AMCA EKG

An EKG tech completes a 12 lead EKG and the patient asks if the tracing shows any heart problems. What is the appropriate response?

Explain that the provider must review and interpret the results

An EKG tech realizes that a STAT EKG order received one hour ago was missed. What action demonstrates an 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 show shows signs of a heart attack. What is the appropriate response within the technician scope of practice?

State that the provider will review and discuss the results

What prefix means “beside, beyond, around”?

Para

What suffix means “berry shaped”

Coccus

What suffix means “to view”?

Opsy

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

Cultural sensitivity

An EKG tech identifies significant ST-segment elevation on a patient’s tracing. What is the appropriate action to communicate this finding?

Personally notify the provider and deliver the tracing

An EKG tech identifies ST-segment elevation in leads I, II, II and AVF during a STAT EKG for a patient with chest pain. What action should the tech take?

Immediately notify the provider of the critical finding

• ST elevation signals myocardial injury. Critical findings require immediate verbal notification to the provider to ensure timely intervention.

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

Participating in accredited continuing education programs

An EKG tech is requested to perform a specialized lead placement for a patient, but lacks the specific training for the procedure. What 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

• applies to unconscious patients in emergency situations, assuming they would want care to save their life.

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 detergent to remove blood, mucous, etc?

Sanitization

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

Disinfection

What solution will help prevent the transmission of hepatitis?

Household bleach

Which organization developed the guidelines for universal precautions?

CDC (the centers for disease control and prevention)

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 tech 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 what…?

Blood

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

Initiate the facility’s Code Blue protocol and begin CPR

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

A) A 55-year-old requiring a pre-operative clearance

B) A 22 year-old reporting a mild headache

C) A 40-year-old with a suspected ankle fracture

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

D)

Which patient symptoms requires the EKG tech to perform a STAT EKG

A) chronic lower back pain

B) substernal chest pressure

C) seasonal nasal congestion

D) localized forearm itching

B)

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

A) perform the EKG immediately without speaking to save time

B) Wait for the physician to enter the order into the electronic chart

C) repeat the order back to the physician to confirm accuracy

D) Ask a nurse to document the order before starting the test

C) Repeat the order back to the physician to confirm accuracy

An EKG tech 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?

A) patients insurance info

B) emergency contact name

C) patient’s room number

D) clinical indication or diagnosis

D) clinical indication or diagnosis

What info must an EKG tech include when professionally introducing themselves to a patient?

Name and job title

What two specific identifiers must an EKG tech use to verify a patient’s identify before performing a procedure?

Full name and date of birth

An EKG tech notices a discrepancy the patient’s stated date of birth and the information on the requisition form. What is the most appropriate action?

Resolve the discrepancy with the staff prior to the EKG

• discrepancy: lack of similarity

When documenting a patient’s medical history regarding an implanted cardiac pacemaker, what information is essential to record in the chart?

The manufacturer, date of implantation, and type of device

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

Personnel directly involved in the patient’s clinical care

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

A) sharp chest pain that worsens with deep inspiration

B) burning sensation in the epigastric region after eating

C) dull aching pain in lower extremities

D) substernal pressure radiating to the left arm or jaw

D) substernal pressure radiating to the left arm or jaw

What feature characterizes an atrial fibrillation rhythm on an EKG tracing?

absence of distinct P waves and an irregularly irregular rhythm

An EKG tech is monitoring a patient who has been prescribed a beta-blocker. What finding should the technician expect?

Decreased heart rate

• beta-blockers inhibit sympathetic nervous system stimulation, resulting in a decreased heart rate and reduced myocardial contractility

Primary therapeutic effects and potential side effects of calcium channel blockers are….

Decreases heart rate and hypotension

Average normal heart rate

72 beats per minute

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

A) respiratory rate of 16/min

B) blood pressure of 118/76 mm hg

C) heart rate of 45/min

D) heart rate of 82/min

C) heart rate of 45/min

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

A) referring the patient to the internet

B) sending the visiting nurse to assess the patient

C) having the patient personalize information that he or she wants to learn

D) keeping a list to community resources that can further assist the patient

D) keeping a list to community resources that can further assist the patient

A patient scheduled for an exercise stress test states. “I am afraid that this text might cause a heart attack.” What response demonstrates appropriate emotional support?

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

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

Evaluation

• measures outcome against goals

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

Ten electrodes are placed on the chest and limbs, and the procedure takes 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 SOB 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. What action effectively prepares the skin while minimizing the risk of injury?

Gently cleansing the placement sites with alcohol and drying them

To prevent wandering baseline artifacts caused by poor electrode contact, how should the EKG tech prepares 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. What action should the EKG tech take first?

Assist the patient back to 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 tech notices a frayed power cord on the treadmill. What action 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

What 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

What technique should an EKG tech use when storing lead wits 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. What diagnostic test should the MA prepare to perform?

12 lead EKG

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

A) v4

B) avr

C) I

D) avf

A) v4

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

Fifth intercostal space in L 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 R sternal border

Which ECG lead is considered bipolar?

A) V4

B) II

C) AVF

D) AVR

B) II

Which ECG lead is paced on the fifth 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 do you do?

Continue recording

What is the universal standard speed for recording an ECG?

25 mm/sec

What is used to mark the ECG paper?

Stylus

What is an artifact?

Problematic because it can mimic life-threatening disrhythmias

Term for when marks on 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 tech is preparing to perform a standard 12-lead EKG on a patient who has bilateral lower extremity amputations. What site should the tech use for the leg electrodes?

Lower abdomen

An EKG tech 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 100-120 per minute

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

Obtain baseline blood pressure and a resting EKG

• baseline vitals and a resting EKG provide a reference point to detect exercise-induced abnormalities, such as ischemia or arrhythmias, during a test.

What 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 tech is explaining the protocol for n exercise stress test. When should blood pressure 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 right arm (RA) electrode?

Right infraclavicular fossa

What is another name for an exercise EKG?

Stress test

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

145/min

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

Starting CPR and attaching an AED

An EKG tech is educating a patient who will wear a Holter monitor for 24 hours. What instructions are appropriate regarding patient hygiene and data recording?

Avoid showering or swimming and document symptoms in the diary

When applying electrode for Holter monitor, what anatomical landmark is the correct placement for V1?

Fourth ICS, R sternal border

What 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 thee 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….

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, know 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 what?

T wave

The graphic representation of ventricular depolarization on an ECG reading is represented by what?

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

What term means there is no consistency to the rhythm, such as Afib

Irregularly irregular

An EKG tech is analyzing the rhythm strip shown here. Using the annotated tracing, the tech counts the small boxes between consecutive R waves and applies the 1500 method to calculate heart rate. Which finding 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….

Rate of 0 with no pulse

What are two PVC’s in a row called?

Couplet

What term 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 pee waves. What 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, what action is required?

Notify the provider immediately