final exam (1)

When applying chest leads, V6 is placed

a.at the fourth ICS, right sternal border

b. at the fourth ICS, left sternal border.

c.in the line with V4 on the midaxillary line

d.at the fifth ICS, left midclavicular line

c.in the line with V4 on the midaxillary line

PVCs occurring in a pattern of every other beat are referred to as ---

a.trigeminy

b.bigeminy

c.runs

d. quadrigeminy

b.bigeminy

On the ECG graph paper _

big boxes equal a 6-second section.

a.twenty

b.thirty

c.ten

d. fifteen

b.thirty

The rhythm in which there is a series of Atrial waves with a Saw toothed appearance is called -----

a. Atrial Fibrillation

b.Premature Atrial Contraction

c.Atrial Flutter

d.Atrial Tachycardia

c.Atrial Flutter

Your patient's heart rate changed from 66 to 110. You note regular, upright, matching P waves. The rhythm has changed from -

a.normal sinus rhythm to sinus Tachycardia

b.normal sinus rhythm to sinus Bradycardia

c.sinus Bradycardia to normal sinus rhythm

d.normal sinus rhythm to sinus arrhythmia

a.normal sinus rhythm to sinus Tachycardia

1. EKG Strip showing PR interval prolonged (more than normal), without dropping a QRS complex.

a.second degree AV block, Mobitz II

b.third degree or complete heart block

c.second degree AV block, Mobitz I

d.first degree AV block

d.first degree AV block

1. To obtain 12-lead EKG, you must apply -

- electrodes to the patient.

a.10

b.8

c.12

d.3

a.10

The ECG complexes are determined to occur in a regular pattern. What method do you use calculate most accurate heart rate?

a.1500 method

b.Any of these method

c.300 method

d. 6-second method

a.1500 method

Together, the contraction and relaxation of the heart make up:

a.Coronary circulation

b.Diastole

c.Systole

d.One cardiac cycle

d.One cardiac cycle

If the patient has amputated left lower leg, electrodes should be placed as

a.LL on left lower leg, RL on the right upper leg

b.LL on left lower abdomen, RL on the right lower abdomen

c.LL on left lower abdomen, RL on the right lower leg

d.LL on left upper leg, RL on the right lower leg

b.LL on left lower abdomen, RL on the right lower abdomen

Vertically, 10 mm represent electrical voltage which is about

a.10 mV

b.0.01 mV

c.0.1 mV

d.1 mV

d.1 mV

Premature Atrial Contraction is a.

a.A premature beat from the sinus node

b.A premature beat from the atrium

c.An premature beat from the AV Junction

d.An premature beat from the ventricle

b.A premature beat from the atrium

Using the (big box - 300) method, if there are four big boxes between two successive R-R (QRS complexes), the heart rate is - a.

a.300 bpm

b.75 bpm

c.100 bpm

d.150 bpm

b.75 bpm

14. An electrocardiogram is a recording of -

a.ability of the heart to pump blood to the body.

b.electrical activity traveling through the heart

c.electrical activity traveling through the body

d. ability of the heart muscles to

b.electrical activity traveling through the heart

You are working as an EKG technician. Your favorite uncle says to you "will you do EKG on me

I come by where you work?" You should tell your uncle that--

a.you need to give detail of your insurance

b.yes, why not, you are welcome

c.you need doctor's order to perform an EKG

d.I am sorry, still I am on part time position.

c.you need doctor's order to perform an EKG

Lead wire color for Left Leg is --

a.red

b.green

c.black

d.white

a.red

atrial dysthythmia has at least three clearly changing P wave and a heart rate of 101 to 150 beats per minute.

a.Wandering atrial pacemaker (WAP)

b.Multifocal atrial tachycardia (MAT)

c..Atrial fibrillation

d.Atrial flutter

b.Multifocal atrial tachycardia (MAT)

The usual speed at which the EKG machine runs out of EKG machine and records EKG at

a.2.5 mm per minute

b.0.25 mm per second

c.25 mm per minute

d.25mm per second

c.25 mm per minute

Which of the following artifacts can be corrected by having the patient relax and stay still?

