CRAT Prep Exam 289 Questions with Verified Answers,100% CORRECT

CRAT Prep Exam 289 Questions with Verified Answers 1. In addition to recording the ECG and preparing the report, an ECG technician must be able to: A. Determine if the tracing is accurate and recognize if interfere ...

CRAT Prep Exam 289 Questions with Verified Answers 1. In addition to recording the ECG and preparing the report, an ECG technician must be able to: A. Determine if the tracing is accurate and recognize if interference causes abnormalities during the recording process. B. Evaluate tracing, recognize abnormal heart rhythms, and report abnormalities to the appropriate health care professionals. C. Maintain patient records and evaluate tracings. D. Perform ultrasounds on blood vessels and assist with angioplasty. - CORRECT ANSWER A. Determine if the tracing is accurate and recognize if interference causes abnormalities during the recording process. 2. Monitor technicians record an ECG tracing and place it into the patient record, but they must perform which of the following? A. Assist the physician with angioplasty. B. Perform an ultrasound of blood vessels. C. Prepare an ECG report. D. Evaluate the tracing and recognize abnormal rhythms. - CORRECT ANSWER D. Evaluate the tracing and recognize abnormal rhythms. 3. Which of the following employees assists the physician with invasive cardiovascular diagnostic tests such as angioplasty, heart surgery, or implantation of artificial pacemakers? A. ECG technician B. Cardiovascular technologist C. Medical assistant D. Monitor technician - CORRECT ANSWER B. Cardiovascular technologist 4. Which of the following is considered an unethical act but is not necessarily illegal? A. Reporting blood pressure results of a stress test incorrectly, resulting in a heart attach to the patient. B. Taking a break when you are required to be viewing multiple patient's heart rhythms. C. Deciding to keep a $10 bill you find on the patient's bedside table. D. Keeping the door open to the patient's room when you expose his or her body to perform an ECG. - CORRECT ANSWER D. Keeping the door open to the patient's room when you expose his or her body to perform an ECG. 5. Which of these is the responsibility of an ECG technician? A. Evaluating electrical tracings on a monitor. B. Recording the ECG and preparing the report for the physician. C. Assisting with invasive procedures. D. Evaluating the rhythm. - CORRECT ANSWER B. Recording the ECG and preparing the report for the physician. 6. Which of the following BEST describes the universal and standards precautions? A. Universal precautions are practiced on patients in isolation and standard precautions are practiced on all patients. B. Universal precautions are practiced on all patients with or without an identified infection and stand precautions are only practiced on isolated patients. C. Universal precautions and standard precautions are the same. D. Standard precautions combine universal precautions and body substance isolation. - CORRECT ANSWER D. Standard precautions combine universal precautions and body substance isolation. 7. What type of ECG procedure is being performed? - Patient is laying down with leads placed on him while the technician records. A. Telemetry monitoring B. Treadmill ECG stress test C. Transtelephonic ECG monitoring D. 12-lead ECG - CORRECT ANSWER D. 12-lead ECG 8. A photo features the first ECG machine, which weighed about 600 lbs and took 6 people to operate. Which scientist won the Nobel prize for this invention? A. Augusta D. Waller B. Wilhelm Einthoven C. Sir Thomas Lewis D. James B. Herrick - CORRECT ANSWER B. Wilhelm Einthoven 9. Which of the following ECG procedures is almost ALWAYS performed in a hospital or in-patient facility? A. Continuous Monitoring B. Ambulatory monitoring C. Treadmill stress test D. Transtelephonic monitoring - CORRECT ANSWER A. Continuous Monitoring 10. Which of the following is preformed as a routine procedure or during an emergency in the hospital setting? A. Treadmill stress test B. 12-lead ECG C. Ambulatory monitoring D. Telemetry monitoring - CORRECT ANSWER B. 12-lead ECG 11. Based on the American Heart Association's recommendations for reduction or prevention of heart disease and stroke, which patient has done the most to reduce his risk? A. Paul Thomas stopped smoking 15 years ago and has maintained a healthy weight by exercising at least 30 minutes every day and eating a well-balanced diet. B. James Jones has never smoked, he has a sedentary job that has him in the office 6 days a week. Because his work schedule, he gets almost no exercise and east fast food frequently. C. Carlton Castle stopped smoking last week, but has not increased his physical activity because he becomes short of breath easily. He lives alone and tends to snack rather than eat regular meals. D. Jack Zeus walks every day and east a fairly well-balanced diet. He has reduced his smoking from one pack per day to a half-pack of low tar cigarettes per day. - CORRECT ANSWER A. Paul Thomas stopped smoking 15 years ago and has maintained a healthy weight by exercising at least 30 minutes every day and eating a well-balanced diet. 12. Which of the following enables lay rescuers to help a person in sudden cardiac arrest? A. Automatic External Defibrillator (AED) B. Holter monitor C. ECG monitor with defibrillator D. Transtelephonic monitoring - CORRECT ANSWER A. Automatic External Defibrillator (AED) 13. Document clear and complete information to provide continuity of care and protect yourself legally. Which is NOT proper documentation in the patient's medical record? A. The ECG was performed at 10:00am and Mr. Smith tolerated the procedure well. B. Mr. Janes complained of check pain during the ECG. Dr. Jackson was notified. C. I did not perform the ECG because Mr. Harris is an old drunk and is nasty and dirty. D. The ECG was ordered because Mr. Henderson complained of shortness of breath and check pain. - CORRECT ANSWER C. I did not perform the ECG because Mr. Harris is an old drunk and is nasty and dirty. 14. The ECG tracing provides critical information about the patient and misdiagnosis could result if the tracing is: A. Too long B. Inaccurate C. Filed in the correct patient record D. Ordered to be run STAT - CORRECT ANSWER B. Inaccurate 15. Which of the following is an unethical act that is also illegal? A. Acting unprofessionally and being disrespectful towards a patient or co-worker. B. Reporting the blood pressure results of a stress test incorrectly and resulting in a myocardial infarction to the patient. C. Exposing the patient's body when preforming any procedure? D. Skipping a mandatory continuing education class. - CORRECT ANSWER B. Reporting the blood pressure results of a stress test incorrectly and resulting in a myocardial infarction to the patient. 16. You perform an ECG on a patient in contact isolation. You removed the gloves and gown when you left the room. What other actions should you take? A. No other actions are needed. B. You should wash your hands. C. Wash your hands and decontaminate your ECG machine. D. Wash your hands and put on a clean gown and gloves. - CORRECT ANSWER C. Wash your hands and decontaminate your ECG machine. 17. Of the following health care employees, which is LEAST likely to perform a 12-lead ECG? A. Respiratory therapist B. Physician C. Physical therapist D. Specially trained nursing assistant - CORRECT ANSWER C. Physical therapist 18. Which of the following is NOT a reason for performing an ECG? A. To diagnose changed in the heart rhythm. B. To monitor people with heart conditions. C. To check for problems with the flow of blood through the heart. D. To evaluate the effectiveness of cardiac medications. - CORRECT ANSWER C. To check for problems with the flow of blood through the heart. 19. What is the best source of information regarding the specific type of ECG machine you are using? A. Your supervisor B. Manufacturer's directions C. Your co-worker D. The procedure manual - CORRECT ANSWER B. Manufacturer's directions 20. Identify AED in pictures. - CORRECT ANSWER D 21. Telemedicine monitoring is generally used to evaluate which of the following? A. ECG tracing over a 24-48 hour period of normal activity. B. Artificial pacemaker functioning C. Heart rhythm during a Code Blue emergency D. Heart rhythm during exercise - CORRECT ANSWER B. Artificial pacemaker functioning 22. Which type of test is being performed? - Patient is walking on a treadmill while an ECG is being performed. A. Telemetry monitoring B. Holter monitoring C. Treadmill stress test D. 12-lead ECG - CORRECT ANSWER C. Treadmill stress test 23. What can you do to make the ECG a positive experience for the anxious patient? A. There is nothing you can do if the patient is anxious B. Clearly explain the procedure and answer the patient's questions. C. Instruct the patient to discuss the procedure with their physician. D. Have the nurse tell the patient to cooperate. - CORRECT ANSWER B. Clearly explain the procedure and answer the patient's questions. 