NHA EKG (CET) study guide (2025) comprehensive questions and verified answers (detailed & elaborated) ACTUAL EXAM 2025 TEST!!

What action should the technician instruct the patient to take if any electrodes become loose during at-home use of an ambulatory monitor?

Apply surgical tape to the electrodes to keep them in place

Which leads record activity of the inferior wall of the left ventricle?

Leads III and AVF

What rhythm is characterized by absent P waves, wide QRS complexes, and a ventricular rate between 20-40/mins?

Idioventricular rhythm

What leads record electrical activity of the lateral wall of the left ventricle?

Leads I, V6, AVL, and V5

In which locations should the EKG technician place the electrodes for a 3-lead ambulatory monitor?

on the right shoulder, the left shoulder, and the left abdomen

An EKG technician is performing a stress test for a patient. What changes indicate that the patient is beginning to show signs of myocardial ischemia?

Depressed ST segment

What leads are bipolar?

Leads I, II, and III

What is the expected reference range for respiratory rate of a newborn patient?

30-49/min

An EKG technician is providing instructions for a patient who is scheduled for an exercise stress test. What instructions should technician include?

"You should avoid wearing shoes with high heels for this test."

An EKG technician is preparing a patient for an exercise stress test. What statement should the technician make before this test?

"This procedure requires informed consent."

What is the final step when applying a Holter monitor?

Document the procedure in the patient's health record

An EKG technician prior to an exercise stress test. What statement by the patient indicates an understanding of the preparation?

"I can smoke the night before the exam."

A patient has a prescription to wear a Holter monitor for 24 hrs. What statement made by the patient indicates an understanding of home care instructions?

"I should record spontaneous symptoms unrelated to an activity."

After turning on the AED and attaching the AED to the patient, what should be done next?

Stand clear from the patient and allow the AED to analyze

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

rounded and upright

What statement should an EKG technician include when preparing a patient for an upcoming exercise stress test?

"Refrain from caffeine, smoking, or alcohol for at least 3 hours prior to the test."

What lead is created between the left arm and left leg?

Lead III

What speed setting should the technician use for a standard 12-lead EKG for a patient experiencing an accelerated junctional rhythm?

25mm/second

(a patient experiencing accelerated junctional rhythm has a heart rate of 60-100 min)

An EKG technician is called to the emergency department to perform a standard 12-Lead EKG on a patient. When the technician arrives, the patient is attached to a 5-lead monitor. What action should the technician take?

Remove the electrodes for the 5-lead monitor before attaching the electrodes for the 12-lead EKG

The sinus arrest is considered a medical emergency when the arrest reaches what duration?

6 seconds

What is the best method for an EKG technician to use when removing hair from electrode placement?

Clippers

What electrode is placed to the right of the patients sternum at the fourth intercostal space?

Lead V1

What three leads are placed at the same horizontal level?

Leads V4, V5, and V6

An interrupted baseline is most likely cased by______

Lead corrosion

How should electrodes be explained to a pediatric patient?

Stickers

How should a patient be prepared for a scheduled 12- lead EKG?

Use an alcohol pad to cleanse the electrode placement sites

Why should a patient wear loose-fitting clothes while waring a Holter monitor?

To reduce artifacts on the tracing

What action should be taken when performing an EKG for a patient that doesn't speak the same language as the technician?

Having a bilingual staff member translate

What wave represents atrial depolarization?

P wave

What wave represents ventricular repolarization?

T wave

What complex is the result of ventricular depolarization?

QRS complex

Where is the lead MCL2 located?

fourth intercoastal space to the left of the patient's sternum

What lead groups represent Einthoven's Triangle?

Leads I, II, and III

What is the most effective technician for an EKG tech. to use to verify that a patient understands the Holter monitor instructions?

Have the patient repeat the instructions back

What sections of the EKG tracing should be used to measure the QRS complex?

Beginning of the Q wave to the end of the S wave

What pulse rate is in the expected reference range for a 2-year-old patient?

120/min

An EKG technician observes varying R-R intervals on a EKG for a 2-year-old patient. What is correct?

"The irregularity is normal and is a result of respiration."

( irregular R-R intervals are commonly seen on pediatric EKGs)

When performing an EKG on an infant, where should the technician place the electrode for lead V3R?

Between V2 and V4 on the right side of the chest

What should be performed for a patient immediately before an exercise stress test?

Measure blood pressure and obtain an EKG while the patient is supine, siting and standing up

What should the technician do when they notice the patient's heart rhythm shows a depressed ST segment during an exercise stress test?

Discontinue the test

What symptom should the technician immediately report to the provider?

Headache

What action by the EKG technician demonstrates compliance with HIPAA regulations?

Th technician uses a privacy screen, on the computer to prevent others from viewing the monitor

What factor can produce an artifact that appears as uniform, small spikes on a EKG tracing?

improper grounding

(AC interference artifact)

What describes a complete cardiac cycle in a healthy heart?

P wave, QRS complex, and T waves

What patient should an EKG technician expect the provider to prescribe a chemical stress test?

A patient who is 40 years old and is unable to walk due to the presence of full leg cast

What vital sign change during an exercise stress test should indicate to an EKG technician that the patient is experiencing distress?

An increase in respirations from 18 to 36/min

A serial EKG tracing shows a rhythm that doesn't match the last tracing that was performed. What should be done?

Verify proper lead placement

When performing a stress test, and EKG technician should recognize that the test can be be stopped when the patient reaches what percentage of their target heart rate?

