EKG certification packet

An EKG technician completes a 12-lead EKG and the patient asks if the tracing shows any heart problems. Which of the following is the appropriate response?

Explain that the provider must review and interpret the results.

An EKG technician realizes that a STAT EKG order received one hour ago was missed. Which action demonstrates the appropriate professional response?

Notify the provider immediately, perform the EKG, and document the delay.

After performing a 12-lead EKG, a patient asks the technician if the tracing shows signs

of a heart attack. Which of the following is the appropriate response within the

technician's scope of practice?

State that the provider will review and discuss the results.

Which of the following prefix means "beside, beyond, around"?

Para

Which of the following suffix means "berry shaped"?

Coccus

Which of the following suffix means "to view"?

Opsy

Which concept refers to the awareness and respect for a patient's specific values, beliefs, and practices during an EKG procedure?

Cultural sensitivity

An EKG technician identifies significant ST-segment elevation on a patient's tracing. Which of the following is the appropriate action to communicate this finding?

Personally notify the provider and deliver the tracing

An EKG technician identifies ST-segment elevation in leads II, III, and aVF during a STAT EKG for a patient with chest pain. Which of the following actions should the technician take?

Immediately notify the provider of the critical finding

Which strategy best enables an EKG technician to stay current with advancements in cardiac monitoring technology and clinical guidelines?

Participating in accredited continuing education programs

An EKG technician is requested to perform a specialized lead placement for a patient but lacks the specific training for the procedure. Which of the following is the appropriate action?

Seek assistance from a supervisor or the ordering provider.

An unconscious patient arrives in the emergency department requiring an immediate EKG. Which type of consent allows the technician to proceed with the test?

Implied consent

What is the most important step in achieving medical asepsis?

Washing hands

What is the term for the scrubbing of instruments with special brushes and detergents to remove blood, mucous, etc?

Sanitization

Which of the following is the process that involves a soaking or wiping process and inhibits the activity of disease-causing organisms?

Disinfection

Which of the following solutions will help prevent the transmission of hepatitis?

Household bleach

Which organization developed the guidelines for universal precautions?

CDC

Which process, used for supplies that would come in contact with internal body tissue or an open wound, involves the use of heat (steam) and an autoclave?

Sterilization

To comply with HIPAA, a medical office must always furnish what information to a new patient to be seen for treatment?

The provision of privacy practices document

An EKG technician needs to step away from the workstation where a patient's digital EKG file is open. Which action secures the Protected Health Information (PHI)?

Locking the computer terminal

According to OSHA, medical personnel must wear PPE (personal protective

equipment) when they have contact with which of the following?

Blood

An EKG technician uses a disposable razor to prepare a patient's chest for electrode placement. According to OSHA guidelines, where must the razor be disposed of?

Puncture-resistant sharps container

An EKG technician observes that a patient becomes unresponsive and stops breathing during an EKG procedure. After confirming the absence of a pulse, which action should the technician take immediately?

Initiate the facility's Code Blue protocol and begin CPR

An EKG technician in an emergency department receives orders for four patients. Which patient requires immediate prioritization for a STAT EKG?

A 60-year-old with crushing chest pain and diaphoresis

Which of the following patient symptoms requires the EKG technician to perform a STAT EKG?

Substernal chest pressure

A physician gives an urgent verbal order for a STAT EKG on a patient experiencing chest pain. Which action must the EKG technician take to ensure the order is verified correctly?

Repeat the order back to the physician to confirm accuracy.

An EKG technician is reviewing a physician's order for a cardiac stress test. Which of the following items is essential for the order to be considered valid?

Clinical indication or diagnosis

Which information must an EKG technician include when professionally introducing themselves to a patient?

Name and job title

Which two specific identifiers must an EKG technician use to verify a patient's identity before performing a procedure?

Full name and date of birth

An EKG technician notices a discrepancy between the patient's stated date of birth and the information on the requisition form. Which of the following is the most appropriate action?

Resolve the discrepancy with the staff prior to the EKG

When documenting a patient's medical history regarding an implanted cardiac

pacemaker, which information is essential to record in the chart?

The manufacturer, date of implantation, and type of device

An EKG technician updates a patient's medical history regarding a newly implanted loop recorder. To strictly adhere to HIPAA privacy standards, the technician must limit disclosure of this information to which party?