24. An abnormal rhythm such as ventricular fibrillation is a medical emergency that needs immediate treatment. In addition to administration of CPR and cardiac medications, the patient will require the use of the: A. Holter monitor B. 12-lead ECG C. Telemetry monitoring D. Defibrillator - CORRECT ANSWER D. Defibrillator 25. Which might you be required to perform a "STAT" ECG? A. During telemetry monitoring B. Early in the morning before surgery C. During a code red emergency D. When a patient has check pain or changes in their cardiac rhythm - CORRECT ANSWER D. When a patient has check pain or changes in their cardiac rhythm 26. When should you wash your hands? A. Between patient contacts B. Before putting on gloves but not between patients C. After removing gloves but not between patients D. After removing gloves but not before putting them on - CORRECT ANSWER A. Between patient contacts 27. ECG are obtained in many locations. At what type of facility is the ECG procedure in this photo being performed? - Patient in hospital gown on a bed. A. Doctor's office B. Patient's home C. Acute care hospital D. Emergency vehicle - CORRECT ANSWER C. Acute care hospital 28. At what age should an individual begin to have an ECG done as part of a complete physical? A. 35 B. 40 C. 65 D. 50 - CORRECT ANSWER B. 40 29. Which statement below is correct? A. Unethical acts are always illegal, but illegal acts are not always unethical. B. Illegal acts are always unethical, but unethical acts are not always illegal. C. Illegal acts are always unethical, but ethical acts are always illegal. D. Illegal acts are always unethical, but unethical acts are not always illegal. - CORRECT ANSWER D. Illegal acts are always unethical, but unethical acts are not always illegal. 30. What type of ECG monitoring system is attached to the patient in this photo in what type of facility is it most commonly applied and removed? - Patient has electrodes placed with the device hooked to their pants. A. Treadmill test monitor; in a medical office B. Holter (ambulatory) monitor; in medical office or out-patient setting C. Telemetry monitor; in medical office D. Holter (ambulatory) monitor; in a hospital - CORRECT ANSWER B. Holter (ambulatory) monitor; in medical office or out-patient setting 31. The study of electrical activity of the heart is known as: A. Electrocardiologist B. Cardiology C. Electrocardiogram D. Electrocardiology - CORRECT ANSWER D. Electrocardiology 32. Telemedicine enables physicians to see ECG tracings from patients who live in remote areas via the machine pictured here. What type of monitor is this? - Patient is in an in-home setting with the monitor being hooked up to a landline. A. Telemetry monitor B. 12-lead ECG monitor C. Transtelephonic monitor D. Holter monitor - CORRECT ANSWER C. Transtelephonic monitor 33. What is the single most important procedure to perform to adhere to universal precautions and prevent the spread of infection? A. Gloving B. Isolation procedures C. Wearing a mask D. Hand washing - CORRECT ANSWER D. Hand washing 34. Which of the following describes "contractibility"? A. The ability of the heart muscle cells to shorten in response to an electrical stimulus. B. The ability of the heart cells to receive and transmit an electrical impulse. C. The ability of the heart to initiate an electrical impulse without being stimulated by another source. D. The ability of the heart muscle cells to respond to an impulse or stimulus. - CORRECT ANSWER A. The ability of the heart muscle cells to shorten in response to an electrical stimulus. 35. Which of the following is the outside, thin layer of the heart, containing the coronary arteries? A. Epicardium B. Pericardium C. Myocardium D. Endocardium - CORRECT ANSWER A. Epicardium 36. On the ECG waveform, what is the beginning of the atrial depolarization to the beginning of the ventricular depolarization, or the time it takes the impulse to travel from the SA node to the AV node? A. QT interval B. QRS complex C. PR interval D. P wave - CORRECT ANSWER C. PR interval 37. In addition to automaticity, what involuntary system controls the heartbeat? A. Sympathetic nervous system B. Parasympathetic nervous system C. Central nervous system D. Autonomic nervous system - CORRECT ANSWER D. Autonomic nervous system 38. What is the J point and why is it used? A. Ventricular depolarization and resulting ventricular contraction; used to measure the heart rate. B. The end of the QRS complex and ventricular depolarization; used to interpret ECG tracings. C. Repolarization of the bundle of HIS and purkinje fibers; used to interpret ECG tracings. D. Period of time from the start of the ventricular depolarization to the end of the ventricular repolarization. - CORRECT ANSWER B. The end of the QRS complex and ventricular depolarization; used to interpret ECG tracings. 39. What does the isoelectric line of the ECG tracing indicate? A. Positive electrical deflections B. Depolarization C. No electrical activity D. Negative electrical deflections - CORRECT ANSWER C. No electrical activity 40. Which of the following statements is MOST correct regarding pulmonary circulation? A. Pulmonary circulation is the transportation of blood between the heart and the entire body, excluding the lungs. B. Pulmonary circulation is the transportation of blood to and from the lungs. Blood is oxygenated in the lungs during pulmonary circulation. C. Pulmonary circulation is the transportation of blood to and from the lungs. Blood is deoxygenated in the lungs during pulmonary circulation. D. Pulmonary circulation is the transportation of blood between the heart and the entire body. Blood is oxygenated in the lungs during pulmonary circulation. - CORRECT ANSWER B. Pulmonary circulation is the transportation of blood to and from the lungs. Blood is oxygenated in the lungs during pulmonary circulation. 41. What is the state of cellular stimulation in the heart that causes it to contract? A. Depolarization B. Repolarization C. Polarization D. Cardiac conduction - CORRECT ANSWER A. Depolarization 42. Which of the following statements BEST describes coronary circulation? A. Circulation of blood to and from the body B. Circulation of blood to and from the lungs C. Circulation of blood to and from the heart muscle D. Circulation of oxygen throughout the body - CORRECT ANSWER C. Circulation of blood to and from the heart muscle 43. Which of the following sequences correctly identifies the pathways for conduction through the heart? A. AV node, SA node, bundle of HIS, bundle branches, purkinje fibers B. SA node, AV node, bundle branches, bundle of HIS, purkinje fibers C. SA node, AV node, bundle of HIS, purkinje fibers, bundle braches D. SA node, AV node, bundle of HIS, bundle branches, purkinje fibers - CORRECT ANSWER D. SA node, AV node, bundle of HIS, bundle branches, purkinje fibers On the ECG waveform, what represents atrial depolarization with resulting atrial contraction? A. Q wave B. T wave C. R wave D. P wave - CORRECT ANSWER D. P wave 45. On the ECG waveform, what is the ventricular repolarization? A. S wave B. P wave C. Q wave D. T wave - CORRECT ANSWER D. T wave 46. Which of the following parts of the conduction system conducts the impulses down both sides of the interventricular septum? A. Bundle branches B. Purkinje fibers C. Bundle of HIS D. AV node - CORRECT ANSWER A. Bundle branches 47. What occurs in the heart during systole and diastole? A. Systole allows blood to flow into the heart and diastole forces blood out of the heart. B. Systole forces blood out of the heart and the relaxation of the heart during diastole allows blood into the heart chambers. C. The heart contracts during both diastole and systole. D. The heart relaxes during both systole and diastole. - CORRECT ANSWER B. Systole forces blood out of the heart and the relaxation of the heart during diastole allows blood into the heart chambers. 48. On the ECG waveform, what represents the repolarization of the bundle of HIS and purkinje fibers? A. Q wave B. U wave C. P wave D. S wave - CORRECT ANSWER B. U wave 49: Structure that pumps blood into the aorta to travel through the entire body. A. Right atrium B. Left atrium C. Right ventricle D. Left ventricle - CORRECT ANSWER D. Left ventricle 50. On the ECG waveform, what is the period of time from the start of the ventricular depolarization to the end of ventricular repolarization? A. QT interval B. U wave C. QRS complex D. ST segment - CORRECT ANSWER A. QT interval 51. What is the term for the ability of the heart cells to receive and transmit an electrical impulse? A. Automaticity B. Excitability C. Conductivity D. Contractibility - CORRECT ANSWER C. Conductivity 52. What structure is responsible for the transporting of blood to the lungs? A. Aorta B. Pulmonary artery C. Pulmonary veins D. Superior vena cava - CORRECT ANSWER B. Pulmonary artery On the waveform, what does the QRS complex represent? A. Atrial depolarization B. Ventricular depolarization and the resulting ventricular contraction C. Ventricular repolarization D. Beginning of atrial depolarization to the beginning of ventricular depolarization - CORRECT ANSWER B. Ventricular depolarization and the resulting ventricular contraction 54. Who labeled the waves of the ECG waveform? A. Lewis B. Waller C. Herrick D. Einthoven - CORRECT ANSWER D. Einthoven 55. Identify the bicuspid valve - CORRECT ANSWER Between the left atrium and the left ventricle. 56. Which of the following is the BEST definition for "automaticity"? A. The ability of the heart to initiate an electrical impulse without being stimulated by another source. B. The ability of the heart cells to receive and transmit an electrical impulse. C. The ability of the heart muscle to shorten in response to an electrical stimulus. D. The ability of the heart muscle cells to respond to an impulse or stimulus. - CORRECT ANSWER A. The ability of the heart to initiate an electrical impulse without being stimulated by another source. 57. Which statement best describes what is happening in the picture? - blood flow within the heart. A. The heart muscle contracts, creating pressure to open the pulmonary and aortic valves. B. Oxygenated blood from the left ventricle travels through the aorta to the coronary arteries. C. The pumping cycle of the heart muscle is controlled by electrical impulses that are initiated and transmitted through the heart. D. Blood from the body returns to the heart via the superior and inferior vena cava. - CORRECT ANSWER D. Blood from the body returns to the heart via the superior and inferior vena cava. 58. What are the phases of the cardiac conduction system, and what action occurs in the heart during each phase? A. Systole- relaxation; diastole- contraction B. Conduction- contraction; circulation- relaxation C. Systole- contraction; diastole- relaxation D. Relaxation- heart resting; contraction- heart contracting - CORRECT ANSWER C. Systole- contraction; diastole- relaxation 59. Which of the following BEST describes "excitability"? A. The ability of the heart muscle cells to shorten in response to an electrical impulse. B. The ability of the heart muscle cells to respond to an impulse or stimulus. C. The ability of the heart cells to receive and transmit an electrical impulse. D. The ability of the heart to initiate an electrical impulse without being stimulated by another source. - CORRECT ANSWER B. The ability of the heart muscle cells to respond to an impulse or stimulus. 