rhythm

- P waves are absent in both rhythms

When placing electrodes on the patient for telemetry, in which of the following locations should an EKG technician place the ground electrode?

a. on the upper right arm

b. on the upper left arm

c. on the left lower leg

d. on the right lower leg

Answer: d. on the right lower leg

Reason:

- A is the placement for the negative arm electrode

- B is the placement for the positive/negative arm electrode

- C is the placement for the positive leg electrode

An EKG technician is evaluating a standard 12-lead EKG tracing during a recording. The technician should recognize that electrical activity of the septal wall is recorded by which of the following leads?

a. Leads aVL and V5

b. Leads I and V6

c. Leads VI and V2

d. Leads III and aVF

Answer: c. Leads VI and V2

Which of the following leads is created between the left arm and left leg?

a. Lead aVL

b. Lead aVF

c. Lead III

d. Lead I

Answer: c. Lead III

An EKG technician eliminates an artifact on a 3-lead EKG tracing by plugging the machine into a different wall outlet. Which of the following caused the artifact?

a. somatic tremor

b. AC interference

c. Interrupted baseline

d. wandering baseline

Answer: b. AC interference

An EKG technician should identify that which of the following is the expected reference range for the body temperature of an adult patient.

a. 35.3 to 36 degrees Celsius (95.6 to 96.8 degrees Fahrenheit)

b. 36.1 to 36.4 degrees Celsius (96.9 to 97.5 degrees Fahrenheit)

c. 36.5 to 37.2 degrees Celsius (97.7 to 99.0 degrees Fahrenheit)

d. 37.3 to 37.6 degrees Celsius (99.1 to 99.7 degrees Fahrenheit)

c. 36.5 to 37.2 degrees Celsius (97.7 to 99.0 degrees Fahrenheit)

An EKG technician is performing an exercise stress test for a patient. Which of the following findings should the technician report to the provider?

a. decreased heart rate

b. increased respiratory rate

c. increased sweating

d. decreased premature beats

a. decreased heart rate

The presence of which of the following on an EKG tracing can indicate a previous myocardial infarction?

a. small P waves

b. prolonged PR interval

c. narrow QRS complex

d. pathologic Q waves

Answer: d. pathologic Q waves

Reason:

-B is incorrect, for it indicates a heart block

Which of the following actions should the EKG technician take immediately after attaching the telemetry lead wires to the electrode?

a. check a baseline EKG tracing for monitor clarity

b. check the wire colors and identifications to ensure attachment to the correct electrodes

c. place the patient in the correct anatomical patient

d. tape the lead wires to the patient's skin to prevent disconnection from the electrodes

b. check the wire colors and identifications to ensure attachment to the correct electrodes

Which of the following is correct regarding the EKG below?

a. the patient is sinus bradycardia

b. the patient has a ventricular pacer

c. the heart rate is 75/min

d. cardiomegaly is evident

Answer: c. the heart rate is 75/min

Reason:

- A is incorrect for the heart rate is too fast to be sinus bradycardia

- B is incorrect for no pacemaker spikes are visible on the tracing

- D is incorrect for it cannot be deduced from the EKG alone.

An EKG technician is preparing a patient for the application of a Holter monitor. The patient tells the technician that she runs about five miles each day. Which of the following responses should the technician make?

a. "You should continue exercising as usual while wearing the monitor"

b. "Make sure to increase your cardiac medications while wearing the monitor to offset the activity"

c. "You should talk to your provider about continuing that activity while wearing the monitor"

d. "Take someone with you when you are running while wearing the monitor"

Answer: a. "You should continue exercising as usual while wearing the monitor"

Reason: You are trying to find out if there are issues in the patients everyday activities

Which of the following leads is created when an EKG technician places the electrodes to the right patient's sternum at the fourth intercostal space?

a. Lead V1

b. Lead I

c. Lead aVR

d. Lead MCL2

a. Lead V1

Which of the following electrodes is used to created leads I, II, and aVR?