Personnel directly involved in the patient's clinical care

Which of the following patient symptoms is most commonly associated with acute myocardial infarction?

Substernal pressure radiating to the left arm or jaw

Which of the following features characterizes an atrial fibrillation rhythm on an EKG tracing?

Absence of distinct P waves and an irregularly irregular rhythm

An EKG technician is monitoring a patient who has been prescribed a beta-blocker. Which of the following findings should the technician expect?

Decreased heart rate

Which of the following describes the primary therapeutic effects and potential side effects of calcium channel blockers?

Decreased heart rate and hypotension

What is the average normal heart rate?

72 beats per minute

An EKG technician measures a patient's vital signs. Which of the following findings is outside the expected reference range and requires notification of the provider?

Heart rate of 45/min

Which of the following actions is helpful in assisting patients with their needs?

Keeping a list of community resources that can further assist the patient

A patient scheduled for an exercise stress test state, "I am afraid that this test might cause a heart attack." Which response demonstrates appropriate emotional support?

I understand your concern; we will continuously monitor your heart to keep you safe.

Which patient education process lets you know that the teaching plan is working?

Evaluation

When instructing a patient about a standard 12-lead EKG, which explanation accurately describes the electrode placement and test duration?

Ten electrodes are placed on the chest and limbs, and the procedure take

a few minutes.

What is the best method of preparation for the patient to ensure a successful ECG

recording?

Making sure the patient's legs are not crossed and the arms are resting at

each side.

A patient with severe shortness of breath requires a 12-lead EKG. To accommodate the patient and minimize artifacts, in which position should the technician place the patient?

Semi-Fowler's

An EKG technician is preparing an elderly patient with fragile skin for electrode

placement. Which action effectively prepares the skin while minimizing the risk of injury?

Gently cleaning the placement sites with alcohol and drying them

To prevent wandering baseline artifacts caused by poor electrode contact, how should the EKG technician prepare the patient's skin?

Wipe the site with alcohol and allow it to dry

A patient reports dizziness immediately after sitting up following the completion of an EKG. Which of the following actions should the EKG technician take first?

Assist the patient back to a supine position

Which post-test observation requires immediate reporting to the nurse or physician after a patient completes a cardiac stress test?

Dizziness and hypotension

While preparing for a stress test, an EKG technician notices a frayed power cord on the treadmill. Which of the following actions should the technician take to ensure safety?

Remove the equipment from service and report the hazard

How often should quality control tests be done for procedures performed in the office?

Daily

Which daily maintenance task is required to ensure the EKG machine is operational and safe for patient use?

Inspecting lead wires for cracks or fraying

When restocking single-use EKG electrodes, which inventory management practice ensures that supplies remain viable for patient care?

Rotating stock so items with earlier expiration dates are used first

Which technique should an EKG technician use when storing lead wires to prevent internal wire breakage and equipment malfunction?

Coil the wires loosely and secure them over the machine

A patient with a history of cardiovascular disease requires assessment of the heart's electrical activity. Which diagnostic test should the medical assistant prepare to perform?

12-lead ECG

Which of the following is an example of an ECG precordial lead?

aVR

The technician is placing leads and electrodes on the patient's chest. At which location will lead V4 be placed?

Fifth intercostal space in the left midclavicular line

When applying chest leads, where is V2 placed?

At the fourth ICS, left sternal border

Where is V1 electrode lead placed for standard ECG?

4th intercostal space at the right sternal border

Which ECG lead is considered bipolar?

II

Which ECG lead is placed on the 5th intercostal space, at the midclavicular line?

V4

Which electrode is not part of the ECG recording?

RL

How many electrodes are used as part of a 12-lead ECG?

10

The patient is asymptomatic during the ECG recording and you notice normal sinus rhythm. What should you do?

Continue recording

What is the universal standard speed for recording an ECG?

25 mm/second

Which of the following is used to mark the ECG paper?

A stylus

What is an artifact?

Problematic because it can mimic life-threatening dysrhythmias

What is the term for when marks on the ECG tracing are caused by another source of activity?

Artifacts

Why should ECG be performed in a quiet environment?

Interference is minimized

You are obtaining an ECG using a 10 lead ECG machine. The patient accidentally coughs while the strip is running, causing an artifact on the strip. How can this be identified as?