60. What is the function of the heart? A. Circulate blood to and from tissues B. Supply nutrients C. Remove carbon dioxide and waste D. Supply oxygen - CORRECT ANSWER A. Circulate blood to and from tissues 61. What is the average heart rate for an adult? A. 100-110 bpm B. 40-60 bpm C. 50-60 bpm D. 60-100 bpm - CORRECT ANSWER D. 60-100 bpm 62. Which of the following statements if TRUE regarding the role of the autonomic nervous system (ANS) in controlling the heartbeat? A. The ANS is involuntary. The sympathetic division increases the heart rate and the parasympathetic division decreases the heart rate. B. The ANS in voluntary. The sympathetic division increases the heart rate and the parasympathetic division decreases the heart rate. C. The ANS is involuntary. The sympathetic division decreases the heart rate and the parasympathetic division increases the heart rate. D. The ANS is voluntary. The sympathetic division decreases the heart rate and the parasympathetic division increases the heart rate. - CORRECT ANSWER A. The ANS is involuntary. The sympathetic division increases the heart rate and the parasympathetic division decreases the heart rate. 63. Which of the following is the pacemaker of the heart? A. AV node B. SA node C. Bundle of HIS D. Purkinje fibers - CORRECT ANSWER B. SA node 64. Trace the pathway for the transport of the blood during systemic circulation, starting with oxygenated blood from the lungs. A. Superior and inferior vena cava, right atrium, tricuspid valve, right ventricle, pulmonary semilunar valve, pulmonary artery, lungs, pulmonary veins, and left atrium. B. Left atrium, mitral valve, left ventricle, aortic semilunar valve, aorta, through the body, superior and inferior vena cava. C. Left atrium, mitral valve, left ventricle, pulmonary artery, through the body, pulmonary vein, superior and inferior vena cava D. Right atrium, mitral valve, right ventricle, aortic semilunar valve, aorta, through the body, superior and inferior vena cava. - CORRECT ANSWER B. Left atrium, mitral valve, left ventricle, aortic semilunar valve, aorta, through the body, superior and inferior vena cava. 65. On the ECG waveform, what is the period of time between ventricular depolarization and the beginning of ventricular repolarization? A. QT interval B. PR interval C. ST segment D. QRS complex - CORRECT ANSWER C. ST segment 66. Each heartbeat consists of the contraction and relaxation of the heart muscle. What is this called? A. The cardiac cycle B. Systole C. Diastole D. Deoxygenation - CORRECT ANSWER A. The cardiac cycle 67. Which of the following methods could you use to estimate the heart rate of a patient with a regular rhythm when the ECG is run at 25 mm/sec? A. Count the number of complete complexes on a 6 second tracing and divide by 10. B. Count the number of large boxes between two R waves and divide that number into 300. C. Count the number of boxes on a 6 second strip and divide by 300. D. Count the number of complexes between the two R waves and divide into 300. - CORRECT ANSWER B. Count the number of large boxes between two R waves and divide that number into 300. 68. What occurs during signal processing inside the ECG machine? A. The electrical impulse is recorded and printed. B. The electrical impulse is sent to the oscilloscope. C. There is no signal processing inside the ECG machine. D. The electrical impulse is amplified and converted into mechanical actions on the display. - CORRECT ANSWER D. The electrical impulse is amplified and converted into mechanical actions on the display. 69. Using the 1500 method, you counted 22 small squares between two R waves. What is the patient's heart rate? A. 60 B. 82 C. 50 D. 68 - CORRECT ANSWER D. 68 1500/22 70. How are lead wires coded? A. Color and letter B. Color only C. Letter and number D. Color and number - CORRECT ANSWER A. Color and letter 71. What are the small sensors that are placed on the skin the receive the electrical activity from the heart called? A. Leads B. Augmented leads C. ECG wires D. Electrodes - CORRECT ANSWER D. Electrodes 72. What is the most common output for a 12-lead ECG? A. Printed format B. Oscilloscope C. Computer screen D. Sensors - CORRECT ANSWER A. Printed format 73. Which two types of leads are unipolar? (measure electrical activity in one direction only). A. Standard and augmented leads B. Chest and augmented leads C. Chest and standard leads D. Check and precordial leads - CORRECT ANSWER A. Standard and augmented leads 74. When calculating heart rates, which method is the only one to use for irregular? A. R-R method B. 1500 method C. 6 second method D. 300 method - CORRECT ANSWER C. 6 second method 75. What are three types of leads used for the 12-lead ECG? A. Standard, limb, and chest leads B. Limb, augmented, and bipolar leads C. Standard, augmented, and chest leads D. Standard, chest, and bipolar leads - CORRECT ANSWER C. Standard, augmented, and chest leads 76. When placed correctly, standard limb leads form the Einthoven triangle. These leads are also known as what type of lead? A. Augmented B. Unipolar C. Negative D. Bipolar - CORRECT ANSWER D. Bipolar 77. What of the following is the correct label for the augmented lead that usually produces a negative deflection? A. aVR B. aVL C. aVF D. aVC - CORRECT ANSWER A. aVR 78. On the ECG graph paper, what do the two large boxes represent in voltage? A. 1 millivolt B. 1 centimeter C. 0.1 millivolt D. 0.5 millivolt - CORRECT ANSWER A. 1 millivolt 79. Which of the following methods should you use to determine the approximate heart rate of a patient with an irregular rhythm when the ECG is run at 25 mm/sec? A. Count the number of large boxes between two R waves and divide into 300. B. Count the number of complete complexes on a 6 second tracing and multiply by 10. C. Count the number of boxes on a 6 second strip and divide by 300. D. Count the number of complex between two R waves and divide by 300. - CORRECT ANSWER B. Count the number of complete complexes on a 6 second tracing and multiply by 10. 80. What is the main difference between single and multi-channel ECG machines? A. The single-channel ECG machine is able to record more than one lead tracing at a time. B. The multi-channel ECG machine is used mostly in physician's offices. C. The multi-channel ECG machine is able to record more than one lead tracing at a time. D. The multi-channel tracing is always mounted. - CORRECT ANSWER C. The multi-channel ECG machine is able to record more than one lead tracing at a time. 81. At the normal paper speed, how much time do the "five heavy lines" on the ECG paper represent? A. 0.04 seconds B. 1 minute C. 25 mm D. 1 second - CORRECT ANSWER D. 1 second 82. At the normal paper speed of 25 mm/sec, what does the smallest box on the ECG paper represent in time and voltage? A. 0.04 seconds, 0.1 mV B. 0.20 seconds, 0.5 mV C. 5 seconds, 1 mV D. 0.5 seconds, 0.5 mV - CORRECT ANSWER A. 0.04 seconds, 0.1 mV 83. What is the advantage of using standard grid ECG paper? A. Standard grid paper is more expensive than dot matrix. B. Standard grid paper requires less ink. C. Standard grid paper is easier to read. D. Standard grid paper produces sharper photocopies. - CORRECT ANSWER D. Standard grid paper produces sharper photocopies. 84. There are three important guidelines to follow for proper use of disposable electrodes. Which of the following is NOT a guideline for using disposable electrodes? A. Keep unused electrodes in a sealed plastic bag to prevent them from drying out. B. Check the expiration date on the package before use. C. Be certain to use the same amount of gel on each electrode during the tracing. D. Use disposable electrodes for only one ECG, with few exceptions. - CORRECT ANSWER C. Be certain to use the same amount of gel on each electrode during the tracing. 85. How many lead wires are used to record a 12-lead ECG? A. 12 B. 10 C. 6 D. 4 - CORRECT ANSWER B. 10 86. What does the ECG machine measure? A. Blood flow through the heart B. Electrical impulses produced by the heart's conduction system. C. Electrical impulses produced by the brain and transmitted to the heart D. Blood flow to the coronary arteries - CORRECT ANSWER B. Electrical impulses produced by the heart's conduction system. 