CET 2022 Study Guide Questions with Complete Solutions, Graded A.

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CET 2022 Study Guide Questions with Complete Solutions What should you do if a pt is experiencing angina during a treadmill test? -Answer- Stop the test, Check the patient first, then notify the MD... (doctor) What would be a contraindication to a stress test? -Answer- an MI (myocardial infarction) or CHF (congestive heart failure); (anytime you don't want to put stress on the heart) Where do you attach the electrodes for telemetry/Holter (ambulatory) monitoring? - Answer- The chest Are there hygiene restrictions during Holter monitor testing? -Answer- yes (e.g. don't shower) What type of activities need to be documented in the diary during a Holter monitor? - Answer- Any activity usual & unusual While doing an EKG you see a flat line tracing, what should you do first? -AnswerAssess the patient What's can cause alternating current (electrical) interference artifacts? -Answeranything electrical Heart rate changes associated with respiration are described as __________________. -Answer- regularly irregular rhythm Patient is asymptomatic (not having any symptoms) during a stress test, what should you do? -Answer- Continue the test The septal wall of the heart is viewed by which leads? -Answer- V1, V2 QRS complex width of < 3 small squares. Is this normal conduction? -Answer- yes (< 0.12) Which waveform represents atrial conduction on an EKG? -Answer- p wave Dyspnea has to do with which vital sign? -Answer- Respirations How do you measure the PR Interval? -Answer- beginning of P wave to beginning of QRS complex With the Bruce protocol stress test, how often do you record pt BP? -Answer- every 2.5 to 3 min / EKG done every 5/10/15 minutesWhich wave differentiates idioventricular rhythm from junctional escape rhythm (both rhythms are slow and have no P waves)? -Answer- QRS How many electrodes are used for Holter monitoring? -Answer- 3-5 Make sure you can identify atrial flutter on a rhythm strip. -Answer- ▪︎saw tooth like p waves ▪︎ratio can vary from 2:1 to 3:1 depending on av conduction ▪︎atrial rate is fast 250-300 bpm ▪︎ventricular rate slower due to (protective) refractory period ▪︎ventricular rate is normally regular but can be irregular ▪︎no p-r interval ▪︎no T wave Report _________________ when pt is doing a stress test. -Answer- syncope (fainting) or any unusual findings What does a QRS complex width of 0.20 seconds indicate? -Answer- delayed ventricular conduction Which control on the EKG machine increases or decreases the amplitude (voltage) of the tracing? -Answer- gain THR (Target Heart Rate) calculation -Answer- 220-age, x .85 Standard calibration mark on an EKG should be _______ small boxes in amplitude (height, up) -Answer- 10 or Gain of 1 After doing a nonstandard EKG on a pt, the gain setting should be returned to ____________. -Answer- 10mm/mv Holter monitor electrodes are distinguished by: ¤ number ¤ letter ¤ symbol ¤ color -Answer- ¤ color Which part of the EKG tracing shows ventricular repolarization? -Answer- T wave Where do the chest electrodes go when performing an EKG? -Answer- ▪︎V1/C1 4th intercostal space to the right of the sternum ▪︎V2/ C2 4th intercostal space to the left of the sternum ▪︎V3/C3 Midway between V2 and V4▪︎V4/C4 5th intercostal space, left midclavicular line ▪︎V5/C5 at horizontal level of position 4 at left anterior axillary line ▪︎V6/C6 at horizontal level of position 4 at left midaxillary line If a patient has a cast on her left arm and left leg, where would you put the limb leads? - Answer- both upper thighs or lower abdomen (same place on each limb) A wide, bizarre QRS complex is characteristic of which type of arrhythmia? -AnswerVentricular ____________ rhythm is associated with an inverted or absent P wave. -Answerjunctional What is the best way to verify a patient understands instructions? -Answer- Have patient repeat directions back and document it Stand on the patient's ___________ side to do an EKG. -Answer- left Multiple small spikes of the same size would indicate which type of artifact? -AnswerAC Electrical Document ______________ & _______________ in the pt's EHR ( Electronic Health Record)when doing an EKG. -Answer- Pt's name, DOB, time, date it was done Which wave represents atrial conduction? -Answer- P wave How to identify A-fib on a rhythm strip -Answer- very irregular, no P waves What would you see on the tracing if the pt has a ventricular pacer? -Answer- spike before wide QRS A loose electrode would most likely cause which artifact? -Answer- wandering baseline What is the color of the lead that serves as the ground? -Answer- green (right leg) How would you determine the regularity of a pt's heart rhythm? -Answer- measure R to R intervals Which line represents a period of zero electric activity? -Answer- isoelectric line (same as baseline) Which lead groups are put in a nonstandard location for a stress test? -Answer- both limb leads (go on chest)What is a sphygmomanometer and which artery do you use to take a BP? -Answer- BP monitor, Brachial postural hypotension -Answer- decrease in blood pressure caused by a sudden change in position (e.g., standing up suddenly) The presence of a deep or wide Q wave on an EKG indicates _______________. - Answer- remote MI (Myocardial infarction, in the past) What on an EKG would tell you an electronic pacemaker is firing but failing to capture? - Answer- spike followed by nothing (no P or QRS wave, depends) _________________ is the most common lead used for continuous monitoring. - Answer- lead II Which lead position would you adjust for a pt who has bilateral leg amputations? - Answer- lower extremities (legs) Which heart block has a PR interval > 0.20? -Answer- 1st Degree Heartblock What is the first thing you should do if the monitor shows ventricular fibrillation? - Answer- check the patient In which leads would you see an inferior wall MI? -Answer- V2, V3, V4 which wave occurs occasionally before the P wave? -Answer- U wave Obtain _________________ from a pt prior to a stress test. -Answer- oxygen saturation What does pulse oximetry measure? -Answer- oxygen saturation On any type of EKG the black lead goes here -Answer- LA (left arm) Which limb produces the AVF reading? -Answer- left foot Where would you put V3 on a pt with Dextrocardia (when the heart is on the opposite or right side of the chest) -Answer- on the right Where would you put the precordial leads on a pt with [Show More]

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