a. left arm

b. right arm

c. left leg

d. right leg

b. right arm

For which of the following patients should an EKG technician expect to see somatic interference on the EKG tracing?

a. A 60-year-old patient who is sweating profusely

b. A 20-year-old patient who is experiencing a seizure

c. A 10-year-old patient who is watching TV

d. A 30-year-old patient who is using a cell phone

Answer: b. A 20-year-old patient who is experiencing a seizure

-

Reason:

- A causes wandering baseline

- D would cause AC interference

An EKG technician notes that the QRS complex is too tall to fit on the EKG paper. Which of the following actions should the technician take?

a. Change the gain control to 20 mm/mV

b. Change the paper speed to 10 mm/second

c. Change the gain control to 5 mm/mV

d. Change the paper speed to 50 mm/second

Answer: c. Change the gain control to 5 mm/mV

Reason:

- Option A, would double the height of the QRS complex

- Changing the speed of the paper would not affect the height

Which of the following methods should an EKG technician use to store electrodes when not in use?

a. loose in the EKG cart

b. in a folded paper bag

c. in an open plastic bag

d. in the original, foil-lined packaging

Answer: d. in the original, foil-lined packaging

Reason: It prevents the gel from drying out

An EKG technician is performing an exercise stress test for a patient. For which of the following findings should the technician expect the provider to stop the test?

a. electrode detachment

b. dizziness

c. sweating

d. increased respiratory rate

b. dizziness

While performing a 5-lead EKG, an EKG technician notices that lead II and lead III are not yet yielding a reading. Which of the following limbs should the technician check to correct the error?

a. right arm

b. left arm

c. right leg

d. left leg

d. left leg

During an exercise stress test, the patient reports fatigue. The EKG technician observes the tracing below. Which of the following actions should the technician take?

a. notify the provider

b. begin chest compressions

c. defibrillate the patient

d. administer rescue breathing

Answer: a. notify the provider

PS - This is ventricular tachycardia

An EKG technician is preparing to perform a standard 12-lead EKG tracing on a patient who has a heart rate of 150/min. Which of the following speed controls should the technician select?

a. 5 mm/second

b. 10 mm/second

c. 25 mm/second

d. 50 mm/second

d. 50 mm/second

An EKG technician has performed an EKG on a patient. Which of the following actions by the technician would protect the patient's health information in accordance with HIPAA regulations?

a. sending the EKG in an encrypted electronic file to the patient's employer

b. Using corrective fluid on the patient's name, address, and physical description on the EKG printout

c. Restricting the patient's access to the EKG file

d. Hand delivering the EKG to the patient's provider

Answer: d. Hand delivering the EKG to the patient's provider

Reasons:

- A is incorrect for the employer is not directly involved with the patient

- B is incorrect for you should NEVER alter medical records

- C is incorrect for you should not hold information from the patient

Which of the following responses should an EKG technician make to a patient in an outpatient clinic who is upset that the technician cannot share the results of the tracing?

a. "I'm sorry, but I only run the strip. I'm not trained to know what's on it."

b. "I understand your frustration. My role as the technician is to conduct the test correctly. The provider is qualified to interpret the results."

c. "I know it's difficult to wait, but from what I can see, you have nothing to worry about."

d. "I wish I could help you. Some providers allow technicians to discuss the tracing, but your provider won't let me communicate results to patients"

b. "I understand your frustration. My role as the technician is to conduct the test correctly. The provider is qualified to interpret the results."

An EKG technician in an outpatient facility is obtaining a patient's vital signs and is having trouble visualizing the patient's chest movement. Which of the following actions should the technician take to obtain an accurate respiratory rate for the patient?

a. Instruct the patient to take deeper breaths so they are easier to count

b. Document that the respiratory rate could not be assessed

c. Place a hand on the middle of the patient's back to count the respirations

d. Estimate a respiratory rate based on the assessed pulse

c. Place a hand on the middle of the patient's back to count the respirations

During an exercise stress test, a patient reports heaviness on his chest and becomes diaphoretic. The EKG technician should recognize these findings as manifestations of which of the following conditions?

a. Transient Ischemic attacks

b. Cerebrovascular accident

c. Congestive HF

d. Myocardial infraction

Answer: d. Myocardial infraction

- MI is a lack of blood flow to the heart causing death of cardiac tissue. Chest discomfort and sweating are manifestations of a potential MI.