87. Which control on the ECG machine regulates how fast or slow the paper runs during the procedure? A. Artifact filter B. Gain control C. LCD display D. Speed control - CORRECT ANSWER D. Speed control 88. Which method (s) of calculating the heart rate can you used for a patient with an irregular rhythm? A. R-R method B. Either the 6 second method or the 1500 method C. Only the 6 second method D. Only the 1500 method - CORRECT ANSWER B. Either the 6 second method or the 1500 method 89. What do the horizontal and vertical lines represent on the ECG graph paper? A. Horizontal= PR interval; vertical= voltage B. Horizontal= voltage; vertical= time C. Horizontal= time; vertical= QRS interval D. Horizontal= time, vertical= voltage - CORRECT ANSWER D. Horizontal= time, vertical= voltage 90. Which of the following is NOT a function of the ECG machine? A. Computerized measurement and analysis of the tracing. B. Validation of ECG interpretation C. Interpretation and storage of ECG results D. Printing the ECG tracing - CORRECT ANSWER B. Validation of ECG interpretation 91. What is the usual setting for the artifact filter to reduce artifact due to muscle tremor? A. 25 mm/sec B. 150 Hz C. 40 Hz D. 50 mm/sec - CORRECT ANSWER C. 40 Hz 92. The ECG report is part of the patient's medical record and must be maintained for how many years? A. Seven years B. Ten years C. Three years D. Fifteen years - CORRECT ANSWER A. Seven years 93. What part of the ECG machine serves as receiving device for the input function? A. Transistors B. Oscilloscpope C. Sensors D. Resistors - CORRECT ANSWER C. Sensors 94. Which control on the ECG machine regulates the output or height of the ECG waveform? A. LCD display B. Gain control C. Speed control D. Artifact filter - CORRECT ANSWER B. Gain control 95. Which of the following is NOT a consideration for handling and storing printed ECGs? A. They are heat and pressure sensitive B. They require no special handling and can be stored for up to 50 years. C. Marks on the ECG tracing make it difficult to read. D. They should be stored away from substances such as alcohol, plastic, sunlight, and x-ray film. - CORRECT ANSWER B. They require no special handling and can be stored for up to 50 years. 96. What type of electrode is most commonly used for an ECG? A. Disposable B. Reusable C. Silver D. Gels and pastes - CORRECT ANSWER A. Disposable 97. Augmented leads are unipolar. Why are they called augmented leads? A. They measure current toward only one electrode B. The ECG machine increases the size of the tracing C. They measure current toward two electrodes D. They are named for Augmen Lewis, who discovered them - CORRECT ANSWER B. The ECG machine increases the size of the tracing 98. What is the standard rate for the data run during the ECG procedure? A. 50 mm/sec B. 25 mm/sec C. 40 mm/sec D. 20 mm/sec - CORRECT ANSWER B. 25 mm/sec 99. Where are the precordial leads located? A. Three on the chest, two on the arms B. On the arms and legs C. On the arms and lower abdomen D. On the chest - CORRECT ANSWER D. On the chest 100. You just performed a "STAT" ECG on Mrs. Stephenson. What should you do with the results? A. Give it directly to your supervisor or other licensed practitioner or place it on the chart and inform them that it has been completed. B. Place it directly on the chart and take a second copy back to the ECG lab. C. Place it in a box at the nursing station and inform your supervisor that it has been completed. D. Place it in the consulting physician's box and inform him or her htat it has been completed. - CORRECT ANSWER A. Give it directly to your supervisor or other licensed practitioner or place it on the chart and inform them that it has been completed. 101. What is the most important consideration when performing an ECG on a patient two days in a row? A. Keep the electrodes at the same site by leaving them in place after the first ECG. B. The electrodes should be places at the same site or as close as possible in order for the tracings to be evaluated correctly. C. Use the same ECG machine for each ECG in order for them to be evaluated correctly. D. The lead wire cables and electrodes should remain attached overnight so the tracing will be accurate. - CORRECT ANSWER B. The electrodes should be places at the same site or as close as possible in order for the tracings to be evaluated correctly. 102. If you were performing an ECG on a patient who has had his left lower leg amputated, where should you put the leg electrodes? A. Place both the left and right electrodes on the lower abdomen. B. Place the left electrode on the upper left and the right leg electrode on the lower leg. C. Place both the left and right electrodes on the upper legs close to the trunk. D. Place both electrodes on the chest below the chest electrodes. - CORRECT ANSWER C. Place both the left and right electrodes on the upper legs close to the trunk. 103. Which of the following statements is TRUE regarding the room or machine used for an ECG? A. The room should be away from electrical equipment and x-ray machines; electrical equipment should be turned off. B. The machine should be placed directly beside other electrical equipment to avoid interference. C. All electrical equipment should be turned off and the room should be closed to other diagnostic rooms. D. The room should always be away from electrical and all electrical equipment should be turned on. - CORRECT ANSWER A. The room should be away from electrical equipment and x-ray machines; electrical equipment should be turned off. 104. If all required information is not on the form, what should you do? A. Refuse to perform the ECG. B. Ask the patient or obtain the information from the medical record. C. Call the physician to obtain the information. D. Ask the patient's visitor for the information. - CORRECT ANSWER B. Ask the patient or obtain the information from the medical record. 105. Your patient, Mrs. Ling, has had a mastectomy. How will this affect the ECG procedure? A. The leads should be placed on the opposite side of the chest and the change should be recorded on the report. B. The results may be altered due to the mastectomy, so place the leads on the back if necessary. C. No changes need to be made to the ECG procedure; a mastectomy will not alter the results. D. No changes need to be made to the ECG procedure; just note that the patient has had a mastectomy on the report. - CORRECT ANSWER D. No changes need to be made to the ECG procedure; just note that the patient has had a mastectomy on the report. 106. You must locate the angle of Louis and the second rib that is adjacent to this landmark when placing the chest electrodes. Then count down to the 4th intercostal space. Which lead do you place on the left sternal border? A. V2 B. V1 C. V4 D. V3 - CORRECT ANSWER A. V2 107. The baseline for the ECG you just performed is drifting off center. This is called wandering baseline. Which of the following is NOT a cause for this type of artifact? A. Tension on the electrode lead wires. B. Adequate electrode gel. C. Dirty electrodes. D. Poor skin preparation. - CORRECT ANSWER B. Adequate electrode gel. 108. Which of the following MOST accurately describes the placement of the V6 electrode? A. Fourth intercostal space at the right of the sternal border. B. Fifth intercostal space on the left midclavicular line. C. On the left anterior axillary line. D. On the midaxillary in line with V4 - CORRECT ANSWER D. On the midaxillary in line with V4 109. If the chest of the pediatric patient is too small to accommodate all the leads for an ECG, what should you do? A. Remove the lead for V3 and note it on the ECG report. B. Move lead V2 to the right side of the chest at the same location as V3. C. Move lead V2 to the right side of the chest at the same location as the left. D. Move lead V3 to the right side of the chest at the same location as the left. - CORRECT ANSWER D. Move lead V3 to the right side of the chest at the same location as the left. 110. What is the most frequent problem that can occur during an ECG and what is it's cause? A. Unwanted marks known as artifact, caused by activity other than electrical activity. B. Unwanted marks on the ECG known as somatic tremors, caused by another source of electrical activity. C. Unwanted marks known as artifact, caused by another source of activity or electrical activity. D. Unwanted marks on the ECG known as AC interference, caused by the electrical activity of the heart. - CORRECT ANSWER C. Unwanted marks known as artifact, caused by another source of activity or electrical activity. 111. What is the MOST appropriate attire for the patient during an ECG? A. No jewelry, no shirt, and a drape or gown for privacy. B. Clothing removed from above the waist, a drape or down tied in front, no jewelry. C. Clothing removed from about the waist and a gown tied in front. D. Clothing removed with a gown tied in front or a drape. - CORRECT ANSWER B. Clothing removed from above the waist, a drape or down tied in front, no jewelry. 112. Three sites assist in electrode placement. They are the angle of Louis, suprasternal notch, and what other site? A. Intercostal lines B. Einthoven's triangle C. Angle of Waller D. Intercostal spaces - CORRECT ANSWER D. Intercostal spaces 113. What are the three imaginary vertical lines on the chest and why are they important? A. Anterior clavicular, midaxillary, anterior axillary. They are used to ensure proper electrode placement. B. Midclavicular, midaxillary, anterior axillary. They are used to identify the location of the patient's previous ECG. C. Midclavicular, midaxillary, anterior axillary. They are used to identify the patient. D. Midclavicular, midaxillary, anterior axillary. They are used to ensure proper electrode placement. - CORRECT ANSWER D. Midclavicular, midaxillary, anterior axillary. They are used to ensure proper electrode placement. 114. An ECG is required during a Code Blue. What special considerations should you take? A. Perform two ECG's in a row to ensure the accuracy of the tracing and note "repeat ECG- same lead placement" on the report. B. Perform the ECG quickly and efficiently using special electrodes during the emergency. C. You should be available but out of the way, take only the ECG machine into the room, and leave the electrodes in place after the recording. D. Place the chart at the head of the bed in order to provide more room for the Code Blue equipment. - CORRECT ANSWER C. You should be available but out of the way, take only the ECG machine into the room, and leave the electrodes in place after the recording. 