a. somatic tremor

b.AC interference

c.Wandering baseline

d.Interrupted baseline

c.Wandering baseline

Your patient's heart rate changed from 110 to 37. You note regular, upright, matching P waves. The rhythm has changed from ---

a.sinus Bradycardia to normal sinus rhythm

b.sinus Tachycardia to sinus Bradycardia

c.normal sinus rhythm to sinus arrhythmia

d. normal sinus rhythm to sinus Tachycardia

b.sinus Tachycardia to sinus Bradycardia

You should place the limb electrodes before the chest electrodes because: 

a.The limb leads rarely require a skin prep or cleansing

b.The ECG will not run at all without the limb leads attached

c.They are closest to you and easiest to reach

d.They don't fall often

b.The ECG will not run at all without the limb leads attached

For adult performing a stress EKG test, which of the following is an indication to stop the test?

a.Diaphoresis

b.Hypertension

Rapid breathing

d. Tachycardia

a.Diaphoresis

You walk by a room where a co-worker is performing an EKG on a female patient. The door is open and the patient is not covered. You should --

a.inform your supervisor about the incident

b.ask your coworker not to forget to close the door and/or curtain

c.say sorry, and just go back to your room

d.quietly close the door and/or curtain

d.quietly close the door and/or curtain

Following are the ways to correct the somatic tremors ----

a.unplug electrical equipments, move bed away from the wall

b. replace loose electrodes and have the patient turn slightly to the side.

c.have patient place hands under his or her buttocks, remind patient not to move

d.apply electrodes securely, remove tension from lead wires

d.apply electrodes securely, remove tension from lead wires

PVCs that occur in different shapes and forms are called

- PVCs.

a.Coupling

b. Unifocal

c.Trigeninal

d.Multifocal

d.Multifocal

Sinus rhythm with a rate more than 100 bpm is.--

a.sinus Bradycardia

b.normal sinus rhythm
c.sinus dysrhythmia
d.sinus Tachycardia

d.sinus Tachycardia

The correct sequence for the conducting system is:

a.SA node, AV node, AV bundle, bundle branches, Purkinje fibers

b.SA node, bundle branches, bundle of His, AV bundle, Purkinje fibers

c.SA node, AV bundle, Purkinje fibers, bundle branches, bundle of His

d.SA node, bundle branches, Purkinje fibers, AV bundle, AV node

a.SA node, AV node, AV bundle, bundle branches, Purkinje fibers

Which of the following EKG changes is a sign of cardiac ischemia?

a.ST segment depression

b.ST segment elevation
c.Wide QRS duration
d.Long PR interval

d.Long PR interval

Usual rate for Wandering Atrial Pacemaker rhythm is - a.

a.100 to 150 bpm

b.60 to 100 bpm.

c.50 to 90 bpm

d. 60 to 80 bpm

b.60 to 100 bpm.

Deoxygenated blood from the body is drained back to -

a. left ventricle

b.right atrium

c.right ventricle

d.left atrium

b.right atrium

When applying chest leads, V1 is placed

a. midway between V3 and V5

b.at the fifth ICS, left midclavicular line

c.at the fourth ICS, right sternal border

d. at the fourth ICS, left sternal border

c.at the fourth ICS, right sternal border

When performing posterior 12 leads EKG, V7 is positioned at -----

a.Right posterior axillary line

b.Left posterior axillary line

c.Right para-spinal line

d.Left para-spinal line

b.Left posterior axillary line

Premature Ventricular contraction is a/an

a.premature beat from sinus node

b.premature beat from AV Junction tissues

c.premature beat from Atrial pathway

d. premature beat from ventricular tissue

b.premature beat from AV Junction tissues

What are common symptoms of low cardiac output?

a.Shortness of breath, hypotension

b.Chest pain, palpitations

c.Dizziness, confusion

d.All of these

d.All of these

During normal cardiac cycle, the electrical impulse representing Atrial depolarization, recorded on the EKG paper as ---------a.

a.T wave

b.QRS complex

c.P wave

d.U Waves

c.P wave

The rate for Accelerated Idio-ventricular rhythm is-

a.20 - 40

b.40 - 100

c60 - 100

d. 100 - 150

b.40 - 100

Which lead is considered ideal for P wave morphology check?

a.I

b.II

c.III

d.V1

b.II

The Einthoven triangle is formed by using the following placement sites

a.right arm, left arm, right leg

b.right arm left arm, left leg

c.right arm, left leg, right leg

d. any one of the above

b.right arm left arm, left leg

The ways to correct the AC interference is/are a.

a.replace loose electrodes and have the patient turn slightly to the side.