An EKG technician observes ST segment depression and T waves inversion in multiple leads on a patient's EKG tracing. Which of the following should the technician suspect?

a. myocardial infraction

b. myocardial injury

c. myocardial ischemia

d. heart block

Answer: c. myocardial ischemia

Reason:

- Myocardial infarction: the presence of long and deep Q waves and resolution of ST segment and T wave changes

- Myocardial injury includes ST-segment elevation

- Heart block affects the PR interval, not the ST segments or T waves

Which of the following terms describes an EKG technician writing defamatory comments in a patient's chart?

a. assault

b. slander

c. libel

d. battery

c. libel

An EKG technician is performing a second standard 12-lead EKG on a patient immediately following for the first test. For which of the following reasons should the technician recognize that resting tab electrodes should not be used for more than two consecutive EKG tracings?

a. the electrodes cannot conduct signal after two EKG tracings

b. the electrodes will not conduct accurately after two EKG tracings

c. the electrodes need to be cleaned after two EKG tracings

d. the electrodes will not re-adhere to the skin after being removed between tracings

b. the electrodes will not conduct accurately after two EKG tracings

An EKG technician is entering a patient's history into the electronic health record. Which of the following statements by the patient should the technician enter into the social history section?

a. "I have smoked cigarettes for a long time"

b. "My parent both had heart attacks"

c. "I had an appendectomy 1 year ago"

d. "I had chicken pox when I was 10 years old"

Answer:: a. "I have smoked cigarettes for a long time"

Reason: Social history pertains to a patient's lifestyle, including living situation, alcohol use, nicotine use,

A patient tells the EKG technician that she does not understand why she needs an ambulatory monitor after having a standard 12-lead EKG 2 days ago. Which of the following responses should the technician make?

a. "An ambulatory monitor records differently than an EKG"

b. "Your provider wants to study your heart over a long period of time."

c. "It is standard practice to attach an ambulatory monitor shortly after an EKG"

d. "The provider wants to perform another test before he communicates his concerns"

Answer: b. "Your provider wants to study your heart over a long period of time."

Reason: Usually the provider wears an ambulatory monitor for between 24hrs to 30 days. This allows the provider to see EKG readings recorded during the patient's usual daily activities.

Identify the following rhythm strip:

a. bundle branch block

b. sinus dysrhythmia

c. premature ventricular contraction

d. complete heart block

Answer: a. bundle branch block

Reason: A bundle branch block occurs when one or both ventricular pathways are damaged. It is characterized by a wider than usual QRS duration, and some P waves are not followed by QRS complexes because the ventricular pathway is blocked. Bundle branch block is often referred to as "bunny ears" because of its shape.

- It is not B because sinus dysrhythmia is when a patient has a heart rate of 60 to 100/ min, irregular rhythm, P waves are present and upright, and the QRS complex is less than 0.12 seconds

- It is not C because premature ventricular contraction is characterized by an irregular rhythm, different shapes in the QRS complex, and a T wave that is in the opposite direction of ventricular depolarization

- It is not D because a complete heart block is characterized by a variable PR interval and a ventricular rate that is less than the atrial rate. A complete heart block can have P waves buried in a QRS complex or a T wave; these characteristics distinguish a complete heart block from a first or second-degree heart block.