115. What is the proper positioning for yourself and the patient during an ECG? A. Work from the right side of the bed with the patient on his or her back with the arms and legs supported and not touching metal. B. Work from the left side of the bed and exam table with the patient on his or her back with the arms and legs supported and not touching metal. C. Provide a drape for the patient, work from the left side, and keep the extremities extended off the bed and not touching metal. D. Work from the left side of the bed or exam table with the patient slightly on this or her left side with the arms and legs supported. - CORRECT ANSWER B. Work from the left side of the bed and exam table with the patient on his or her back with the arms and legs supported and not touching metal. 116. While you are performing an ECG, the tracing looks like this? What should you do? - Flat line A. Remain calm and inform your supervisor immediately. B. Check the patient; if the patient is able to respond, report the tracing results to the licensed practitioner. C. Remain calm and check the electrodes, lead wires, and cables for proper attachment. D. Check the patient, if the patient is able to respond, check the electrodes, lead wires, and cables for proper attachment. - CORRECT ANSWER D. Check the patient, if the patient is able to respond, check the electrodes, lead wires, and cables for proper attachment. 117. What is the ICD-9 Code? A. Diagnostic codes used to ensure that proper treatment is provided for the patient. B. Billing codes used to ensure reimbursement to the facility where you are employed. C. Diagnostic codes used to ensure reimbursement by the patient's insurance. D. Billing codes used to ensure that proper treatment is provided for the patient. - CORRECT ANSWER C. Diagnostic codes used to ensure reimbursement by the patient's insurance. 118. How should you modify the ECG procedure for a pregnant patient? A. Place the patient slightly on her right side and note the number of months pregnant. B. Place the patient slightly on her left side and place the leads on her lower abdomen. C. Place the patient slightly on her left side and note the number of months pregnant. D. Document on the ECG that the patient is pregnant and the number of months. - CORRECT ANSWER C. Place the patient slightly on her left side and note the number of months pregnant. 119. Name this artifact and its cause- fuzzy baseline, but not thick. A. Wandering baseline; dirty electrodes B. AC interference; corroded leads C. Somatic tremor; shivering D. This is not artifact - CORRECT ANSWER C. Somatic tremor; shivering 120. Your patient, Jose Martinez, is a 12-year-old boy who requires an ECG. When you look at his chart, you note he has dextrocardia. What should you do? A. The limb leads and chest leads should be reversed, or a mirror image of the usual chest placement. B. Place the chest leads in the usual position and rate the limb leads to opposite sides. C. The chest leads should be reversed or a mirror image of the usual chest lead placement. D. Do not change the placement of any leads but explain the procedure in simple terms to Jose. - CORRECT ANSWER A. The limb leads and chest leads should be reversed, or a mirror image of the usual chest placement. 121. What can be done to help with somatic tremor artifact? A. Warm and reassure the patient, remind the patient not to move, have he patient put hands palm down under buttocks. B. Reposition the lead wires, move the patient's bed away from the wall, use new electrodes. C. Eliminate the source of interference, ground the machine, and re-attach the lead wires correctly. D. Apply electrodes securely, remove tension, and re-clean the skin properly. - CORRECT ANSWER A. Warm and reassure the patient, remind the patient not to move, have he patient put hands palm down under buttocks. 122. What does general day to day care and maintenance of the ECG equipment consist of? A. Disinfection of the machine, lead wires, and reusable electrodes. B. Cleaning the machine and restocking supplies. C. Storing the equipment properly, untangling the lead wires, and stocking supplies. D. Cleaning the machine, lead wires, and reusable electrodes and untangling the cables. - CORRECT ANSWER B. Cleaning the machine and restocking supplies. 123. Describe the difference between a routine ECG and continuous cardiac monitoring? A. Cardiac monitoring uses 3 leads with different placements. B. Cardiac monitoring uses 4 leads, utilizing the limbs. C. Cardiac monitoring uses the 6 chest leads. D. Cardiac monitoring is the same as a routine ECG. - CORRECT ANSWER A. Cardiac monitoring uses 3 leads with different placements. 124. You are unable to run a "clean" tracing. Which of the following may be the reason for this? A. The patient is not touching any metal portion of the bed or exam table. B. Electrodes are not properly attached to the patient's skin. C. The patient is unresponsive. D. Clips are securely attached to the electrodes. - CORRECT ANSWER B. Electrodes are not properly attached to the patient's skin. 125. What is the rate of the rhythm for sinus tachycardia? A. 60-100 bpm B. Less than 60 bpm C. Greater than 100 bpm D. 72 bpm - CORRECT ANSWER C. Greater than 100 bpm 126. Determine the rate of this rhythm strip- 4 complete regular complexes. A. 40 bpm B. 37 bpm C. 18 bpm D. Greater than 60 bpm - CORRECT ANSWER A. 40 bpm 127. The ECG tracing is considered a legal document and needs to be included in the patient's medical record. What information needs to be included on this document? A. Patient's social security number, physician's name, and location. B. Patient's date of birth, diagnosis, and medication being taken. C. Physician's name, your name, and patient's address. D. Patient's name, date, and time of day. - CORRECT ANSWER D. Patient's name, date, and time of day. 128. What rhythm originating in the sinus node is affected by the breathing pattern of the patient? A. Sinus tachycardia B. Sinus bradycardia C. Normal sinus rhythm D. Sinus dysrhythmia - CORRECT ANSWER D. Sinus dysrhythmia 129. At Mayo Clinic when sinus arrest continues for 5 seconds or more it is considered: A. Sinus bradycardia B. Sinus dysrhythmia C. Code Blue Medical Emergency D. Normal sinus rhythm - CORRECT ANSWER C. Code Blue Medical Emergency 130. Which of the following patients is probably NOT showing signs of decreased cardiac output? A. Ms. Steever, a 68-year-old female with very pale, cool skin. B. Mr. Chapman, a 58-year-old male who states he feels like he has a belt wrapped around his chest. C. Mr. Hughes, a 42-year-old male who is having difficulty answering your questions and does not know the date or time. D. Mr. Amos, a 78-year-old male who has needed assistance to the bathroom 4 times in the last two hours. - CORRECT ANSWER D. Mr. Amos, a 78-year-old male who has needed assistance to the bathroom 4 times in the last two hours. 131. On the ECG tracing, the place at which the depolarization is complete, and repolarization starts is known as the: A. QRS complex B. P wave C. J point D. PR interval - CORRECT ANSWER C. J point 132. When you evaluate the rhythm of an ECG tracing, which BEST describes what you are doing? A. Calculating the heart rate for the atria and the ventricles based on whether they are regular or irregular. B. Determining the regularity by measuring the P-P and R-R intervals in a 10-second strip. C. Analyzing the P-wave configuration by answering questions related to the size, shape, and location of the QRS complex. D. Placing on point of the calipers on the beginning of the WRS complex and the other on the J point. - CORRECT ANSWER B. Determining the regularity by measuring the P-P and R-R intervals in a 10-second strip. 133. When evaluating the QRS measurement of an ECG tracing, which of the following questions does NOT need to be answered? A. Does each P wave have a QRS complex following it? B. Are the QRS complexes of equal length? C. What is the actual measurement, and is it within the normal limits? D. Do all QRS complexes look alike, and are any unusual QRS complexes associated with an ectopic beat? - CORRECT ANSWER A. Does each P wave have a QRS complex following it? 134. Sinus tachycardia may be a normal finding in people as a result of: A. Exercise B. Sleeping C. Myocardial infarction D. Hypertension - CORRECT ANSWER A. Exercise 135. What method would you use to determine the heart rate for the ECG tracing below? - Irregular rhythm A. Multiply times 10 the number of P waves or QRS complexes in a 6-second strip. B. Count the number of small boxes between two P waves or two R waves and divide by 1500. C. Measure from the beginning of the P wave to the beginning of the QRS complex. D. Measure the distance between two P waves or two R waves. - CORRECT ANSWER A. Multiply times 10 the number of P waves or QRS complexes in a 6-second strip. 