b. have patient place hands under his or her buttocks, remind patient not to move

c.apply electrodes securely, remove tension from lead wires

d.unplug electrical equipments, move bed away from the wall

d.unplug electrical equipments, move bed away from the wall

The innermost layer of the heart is called the:

a.epicardium

b.endocardium

c.visceral pericardium

d. Pericardium

b.endocardium

A patient using a diary with Holter monitoring should include all of the following except:
a.Sexual activity
b.Dizziness sensation
c.Exercising
d.Reading

d.Reading

Sinus rhythm with heart rate increasing during inspiration and decreasing during expiration is-

a.sinus Tachycardia

b.sinus dysrhythmia

c.sinus Bradycardia

d. normal sinus rhythm

b.sinus dysrhythmia

Which of the following EKG settings requires patient's informed consent?

a.Holter monitor

b.Stress EKG test

c.Posterior 12 lead EKG

d. Telemetry monitor

b.Stress EKG test

The three types of leads that make up a 12-lead ECG consist of:

a.4 augmented limb, 4 standard bipolar, and 4 chest leads

b.3 standard bipolar, 3 augmented limb, and 6 chest leads

c.6 standard bipolar, 3 augmented limb, and 3 chest leads

d. 6 augmented limb, 3 standard bipolar, and 3 chest leads

b.3 standard bipolar, 3 augmented limb, and 6 chest leads

V1 - V2 - V3 - V4 - V5 - V6 are known as: a.

a.Standard leads

b.Precordial leads

c.Bipolar leads

d.Augmented limb leads

b.Precordial leads 

1. note: V1 - V2 - V3 - V4 - V5 - V6

Measurement of PR interval is ----

a.beginning of P wave to beginning of QRS complex

b.beginning of P wave to the end of P wave

c.end of P wave to the end of QRS complex

d.beginning of P wave to end of QRS complex

a.beginning of P wave to beginning of QRS complex

The heart's ability to initiate its own electrical impulse is known as

a.Conductivity

b.Contractility

c.Excitability

d.Automaticity

d.Automaticity

Deplarization of the cells causes the heart muscle to .--.

a. refill the chambers of the heart

b.relax (lengthen)

c.contract (shorten)

d.None of the above

contract (shorten)

The heart block dysrhythmia which is characterized by complete atrio-ventricular dissociation is

a.Third degree AV block b.Second degree AV block, type I c.Second degree AV block, type II d.First degree heart block

a.Third degree AV block

The superior vena cava carries

a. oxygen-rich blood to the left atrium

b.oxygen -rich blood to the right atrium

c.oxygen-poor blood to the right atrium

d.oxygen-poor blood to the left atrium

c.oxygen-poor blood to the right atrium

When the EKG paper is read in a horizontal way, it gives the information related to:

a.voltage

b.time(duration)

c.height

d.amplitude 

b.time(duration)

What would be the first and the most appropriate thing to say if a patient refuses an EKG 

a.may I know why you don't wish to have an EKG done?

b.your doctor has order this test and it must be done

c.don't worry, it only takes a few seconds

d.I will have to report you to my supervisor immediately

a.may I know why you don't wish to have an EKG done?

An ECG tracing showing big waves that doesn't fit in the graph paper with the standard gain, what's the next step?

a.Adjust the gain to 20 mm/mV

b.Adjust the gain to 15 mm/mV

c.Adjust the gain to 10 mm/mV

d. Adjust the gain to 5 mm/mV

d. Adjust the gain to 5 mm/mV

Which of the following statements made by the patient indicates understanding of Event monitor?

a.I should remove the monitor when I go to bed"

b.I should stop my heart medications before using the monitor"

c.I should press on the button once I feel any symptom

d.I should resume my daily activities including my swimming lessons

c.I should press on the button once I feel any symptom

During sinus rhythm (normal heart activity) the primary pacemaker is --

a.AV junction

b.Bundle of HIS

c.AV node

d.SA node

d.SA node

One "small square" when is measured in horizontal axis for duration is equal to:

a. 0.2 sec

b.0.04 sec

c.0.08 sec

d. none of the above

b.0.04 sec

aVR - aVL - aVF are known as:

a.Augmented limb leads

b.Standard leads

c.Precordial leads

d.Bipolar leads

a.Augmented limb leads

Which of the following leads explore the left lateral wall of the left ventricle?