An EKG technician is preparing a patient for a standard 12-lead EKG. Which of the following is the correct placement for lead V4?

a. The fifth intercostal space at the midclavicular line

b. the fourth intercostal space at the midaxillary line

c. the fifth intercostal space at the midaxillary line

d. the fourth intercostal space at the midclavicular line

Answer: a. The fifth intercostal space at the midclavicular line

An EKG technician is performing an exercise stress test for a patient who exhibits ventricular fibrillation on the EKG tracing. Which of the following actions should the technician take first?

a. determine if the patient is responsive

b. check the patient for breathing

c. begin chest compressions

d. apply automated external defibrillator (AED) pads.

Answer: a. determine if the patient is responsive

Which of the following statements should an EKG technician make when preparing an 8-year old patient for a standard 12-lead EKG?

a. "I am going to apply some stickers to your belly, arms, and legs for the test"

b. "I am going to apply these adhesive electrodes to your chest and extremities for the EKG."

c. "I am going to conduct an electrocardiograph on your heart."

d. "I need you to hold still while I attach these wires to you for the electrocardiogram"

a. "I am going to apply some stickers to your belly, arms, and legs for the test"

An EKG technician should recognize that electrical interferences on a 12-lead EKG tracing is most likely a result of which of the following?

a. patient movement

b. expired electrodes

c. crossed wire leads

d. insufficient skin preparation

Answer: c. crossed wire leads

Reason:

- A would lead to somatic tremor

- B would lead to a wandering baseline

- D would lead to a wandering baseline

An EKG technician is working with a patient who has a below-the-knee amputation of the left leg. In which of the following locations should the technician place the right leg electrode?

a. On the lower right foot

b. on the lower right abdomen

c. on the lower left torso

d. on the lower right leg

b. on the lower right abdomen

An EKG technician is instructing a patient about the use of a transtelephonic monitor with loop memory. Which of the following instructions should the technician include?

a. "Press the record button on the device when you begin to feel dizzy or have chest pain."

b. "Remove the monitor when connecting to the phone or internet to send the recording to the central monitoring location."

c. "Record a notation in your diary that describes the time and activity you were doing when the pain started."

d. "Contact the technician at the central monitoring station whenever you begin to experience chest pain."

a. "Press the record button on the device when you begin to feel dizzy or have chest pain"

Which of the following actions should the EKG technician take to resolve a wandering baseline on a patient's EKG tracing?

a. relieve tension from the lead wires

b. clean the lead wires after each use

c. Provide a blanket to the patient

d. Have the patient remove any personal electronic devices

Answer: a. relieve tension from the lead wires

Reason:

- B is used for an interrupted baseline

- C is used for somatic tremors

- D is used for AC interference

When an EKG technician is obtaining a pulse from a patient, which of the following terms should the technician use to document the rhythm of the pulse?

a. weak

b. strong

c. bounding

d. irregular

Answer: d. irregular

Reason: A-C describes volume

An EKG technician is speaking with a patient on the phone. The patient is wearing a Holter monitor and reports severe chest pain and shortness of breath. Which of the following actions should the technician take?

a. Have someone call emergency services while remaining on the call with the patient

b. remind the patient to document the incident in the patient diary

c. Place the patient on hold and consult with the patient's provider

d. Tell the patient to hang up the phone and call emergency services

a. Have someone call emergency services while remaining on the call with the patient

Which of the following sites is the most accurate for an EKG technician to use when measuring the body temperature of a young child?

a. oral

b. axillary

c. temporal

d. tympanic

c. temporal

While performing a standard 12-lead EKG, an EKG technician notices that none of the leads are giving a reading. Which of the following limbs should the technician check first when correcting this problem?

a. right arm

b. left arm

c. right leg

d. left leg

c. right leg

Which of the following arteries is the best location for an EKG technician to use to measure the heart rate for an adult patient following an exercise stress test?

a. radial

b. carotid

c. femoral

D. brachial

Answer: a. radial

Reason:

- B is used for checking conscious

- C is used for checking conscious

- D is used for checking conscious

An EKG technician is preparing a patient for Holter monitor placement. Which of the following actions should the technician take to reduce the chance of artifacts on the tracing?