136. Mr. Samson is alert and oriented, has no chest pain, and his blood pressure is stable. What is he showing signs of? A. Decreased cardiac output B. Ventricular tachycardia C. Premature atrial contractions D. Adequate cardiac output - CORRECT ANSWER D. Adequate cardiac output 137. In which condition do the P-P and R-R intervals progressively widen then narrow, following the patient's breathing pattern? A. Sinus tachycardia B. Sinus dysrhythmia C. Sinus braycardia D. Normal sinus rhythm - CORRECT ANSWER B. Sinus dysrhythmia 138. What is a common symptom of low cardiac output? A. High blood pressure B. Alert and oriented C. Increased perfusion of vital organs D. Low blood pressure - CORRECT ANSWER D. Low blood pressure 139. What should you do if a patient complains of dizziness or palpitations and the patient's heart rate is below 50 bpm? A. Notify the physician or licensed practitioner B. Take care of the patient in the next room C. Lay the patient down and offer a glass of water D. Give the patient cardiac medications - CORRECT ANSWER A. Notify the physician or licensed practitioner 140. Which of the following is NOT a component of an ECG rhythm strip? A. Rhythm and rate B. P wave configuration and PR interval C. Sinus interval and configuration D. QRS duration and configuration - CORRECT ANSWER C. Sinus interval and configuration 141. What is the normal range for the PR interval, and why is measuring it a necessary step during an ECG evaluation? A. Range 0.10-0.20 second; to determine if the electrical current is being delayed or initiated from a location other than the SA node. B. Range 0.12-0.20 second; to determine if the electrical current is being delayed or initiated from a location other than the SA node. C. Range 0.12-0.20 second; to determine the coordination between the atrial and ventricular contractions. D. Range 0.12-0.20 second; to determine the time it takes for the ventricles to depolarize or contract. - CORRECT ANSWER B. Range 0.12-0.20 second; to determine if the electrical current is being delayed or initiated from a location other than the SA node. 142. A nursing home calls a cardiology office requesting that a trans telephonic pacemaker check be conducted on a new admission to the facility. The technician finds no medical record indicating that the patient has been followed by the practice. What is the technician's next step? A. Schedule a cardiology consultation B. Perform trans telephonic pacemaker check C. Ask the nursing home staff to arrange for transportation to the office D. Contact the primary care physician's office to obtain a prescription for trans telephonic monitoring - CORRECT ANSWER D. Contact the primary care physician's office to obtain a prescription for trans telephonic monitoring 143. When is it appropriate to contact a patient's family member? A. Never B. Only if the patient is non-compliant C. Only if the physician gives permission D. Only if the patient has signed a HIPAA form giving permission - CORRECT ANSWER D. Only if the patient has signed a HIPAA form giving permission 144. In addition to a patient's name, all of the following can be used in the patient identification process EXCEPT the patient's... A. Room number B. Account number C. Last four digits of SSN D. Medical record number - CORRECT ANSWER A. Room number 145. In the absence of a release form, a patient's health information may be shared with the patient's ______ without committing a HIPAA violation. A. Child B. Spouse C. Physician D. Verbally reported power of attorney - CORRECT ANSWER C. Physician 146. What should be done when a patient reports that their demographic information is incorrect? A. Request written documentation B. Cross out the incorrect information C. Call the referring doctor's office to request another enrollment form D. follow the organizational procedure and correct the error immediately - CORRECT ANSWER D. follow the organizational procedure and correct the error immediately 147. What is the benefit to the clinician from explaining planned services or pending procedures clearly to patients? A. Better results B. No legal action C. Fewer complications D. Increased patient compliance - CORRECT ANSWER D. Increased patient compliance 148. Ensuring that the electrocardiograph is properly grounded reduces the risk of: A. Electrical shock B. Paper speed acceleration C. Faulty interpretation of results D. 60-cycle electrical interference - CORRECT ANSWER D. 60-cycle electrical interference 149. Eliminated - CORRECT ANSWER Eliminated 150. A technician has been ordered to obtain an ECG from an unconscious patient. The technician should: A. Ask family members to identify the patient B. Explain procedure to the family in the room C. Inform the family that the ECG will not be performed D. Perform the ECG quietly so as to not disturb the patient - CORRECT ANSWER B. Explain procedure to the family in the room 151. An in-hospital telemetry technician arrives for their shift and notices that the report for the prior shift has not been completed. The telemetry technician should: A. Notify the ordering physician of the situation B. Note in the patient's record that no charting had been performed in the prior shift C. Notify the supervisor or senior technician of the situation to seek advice on how to proceed. D. Complete the record utilizing currently observed findings but utilizing the time and date from the prior shift - CORRECT ANSWER C. Notify the supervisor or senior technician of the situation to seek advice on how to proceed. 152. A patient with a trans telephonic monitor suddenly begins slurring his words and complaining that he has a tingling in his left arm. What is the MOST appropriate action? A. Activate EMS B. Drive to the hospital C. Call the referring doctor D. Call the TTM call center - CORRECT ANSWER A. Activate EMS 153. A patient with an event monitor calls the service to submit his recordings. What is the BEST approach for recording the patient's symptoms? A. Use the patient's verbiage B. Translate to medical terminology C. Use the diagnosis provided by the patient's physician D. Suggest likely symptoms associated with his recording - CORRECT ANSWER A. Use the patient's verbiage 154. A primary care physician's office calls the cardiology office. For a diagnosis of syncope, she orders a 48-hour Holter monitor to be placed on a patient new to the cardiology office. The cardiology office is unable to contact the patient by phone within the following 24 hours to schedule the patient's testing. What is the next step when arranging for this patient's care? A. Call the primary physician's office to verify contact information B. Keep trying to contact the patient by phone for at least a week C. Send a registered letter to the patient with an appointment included D. Mail a letter to the primary physician's office with an appointment for the patient - CORRECT ANSWER A. Call the primary physician's office to verify contact information 155. A testing facility is ordered to send a mobile cardiovascular telemetry monitor to a patient. The testing facility notifies the cardiology office that the patient's primary insurance does not cover this type of service. The original order came from the patient's primary care physician for palpitations. An appropriate next step should be: A. Call the patient and advice them that their insurance will not cover the test B. Place a 30-day patient activated event monitor that is covered by the patient's insurance C. Call the patient to determine whether they have experienced any worse symptoms than palpitations that may qualify them for the testing ordered D. Contact the primary care physician's office and explain the issue regarding coverage, offering a different type of monitor that would be covered by the patient's insurance - CORRECT ANSWER D. Contact the primary care physician's office and explain the issue regarding coverage, offering a different type of monitor that would be covered by the patient's insurance 156. The trans telephonic technicians responsible for checking pacemakers in a cariology office notes that a particular demographic area of their patient population has more problems with unpredictable disconnections during transmissions than other locations. What is the MOST APPROPRIATE next step for the technician to take? A. Create a list of patients who have had a problem with disconnections B. Schedule the patients to come into the office with their monitors for the next pacemaker evaluation C. Contact their supervisor about discussing the issue with the department responsible for telephone services D. Ask the patients experiencing disconnections which long distance provider they are using and document it - CORRECT ANSWER C. Contact their supervisor about discussing the issue with the department responsible for telephone services 157. The MOST effective ECG analysis requires following which sequence of steps? A. Rate, P wave, PR interval, QRS complex, and regularity B. P wave, PR interval, QRS complex, regularity, and rate C. PR interval, P wave, regularity, rate, and QRS complex D. Regularity, rate, P wave, PR interval, and QRS complex - CORRECT ANSWER D. Regularity, rate, P wave, PR interval, and QRS complex 158. Measure the PR interval- 6 small squares A. 0.24 seconds B. 0.28 seconds C. 0.30 seconds D. 0.14 seconds - CORRECT ANSWER A. 0.24 seconds 159. The first negative deflection notes in the QRS complex is which wave? A. Q wave B. S wave C. R wave D. T wave - CORRECT ANSWER A. Q wave 160. On a standard ECG graph paper, a deflection of the tracing upward or downward by one large box (outlined by thick dark lines) from the baseline represents: A. 0.25 millivolt B. 0.5 millivolt C. 1.0 millivolt D. 1.0 volt - CORRECT ANSWER B. 0.5 millivolt 161. An ECG caliper measurement of peak to peak flutter waves reveals five small boxes. What is the atrial rate for this rhythm? A. 60 bpm B. 120 bpm C. 150 bpm D. 300 bpm - CORRECT ANSWER D. 300 bpm 162. Which of these is a method that can be used to calculate the ventricular rate of a cardiac rhythm when the R-R is regular? A. Add the number of large boxes between 2 R waves to 300 B. Subtract the number of large boxes between 2 R waves from 300 C. Multiply the number of large boxes between 2 R waves by 300 D. Divide the number of large boxes between 2 R waves into 300 - CORRECT ANSWER D. Divide the number of large boxes between 2 R waves into 300 163. What are the atrial and ventricular rates on this rhythm strip? - 23 small boxes between R-R, 7 small boxes between P-P A. 300 V/ 80 A B. 150 V/ 40 A C. 280 A/ 70 V D. 300 V/ 90 A - CORRECT ANSWER C. 280 A/ 70 V 164. Which of the following rhythms may be characterized by regular P-P and regular R-R intervals occurring at different rates? A. Wenchebach B. Atrial fibrillation C. Complete heart block D. First degree heart back - CORRECT ANSWER C. Complete heart block 165. What is the ventricular rate for this rhythm strip? - 38 small boxes between R-R A. 30 bpm B. 40 bpm C. 60 bpm D. 80 bpm - CORRECT ANSWER B. 40 bpm 166. The relationship between the conducted P waves and the QRS complexes in a sinus arrhythmia will: A. Not be discernable B. Be one P wave per