a.V1, V2

b.V3, V4

c.V5, V6

d.II, III

c.V5, V6

Normal QRS complex duration is --

- second.

a.0.12 to 0.20

b.0.22 to 0.26
c.0.06 to 0.10

d. 0.28 to 0.32

c.0.06 to 0.10

What adjustment is needed for recording EKG on a patient with orthopnea?

a.Put the patient on the left side

b.Put the leg electrodes on the abdomen
c.Put V1 and V2 electrodes higher level than normal
d.Put the patient in semi sitting position

d.Put the patient in semi sitting positio

In a normal ECG tracing, the T wave represents the:

a.repolarization of the atria

b.repolarization of the ventricles

c.depolarization of the ventricles

d.depolarization of the atria

b.repolarization of the ventricles

Normal PR Interval is

- second.

a.0.28 to 0.32

b.0.22 to 0.26
c.0.06 to 0.10
d.0.12 to 0.20

d.0.12 to 0.20

Which of the following leads explore the anterior wall of the heart

a.Leads I, II, IlI

b.Leads V3, V4

cLeads V5, V6

d. Leads aVF, aVL

b.Leads V3, V4

note:

Leads	Heart Wall / Area	Main Coronary Artery
V1–V2	Septal wall	Left anterior descending (LAD)
V3–V4	Anterior wall	Left anterior descending (LAD)
V5–V6	Lateral wall	Circumflex artery
Leads I, aVL	High lateral wall	Circumflex artery
Leads II, III, aVF	Inferior wall	Right coronary artery

Which of the following EKG changes may indicate the patient suffering from a Myocardial infarction?

a. Absent P wave

b.Wide QRS duration

c.ST segment elevation

d. Short PR interval

c.ST segment elevation

The tricuspid valve is located between the:

a.left atrium and left ventricle

b. right ventricle and the pulmonary artery

c.left ventricle and the aorta

d.right atrium and right ventricle

d.right atrium and right ventricle

Unwanted marks on the EKG tracing caused by other source than myocardium is/are called

a.Asystole

b.standardization marks

c.artifacts

d. conduction marks

c.artifacts

With junctional rhythms P waves may be:

a. Upright and peaked

b.Multiple shapes

c.Having variable PR intervals

d.Absent or inverted

d.Absent or inverted

As you are conducting 12-lead EKG, a red line appears at the bottom of your EKG graph paper. This

means--

a. you have placed an electrode at the wrong place

b.Nothing, this is what occurs with each 12- lead EKG.

c.the EKG paper is running low and needs to be replaced soon.

d.the patient has moved during the procedure and so invalid recording

c.the EKG paper is running low and needs to be replaced soon.

The valve located between the left atrium and left ventricle is the:

a.Mitral (bicuspid) valve

b.Pulmonary valve

c.Aortic valve

d.Tricuspid valve

a.Mitral (bicuspid) valve

The term Dyspnea means:

a.Shortness of breath

b.Fast breathing rate

c.Normal breathing rate

d.Slow breathing rate

a.Shortness of breath

Wenckebach rhythm is a -

-- heart block

a.first degree

b.second degree, Type I

c.third degree

d. second degree, Type II

b.second degree, Type I

Which of the following EKG devices is used as real time monitor in hospital?

a. Holter monitor

b.Loop Memory event monitor

c.Telemetry monitor

d.12 lead EKG

c.Telemetry monitor

Two PVCs back to back are referred to as a a.

a.PVC occurring as multifocal

b. PVCs occurring as trigeminy

c.PVCs occurring as bigeminy

d.PVCs occurring as couplet

d.PVCs occurring as couplet

Leads I - II - IlI are known as:

a.Standard (bipolar) limb leads

b.Precordial leads

c.Unipolar limb leads

d. augmented limb leads

a.Standard (bipolar) limb leads

Diastole is the - phase of the heart

a.ventricular squeezing

b. contraction

c.relaxation

d.blood moving through the heart

c.relaxation

Which of the following is an indication to stop a stress EKG test

a.Respiratory rate of 25/ min

b.Hypertension of 170/90

c.Fatigue

d.Pulse Oximeter 90%

a.Respiratory rate of 25/ min

The right side of the heart (Right Ventricle) -

a.pumps Oxygen-poor blood to the lungs

b.pumps Oxygen rich blood to the lungs

c.pumps Oxygen rich blood to the Aorta

d.pumps Oxygen poor blood to the Aorta

a.pumps Oxygen-poor blood to the lungs

The phase of the cardiac cycle when the heart is pumping blood out to the body, also known as the contraction phase, is:

a.Systole

b.Diastole

c.Conductivity

d.Automaticity

a.Systole

Which of the föllowing rhythms would need immediate CPR and defibrillation?