Somatic tremor

An EKG technician is preparing to perform a standard 12-lead EKG on a patient who has bilateral lower extremity amputations. Which of the following sites should the technician use for the leg electrodes?

Lower abdomen

An EKG technician finds a patient unresponsive and pulseless. After activating the emergency response system, which action must the technician take immediately?

Begin chest compressions at a rate of 100 to 120 per minute

An EKG technician is preparing a patient for a cardiac stress test. After verifying the patient's identity and ensuring informed consent is signed, which action is required to establish a clinical reference point before the exercise phase begins?

Obtain baseline blood pressure and a resting EKG

Which formula is used to calculate a patient's maximum predicted heart rate for an exercise stress test?

220 minus the patient's age

An EKG technician is explaining the protocol for an exercise stress test. Which of the following statements accurately describes when blood pressure must be documented?

During the last minute of each exercise stage

To minimize somatic tremor artifacts during an exercise stress test, which location is appropriate for the Right Arm (RA) electrode?

Right infraclavicular fossa

What is another name for an exercise ECG?

Stress test

A 50-year-old patient is scheduled for an exercise stress test. Using the standard formula (220 - age), which value represents the target heart rate of 85% of the maximum predicted heart rate?

145/min

(Max HR is 220 minus age (170/min). Target is 85% of max. 170 x 0.85 = 144.5, rounded to 145/min.)

During an exercise stress test, a patient becomes unresponsive and pulseless with a rhythm of ventricular tachycardia. Which intervention is the immediate priority?

Starting CPR and attaching an AED

An EKG technician is educating a patient who will wear a Holter monitor for 24 hours. Which of the following instructions is appropriate regarding patient hygiene and data recording?

Avoid showering or swimming and document symptoms in the diary.

When applying electrodes for a Holter monitor, which anatomical landmark is the correct placement for the V1 lead?

Fourth intercostal space, right sternal border

Which of the following instructions would you give to a patient that is going to be wearing a Holter monitor?

Depress the event marker for significant symptoms

How many chambers are there in the human heart?

4

Located near the back of the body, which body cavity is a continuous internal opening that includes the cranial and spinal cavities?

Posterior (dorsal) cavity

The heart's ability to create its own electrical impulse is known as which of the

following?

Automaticity

Each large square (5 small squares in length) on an ECG reading represents how many seconds?

0.2 seconds

On ECG papers, what are horizontal measurements used to determine?

Heart rate

What do the horizontal and vertical lines measure when interpreting waveforms on an electrocardiogram?

Time; amplitude

One complete heartbeat, known as a full cardiac cycle, lasts for approximately how long?

0.8 seconds

What is the most accurate method for acquiring a heart rate?

1500 method

As an impulse moves toward a positive electrode it produces what type of deflection?

Upward

Repolarization of the ventricles is represented by which of the following?

T wave

The graphic representation of ventricular depolarization on an ECG reading is

represented by which of the following?

QRS complex

A 62-year-old man presents to the emergency department with sudden-onset substernal chest pain and diaphoresis beginning 45 minutes ago. His 12-lead ECG is shown, with each lead color-coded to its corresponding coronary artery territory. Using the ECG, which waveform finding in the leads mapped to the inferior right coronary artery territory is most consistent with an acute myocardial infarction in that region?

ST segment elevation

Which of the following terms means there is no consistency to the rhythm, such as atrial fibrillation?

Irregularly Irregular

An EKG technician is analyzing the rhythm strip shown here. Using the annotated tracing, the technician counts the small boxes between consecutive R waves and applies the 1500 method to calculate the heart rate. Which of the following findings should be recorded?

Regular rhythm with a heart rate less than 60/min

If a patient is said to be in asystole, the characteristics would be described as which of the following?

Rate of 0 and no pulse

What are two PVC's in a row called?

Couplet

Which of the following terms refers to the ventricular ectopic discharge at a rapid, regular rate in excess of 100 beats per minute?

Ventricular tachycardia

An EKG technician is analyzing the rhythm strip shown here. Based on direct observation of the tracing, the technician notes the regularity of the rhythm, the appearance of the QRS complexes, and the absence of identifiable P waves. Which of the following is the correct interpretation?

Ventricular tachycardia

An EKG technician is monitoring a patient when the rhythm strip shown here appears on the screen. Based on the pattern observed in the tracing, which of the following actions is required?

Notify the provider immediately