QRS complex C. Display varying conduction patterns D. Display a distinct ratio greater than one P wave per QRS - CORRECT ANSWER B. Be one P wave per QRS complex 167. Which cardiac chamber contains MOST of the muscle mass of the heart? A. Left atrium B. Right atrium C. Left ventricle D. Right ventricle - CORRECT ANSWER C. Left ventricle 168. The conduction system terminated with the: A. Bundle of HIS B. Sinoatrial node C. Purkinje fibers D. Atrioventricular junction - CORRECT ANSWER C. Purkinje fibers 169. The P wave on the electrocardiograph represents an electrical impulse that spread through the: A. Atria B. Ventricles C. Bundle of HIS D. Purkinje fibers - CORRECT ANSWER A. Atria 170. To get an accurate measurement of the QRS complex, measure from: A. The beginning of the Q wave to the end of the S wave B. The middle of the Q wave to the middle of the S wave C. The end of the Q wave to the end of the S wave D. Before the Q wave to after the end of the S wave - CORRECT ANSWER A. The beginning of the Q wave to the end of the S wave 171. Which waveform represents ventricular repolarization on an ECG strip? A. P wave B. R wave C. S wave D. T wave - CORRECT ANSWER D. T wave 172. ECG preliminary findings are MOST frequently recorded by the: A. Nurse B. Physician C. Supervisor D. Technician - CORRECT ANSWER D. Technician 173. An 84-year-old man is wearing a mobile cardiovascular telemetry monitor with cellular real-time transmission capabilities for near syncope. The patient's wife calls the monitor testing facility and asks what the patient's rhythm shows. The monitor tech notes normal sinus rhythm at 74 bpm. The spouse then tells that technician that her husband just passed out at home and is breathing but unresponsive. Which action is the MOST appropriate next step for the monitor technician? A. Inquire about what medications he takes B. Direct the wife to shake her husband gently C. Activate the EMS, reassure the wife that help is on the way D. Ask the wife whether the monitor is connected appropriately - CORRECT ANSWER C. Activate the EMS, reassure the wife that help is on the way 174. ______ is one way to troubleshoot 60-cycle ECG interference. A. Having the patient hyperventilate B. Adjusting the standardization mark C. Cleaning the skin with isopropyl alcohol D. Moving the ECG plug to a different outlet - CORRECT ANSWER D. Moving the ECG plug to a different outlet 175. The normal gain setting for EKG acquisition is: A. 5 mm/mV B. 10 mm/mV C. 15 mm/mV D. 20 mm/mV - CORRECT ANSWER B. 10 mm/mV 176. In lead II, what would indicate lead reversal? A. ST elevation B. An upright T-wave C. An inverted QRS complex D. a prolonged QRS complex - CORRECT ANSWER C. An inverted QRS complex 177. While conducting a routine trans telephonic pacemaker check, the patient states he is short of breath and atrial fibrillation is noted in the presenting rhythm strip. The technician's next step should be to: A. Put the patient on hold and call his cardiologist B. Put the patient on hold and call the pacemaker nurse C. Finish up with the patient and move on to the next patient D. Compare test results with past tests while the patient is on the phone - CORRECT ANSWER D. Compare test results with past tests while the patient is on the phone 178. Patients with atrial fibrillation are at risk for: A. Embolism B. Hypertension C. Increased cardiac output D. Peripheral artery disease - CORRECT ANSWER A. Embolism 179. What is a key component when contesting a denial of insurance payment for a specific date of service provided? A. The patient's photo ID B. The patient's testing report C. The patient's past billing record D. The patient's opinion on the matter - CORRECT ANSWER B. The patient's testing report 180. If a dual chamber pacemaker's ventricular lead senses a non-cardiac signal what is MOST LIKELY to occur? A. Atrial under sensing B. Failure to capture ventricle C. Inappropriate atrial pacing D. Failure to capture ventricular pace - CORRECT ANSWER D. Failure to capture ventricular pace 181. A Parkinson tremor will typically manifest itself on an ECG tracing as: A. A flat line B. An erratic baseline C. Uniform small spikes D. A wandering baseline - CORRECT ANSWER B. An erratic baseline 182. On an ECG machine, what sweep speed should the recorder be set at for 1 mm to equal 400 milliseconds? A. 25 mm/per second B. 50 mm/per second C. 100 mm/per second D. 200 mm/per second - CORRECT ANSWER A. 25 mm/per second 183. A technician receives an ECG recording that displays no discernable cardiac information. Which action should be the first step in troubleshooting the problem? A. Check leads B. Replace batteries C. Order replacement monitor D. Document time of recording - CORRECT ANSWER A. Check leads 184. The hospital telemetry cardiac monitor technician notes a significant amount of wandering baseline on a newly admitted patient's ECG tracing. Which of the following is the MOST LIKELY cause of the wandering baseline? A. ECG calibration B. Chills due to fever C. Lead wire reversal D. Electrode placement - CORRECT ANSWER D. Electrode placement 185. Which valves prevent the backflow of blood from the aorta and pulmonary arteries into the ventricles during diastole? A. Sinoatrial B. Semilunar C. Eustachian D. Atrioventricular - CORRECT ANSWER B. Semilunar 186. In a normal sinus rhythm, the sinus node fires at a rate of: A. 40-60 per minute B. 61-100 per minute C. 101-150 per minute D. 151-180 per minute - CORRECT ANSWER B. 61-100 per minute 187. The main cause of sinus arrhythmia in adults is: A. Respiration B. hypokalemia C. Ectopic beats D. Caffeine intake - CORRECT ANSWER A. Respiration 188. What rhythm is shown on this strip? - Reg, 1 P per 1 QRS, 38 small boxes between R-R A. Sinus rhythm B. Atrial fibrillation C. Sinus bradycardia D. Multifocal atrial rhythm - CORRECT ANSWER C. Sinus bradycardia 189. What rhythm is shown on this strip? - Irregular, 1 P per 1 QRS, normal PRI and QRS A. Junctional rhythm B. Sinus arrhythmia C. First degree AV block D. Wandering atrial pacemaker - CORRECT ANSWER B. Sinus arrhythmia 190. What is the rhythm shown on this strip? - Flat line A. Asystole B. Atrial fibrillation C. AV dissociation D. Ventricular fibrillation - CORRECT ANSWER A. Asystole 191. Another name for second degree AV block type I is: A. Thorell B. Einthoven C. Bachmann D. Wenckebach - CORRECT ANSWER D. Wenckebach Or Mobitz I 192. What rhythm is shown on this strip? - Irregular, multipe P waves per QRS, but PRI is consistent A. Complete heart block B. First degree AV delay C. Second degree AV block, Mobitz type I D. Second degree AV block, Mobitz type II - CORRECT ANSWER D. Second degree AV block, Mobitz type II 193. A characteristic of a third-degree AV block is: A. An aberrant pathway in the left atrium B. An aberrant neuro pathway in the right atrium C. The automaticity of the ventricle exceeding that of the atria D. The conduction of the atrial impulse failing to reach the ventricle - CORRECT ANSWER D. The conduction of the atrial impulse failing to reach the ventricle 194. What rhythm is shown on this strip? - Regular, sawtooth A. Atrial flutter B. Atrial fibrillation C. Sinus arrhythmia D. Idiopathic rhythm - CORRECT ANSWER A. Atrial flutter 195. Which of the following ECG characteristics distinguishes atrial flutter from other atrial dysrhythmias: A. The presence of fibrillatory waves B. The presence of delta waves before QRS C. The "saw tooth" or "picket fence" appearance of waveforms before the QRS D. P waves of varying sizes and amplitude - CORRECT ANSWER C. The "saw tooth" or "picket fence" appearance of waveforms before the QRS 196. The PR interval of a first degree heart block: A. Constant and greater than 0.20 seconds in duration B. Is completely variable in duration C. Gradually decreases in duration until a P wave appears without a QRS complex D. Gradually lengthens until a P wave appears without a QRS complex - CORRECT ANSWER A. Constant and greater than 0.20 seconds in duration 197. The ECG characteristics in Myocardial Ischemia includes: A. Changes in the ST segment and T waves B. Widening of the QRS complex C. Changes in the QRS complex and ST segment D. Prolongation of the PR interval - CORRECT ANSWER A. Changes in the ST segment and T waves 198. A 70 year old patient has a history of off/on chest pain. His resting ECG is normal. It is decided to put him through an exercise stress test. Which of the following will be the target heart rate? A. 180 bpm B. 150 bpm C. 220 bpm D. 160 bpm - CORRECT ANSWER B. 150 bpm 199. Which of the following is an indication for stress testing? A. Acute MI B. Severe hypertension C. Angina at rest D. Evaluation of chest pain in a patient with a normal baseline EKG - CORRECT ANSWER D. Evaluation of chest pain in a patient with a normal baseline EKG 200. How many electrodes are used with a Holter monitor? A. 10 B. 6 C. 11 D. 5 - CORRECT ANSWER D. 5 201. Which of the following is considered a negative Holter? A. Pauses B. Bradycardias and tachcardias C. No significant arrhythmias or ST changes D. ST elevation or depression - CORRECT ANSWER C. No significant arrhythmias or ST changes 202: Skip - CORRECT ANSWER Skip 203. The drug which is given to relieve pain and anxiety in MI patients? A. Digoxin B. Beta blockers C. Morphine D. Lidocaine - CORRECT ANSWER C. Morphine 204. The most common side effect when the patient takes Nitroglycerin to relieve angina? A. Drowsiness B. Bronchospasm C. Headache D. Mental disorientation - CORRECT ANSWER C. Headache 205. Drug used in Pharmacologic stress tests are? A. Adensonine B. Dypyramidole C. Dobutamine D. All of the above - CORRECT ANSWER A. Adensonine 206. The hallmark characteristics seen in ventricular fibrillation? A. Fibrillation waves B. Saw tooth waves C. Chaotic waves D. Tooth waves - CORRECT ANSWER C. Chaotic waves 207. What is the correct order of the chain of infection? A. Means of transmission, susceptible