a. Atrial fibrillation

b.Premature Ventricular Complexes

c.Ventricular Fibrillation

d.Accelerated junctional rhythm

c.Ventricular Fibrillation

A single beat that originates earlier from an ectopic focus from Atria, other than the SA node is called -----

a.Premature Atrial complex

b.premature Junctional complex

c.Premature sinus complex

d. premature ventricular

a.Premature Atrial complex

In a normal ECG tracing, the QRS complex represents the: ,

a.depolarization of the ventricles

b..repolarization of the ventricles

c.depolarization of the atria

d.repolarization of the atria

a.depolarization of the ventricles

The type of block in which the P waves have no relationship to the QRS complexes.

a.third degree heart block

b.first degree heart block

c.second degree heart block, type II

d. second degree heart block, type I

a.third degree heart block

 During an exercise stress test, what will the patient be asked to do?

a.Decrease the level of exertion as the test progresses

b.Maintain same level of exertion throughout the test

c.Increase the level of exertion as the test progresses

d. The patient will not be asked to do anything during the test

c.Increase the level of exertion as the test progresses

a.Premature Junctional Complex

b.Sinus Tachycardia

c.Supraventricular Tachycardia

d.Junctional Escape Rhythm

c.Supraventricular Tachycardia

8In pediatric population, which electrode is displaced to right chest?

a.V2

b.V3

c.V4

d.V5

b.V3

What is the heart rate?

a.100 bpm

b.130 bpm

c.160 bpm

d.200 bpm

c.160 bpm

a.Premature Junctional Complex

b.Accelerated Junctional Rhythm

c.Junctional Tachycardia

d.Junctional Escape Rhythm

a.Premature Junctional Complex

a.Atrial Fibrillation

b.Premature Atrial Complexes

c.Wandering Atrial Pacemaker

d. Sinus Bradycardia

b.Premature Atrial Complexes

A straight line connecting two waves is called

a.interval

b.Pause

c.Segment

dJunction

c.Segment

a.PVC Premature Ventricular Contraction

b.Ventricular Tachycardia

c.Idio-Ventricular Rhythm

d.Ventricular Fibrillation

b.Ventricular Tachycardia

a.PVC Premature Ventricular Contraction

b.Ventricular Tachycardia

c.Idio-Ventricular Rhythm

d.Ventricular Fibrillation

d.Ventricular Fibrillation

a.First Degree Heart Block

b.Second Degree, Type I Heart Block

c.Second Degree, Type II Heart Block

d.Third Degree (complete) Heart block

a.First Degree Heart Block

Which of the following describe the last wave in this EKG tracing?

a.Ventricular Fibrillation

b.Ventricular tachycardia

c.Premature Ventricular Complex

d.Premature Atrial Complex

c.Premature Ventricular Complex

a.PVCs occurring as Run

b.PVCs occurring as Couplet

c.PVCs occurring as Bigeminy

 d.PVCs occurring as Trigeminy

c.PVCs occurring as Bigeminy

a.Atrial Fibrillation

b.Atrial Flutter

c.Wandering Atrial Pacemaker

d.Atrial Tachycardia

a.Atrial Fibrillation

a.Ist Degree Heart Block

b.2 nd degree Heart block, type I

c.2 nd degree Heart block, type II (Mobitz II)

d.3 rd degree (complete) Heart block

c.2 nd degree Heart block, type II (Mobitz II)

a.1st Degree Heart Block

b.2 nd degree Heart block, type I

c.2 nd degree Heart block, type II (Mobitz lI)

d.3 rd degree (complete) Heart block

b.2 nd degree Heart block, type I

a.PVC Premature Ventricular Contraction

bVentricular Tachycardia

c.Idio Ventricular Rhythm

d. Ventricular Fibrillation

c.Idio Ventricular Rhythm

a.Atrial Fibrillation

b.Atrial Flutter

c.Wandering Atrial Pacemaker

d.Atrial Tachycardia

b.Atrial Flutter

a.Asystole

b.Agonal

c.Ventricular fibrillation

d.Sinus bradycardia

a.Asystole