a. ensure the patient has not eaten for at least 2 hrs prior to the placement

b. instruct the patient to replace any loose electrodes in an adjustment spot on her chest

c. have the patient wear tight clothes to hold the electrodes in place

d. use stress loops on the electrodes to reduce tension on the leads

d. use stress loops on the electrodes to reduce tension on the leads

Identify the rhythm in the tracing below.

a. multiple atrial tachycardia (MAT)

b.. Atrial fibrillation (AF)

c. wandering atrial pacemaker (WAT)

d. atrial flutter with variable conduction

Answer: b.. Atrial fibrillation (AF)

Reason:

- A is incorrect for MAT is characterized by the presence of variable P waves and a ventricular rate greater than 100/min. There are no identifiable P waves in this rhythm, and the ventricular rate is 60/min.

- B is correct for AF is characterized by the absence of P waves, irregular rhythm, and a ventricular rate of 60-100/min.

- It is not C because (WAT) is characterized by the presence of variable P waves and a ventricular rate less than 100/min. There are no identifiable P waves in this rhythm, and the ventricular rate is 60/min.

- It is not D because atrial flutter with variable conduction is characterized by the presence of large flutter waves and a ventricular rate of 60 to 100/min. There are no identifiable P waves in this rhythm, and the ventricular rate is 60/min.

An EKG technician is performing a standard 12-lead EKG on a patient who is 9 years old. In which of the following locations should the technician place the V6 electrode?

a. right midclavicular space

b. left midclavicular space

c. right midaxillary line

d. left midaxillary line

d. left midaxillary line

For which of the following types of heart block should an EKG technician observe the patient for signs and symptoms of decreased cardiac output that could lead to cardiac rest?

a. first-degree AV block

b. Second-degree AV block, Mobitz I

c. Second-degree AV block, Mobitz II

d. Third-degree AV block

Answer: d. Third-degree AV block

Reason;

- First-degree V block is typically tolerated by the patient, depending on the underlying rhythm. The technician should monitor this patient to ensure that this rhythm does not deteriorate into another degree of heart block.

- Second-degree AV block, Mobitz I, also called Wenckebach, the patient may or may not show signs of decreased cardiac output, depending on how well the tolerate the rhythm

- Second-degree AV block, Mobitz II, also called classic heart block, it is important to recognize an increase in the degree of block that is occurring compared to type I. The technician should observe the patient closely because they can slip into third-degree AV block.

- Third-degree AV block, the technician must observe the patient for signs and symptoms of decreased cardiac output

During an exercise stress test, an EKG technician notices that the patient appears to be hyperventilating. Which of the following actions should the technician take first?

a. administer oxygen to the patient

b. slow down the test

c. stop the exercise portion of the test

d. check the patient's respiratory rate

d. check the patient's respiratory rate

A thin spike before the P wave indicates that a pacemaker has been implanted to pace which of the following.

a. atria

b. ventricles

c. early repolarization

d. late repolarization

Answer: a. atria

Reason:

- For ventricular pacing, the pacemaker spike would appear before the QRS complex

- For early repolarization, the pacemaker spike would occur before the ventricles repolarize

- For late repolarization, the pacemaker spike would occur after the ventricles repolarize

An EKG technician is preparing a patient for an exercise stress test. Which of the following should the technician place on the right lower side of the anterior torso?

a. Lead VI

b. Lead V6

c. Lead RA

d. Lead RL

Answer; d. Lead RL

An EKG technician should recognize that patients are restricted from performing which of the following activities while wearing a Holter monitor?

a. yoga

b. smoking

c. sexual activities

d. showering

d. showering

Which of the following is the most effective technique for an EKG technician to use to verify that a patient understands the Holter monitor instructions?

Ask the patient if they understand the instructions.

Have the patient repeat the instructions back.

Watch the patient for signs of understanding.

Have the patient complete a test about the instructions.

Have the patient repeat the instructions back.