85% to 100%

(The formula for a patient's target heart is 220-patient's age x 0.85)

V5 lead location

5th intercostal space, left anterior axillary line

V6 lead location

5th ICS, left midaxillary line

V7 lead location

left posterior axillary line

Lead V8 placement

left midscapular line

V8R lead location

Right midscapular line

What site is the most accurate for an EKG technician to use when measuring the body temperature of a young child?

Temporal

What lead be placed on the anterior torso during an exercise stress test?

Lead RL

While performing a 5 lead, EKG, a technician notices the lead II and Lead III aren't yielding a reading. What limb should be checked to correct the error?

Left leg

In what situation is it acceptable for an EKG technician to share a patient's protected health information?

An inquiry for training purposed from the quality assurance office

What finding is consistent with bradycardia?

Cold, clammy skin

The expected reference range for body temperature of an adult patient is_______

36.5 C to 37.2 C

(97.7-99.0F)

What is the difference between an accelerated idioventricular rhythm and a junctional rhythm?

Accelerated idioventricular rhythm has wide QRS complexes

What does a patient experiencing a variation in respirations that correlates with the EKG tracing indicate?

Sinus dysrhythmia

When performing a posterior 12-lead EKG, which lead should the technician place along the paraspinous border?

Lead V9

What limb is used to create leads I, II, and AVR?

Right arm

What will help reduce artifacts on Holter monitor tracing during placement?

Use stress loops on the electrodes to reduce tension on the leads

When the EKG technician is obtaining a pulse from a patient, what term should the technician use to document the rhythm of the pulse?

irregular

What actions should the EKG technician take immediately after attaching the telemetry lead wires to the electrodes?

Check the wire colors and identifications to ensure attachment to the correct electrodes

Where do you apply a transtelephonic event monitor using a heart card?

Apply the card over the middle to lower part of the sternum

Where should the EKG technician place the electrodes for leads V7, V8, and V9?

Evenly spaced on the back between the axillary line and the vertebral column at the 5th ICS

Elevated ST segments in multiple leads indicates____

Signs of acute myocardial injury

Where is apical pulse measured?

Between the fifth and sixth ribs, at the left midclavicular line

Where should the right leg electrode be placed when the patient has below-the-knee amputation of the left leg?

on the lower right abdomen

If you have problems obtaining an accurate respiratory rate for a patient, what action should be taken?

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

Why shouldn't resting tab electrodes be used for more than 2 consecutive EKG tracings?

The electrodes will not conduct accurately after two EKG tracings

What type of heart block should the technician observe the patient for signs and symptoms of decreased cardiac output that could lead to cardiac arrest?

Third-degree AV block

Which speed control should the EKG machine be set to for a patient with a heart rate 150/min?

50mm/second

What is a cause for discontinuing a stress test?

ST segment elevation

The electrical activity of septal wall is recorded by what leads?

Leads V1 and V2

What is a common manifestation of symptom of myocardial infarction?

Cyanosis

What actions should you take after noticing an accelerated idioventricular rhythm on the tracing?

Call for help and stay with patient

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

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

What is the maximum number of tracing that an EKG technician can obtain on the same patient using a single set of disposable electrodes?

Two

What action should an EKG technician take when a patient who is unable to read is scheduled for a stress test and must sign an informed consent form?

Verify the patient's understanding of the procedure

What can cause sinus arrhythmia?

The patient's respirations

An EKG technician eliminates an artifact on a 3-lead EKG tracing by plugging the machine into a different wall out. What caused the artifact?

AC interference

An EKG technician notices that waveform on an EKG are very close together and the patient has unusually rapid heart rate. The tech. should change the paper speed to________

50 mm/second

(A faster paper speed spreads on the waveforms and makes the tracing easier to read)

What PPE should be apply to a patient with droplet precautions?

Simple face masks

The purkinje fibers serve what purpose?

Carry electrical impulse directly to ventricular muscle tissue

What should an EKG technician do before storing EKG cables to prevent the transmission of microorganisms?

Wipe the cables with disinfectant

What rhythm is characterized by upright P waves, narrow QRS complexes, and a ventricular rater between 60-100/min?

Sinus rhythm

What is the order in which the EKG technician should document a patient's vital signs?

Temperature, pulse, respirations, and blood pressure

What is used to ensure the EKG machine is working properly?

Calibration

What actions should be taken when a U wave is detected and the patient reports chest pain an discomfort?

Notify the patient's provider

The AV junction serve what purpose?

Conduct electrical impulses from the AV node

What rhythm is characterized by P waves or fibrillatory or flutter waves, narrow QRS complexes , and ventricular rate between 60-100/min?

Atrial rhythm

AN EKG technician is preparing a 5-year-old child for a standard 12-lead-EKG. What actions should the technician take?

Allow the child to apply the electrodes on a doll before the procedure

What is the electrode charge combination for the limb leads for a standard 12-lead EKG?

Right arm negative pole

left arm positive pole

left leg positive pole

The R-R interval on a patient's tracing has five large boxes. What is the patient's heart rate?

60/min

(300/5=60)

After using an AED on a patient, which instructions should be expected next?

Resume performing CPR on the patient

What is a characteristic of the EKG tracing for a patient who has atrial fibrillation?

R-R interval is irregularly irregular

When placing electrodes on the patient for telemetry, where should you place the ground electrode?

on the right lower leg