host, source B. Source, means of transmission, susceptible host C. Susceptible host, means of transmission, source D. All of the above - CORRECT ANSWER B. Source, means of transmission, susceptible host 208. Which of these wouldn't be a cause or reason to stop the exercise electrocardiography? A. Patient is complaining of shortness of breath B. Patient's heart rate is considered normal C. Physician observes blood pressure, EKG or heart rhythm changes that are not perceived by the patient D. The patient reaches the target heart rate - CORRECT ANSWER B. Patient's heart rate is considered normal 209. Small or non-existent Diastole pause is seen in: A. Sinus rhythm B. Sinus bradycardia C. Sinus tachycardia D. Sinus arrest - CORRECT ANSWER B. Sinus bradycardia 210. A PVC that occurs during the relative refractory period is referred to: A. Bigeminy B. A couplet C. Bundle branch block D. R-on-T phenomenon - CORRECT ANSWER D. R-on-T phenomenon 211. Which of the following BEST describes idioventricular rhythm? A. Heart rate 40-60 bpm, irregular, no P waves, preceding a wide QRS B. Heart rate 20-40 bpm, irregular, no P waves, preceding a narrow QRS C. Heart rate 20-40 bpm, almost always regular, no P waves, preceding a wide QRS D. Heart rate 40-60 bpm, almost always regular, no P waves, preceding a narrow QRS - CORRECT ANSWER C. Heart rate 20-40 bpm, almost always regular, no P waves, preceding a wide QRS 212. The following rhythm strip represents what? - No p waves or QRS complexes, completely chaotic and random A. Atrial fibrillation B. Supraventricular tachycardia C. Ventricular fibrillation D. Ventricular tachycardia - CORRECT ANSWER C. Ventricular fibrillation 213. A regular rhythm with a narrow QRS complex and no noted P waves with a rate between 40-60 bpm is known as: A. Junctional escape B. Accelerated junctional C. Idioventricular escape D. Premature ventricular contraction - CORRECT ANSWER A. Junctional escape 214. Which of these rates could be considered a junctional tachycardia? A. 40 bpm B. 60 bpm C. 90 bpm D. 130 bpm - CORRECT ANSWER D. 130 bpm 215. Atrial flutter is best described as a rapid atrial depolarization of: A. Multiple foci B. A re-entering foci C. A sinus node foci D. A single ectopic beat - CORRECT ANSWER B. A re-entering foci 216. Atrial fibrillation with a slow ventricular response has a (n): A. Atrial rate less than 60 bpm B. Ventricular rate less than 60 bpm C. Ventricular rate greater than 60 bpm D. Junctional rate greater than 60 bpm - CORRECT ANSWER B. Ventricular rate less than 60 bpm 217. The following rhythm strip represents what? - Irregular, fast, chaotic A. Multifocal atrial tachycardia B. Supraventricular tachycardia C. Atrial fibrillation with rapid ventricular response D. Atrial flutter with a variable ventricular response - CORRECT ANSWER C. Atrial fibrillation with rapid ventricular response 218. Atrial tachycardia is best described as a rapid arrhythmia which: A. Is irregular and is paroxysmal B. Is regular and occurs in bursts or may be sustained C. Causes a ratio of conduction to the ventricles D. Is associated with poor atrioventricular conduction - CORRECT ANSWER B. Is regular and occurs in bursts or may be sustained 219. A regular rhythm with a rate of 158 bpm and a narrow QRS complex is best described as: A. Ventricular tachycardia B. Supraventricular tachycardia C. Paroxysmal atrial tachycardia D. Atrial fibrillation with a rapid ventricular response - CORRECT ANSWER B. Supraventricular tachycardia 220. Which rhythm is characterized by P waves that have a variety of shapes? A. Atrial flutter B. Atrial fibrillation C. Sinus arrhythmia D. Wandering atrial pacemaker - CORRECT ANSWER D. Wandering atrial pacemaker 221. During sinus rhythm, an early narrow complex beat without a P wave preceding it would be as a: A. First degree AV block B. Premature atrial contraction C. Premature junctional contraction D. Premature ventricular contraction - CORRECT ANSWER C. Premature junctional contraction 222. First degree AV block is determined by the measurement of the: A. PR interval B. QT interval C. ST segment D. QRS segment - CORRECT ANSWER A. PR interval 223. What occurs when a ventricular pacemaker senses electrical current from sources other than the heart? A. Oversensing B. Failure to capture C. Pacemaker turns off D. Increasing pacing rate - CORRECT ANSWER A. Oversensing 224. Supraventricular tachycardia is a : A. Wide complex tachycardia greater than 150 bpm B. Narrow complex tachycardia great than 150 bpm C. Grossly irregular wide complex tachycardia greater than 150 bpm D. Grossly irregular narrow complex tachycardia greater than 150 bpm - CORRECT ANSWER B. Narrow complex tachycardia great than 150 bpm 225. Atrial fibrillation is BEST described as: A. Chaotic, asynchronous electrical activity in the atrial tissue B. Chaotic, asynchronous multiple premature atrial contractions C. Retrograde, synchronous electrical activity originating from a single atrial focus D. Retrograde, asynchronous electrical activity originating from the sino-atrial node - CORRECT ANSWER A. Chaotic, asynchronous electrical activity in the atrial tissue 226. Which pacemaker complication shows a pacing spike, but no waveform immediately following it? A. Malfunctioning B. Malsensing C. Oversensing D. Loss of capture - CORRECT ANSWER D. Loss of capture 227. When the QRS complex measures ______, a bundle branch block must be considered. A. 0.06 to 0.10 seconds B. 0.04 to 0.08 seconds C. Less than 0.06 seconds D. 0.12 seconds or greater - CORRECT ANSWER D. 0.12 seconds or greater 228. Which of the following best describes a lack of ventricular spike and normal QRS complex on an ECG tracing of a patient with an AV sequential pacemaker? A. The pacemaker is not sensing the patient's inherent heart rate B. The pacemaker has sensed an electrical current from outside of the heart C. The patient's own conduction system "kicked in" and inhibited the pacemaker D. The myocardium has not depolarized - CORRECT ANSWER C. The patient's own conduction system "kicked in" and inhibited the pacemaker 229. If a patient is experiencing hypotension, lightheadedness, blackouts, and bradycardia, what pacemaker complication may be occurring? A. Malfunctioning (failure to pace) B. Malsensing (failure to sense) C. Loss of capture D. Oversensing - CORRECT ANSWER A. Malfunctioning (failure to pace) 230. What additional patient information is needed on the ECG tracing when a bundle branch block is discovered? A. Patient symptoms B. Blood pressure reading C. Patient's underlying rhythm D. Patient's cardiac history - CORRECT ANSWER C. Patient's underlying rhythm 231. If the electronic pacemaker is set to 72 bpm and the AV node is firing at 58 bpm, what is the patient's heart rate? A. 58 bpm B. 72 bpm C. 65 bpm D. 0 bpm - CORRECT ANSWER A. 58 bpm 232. If the dysrhythmia is one that originates from above the ventricles and you notice a wide QRS complex, which rhythm could this be? A. Supraventricular tachycardia B. Third degree AV block rhythm C. Bundle branch block D. Atrial fibrillation - CORRECT ANSWER C. Bundle branch block 233. Which term indicates the stimulation of electrical current from the pacemaker generator? A. Triggered B. Packing spike C. Atrial capture D. Over-sense - CORRECT ANSWER B. Packing spike 234. Which of the following in NOT one of the components to be evaluated on a pacemaker tracing? A. The presence of atrial and/or ventricular spikes B. The chamber depolarization characteristics C. The QT interval D. The AV delay - CORRECT ANSWER C. The QT interval 235. What is the advantage of atrioventricular pacing? A. It delivers direct stimulation to the ventricles to produce a ventricular contraction B. Both ventricles are stimulated to contract, compared to only the lower portion of the right ventricle being stimulated C. It mimics the normal cardiac conduction system and allows for the atria to contract completely prior to the ventricles to allow for an atrial kick D. The conduction system from the AV node through the ventricles is intact and functioning - CORRECT ANSWER C. It mimics the normal cardiac conduction system and allows for the atria to contract completely prior to the ventricles to allow for an atrial kick 236. What happens when one or both of the ventricular pathways are not functioning properly due to damage or a delay from cardiac disease, drugs, or other conditions? A. A bundle branch block occurs B. The patient experiences PVC's C. A second-degree heart block, type I occurs D. An idioventricular rhythm occurs - CORRECT ANSWER A. A bundle branch block occurs 237. When is an atrial pacemaker used alone? A. When conduction in the ventricles is not working properly B. When the conduction system from the AV node through the ventricles are intact and functioning C. When the atria need to contract completely prior to the ventricles to allow for atrial kick D. When both ventricles are stimulated to contract - CORRECT ANSWER B. When the conduction system from the AV node through the ventricles are intact and functioning 238. When is a ventricular pacemaker used? A. When conduction in the ventricles is not working properly B. When the conduction system from the AV node through the ventricles is intact and functioning C. When the atria need to contract prior to the ventricles to allow for an atrial kick D. When both ventricles are stimulated to contract - CORRECT ANSWER A. When conduction in the ventricles is not working properly 239. How is a right bundle branch block (RBBB) distinguished from a left bundle branch block (LBBB)? A. Lead V1 is referenced, and if the QRS is positively deflected it is a LBBB and if the QRS is negative, it is a RBBB B. Lead V1 is referenced, and if the QRS is positively deflected it is a RBBB, and if the QRS is negative, it is a LBBB C. Monitor leads I, II, and III and observe the P wave configuration D. Monitor leads V1 and V6 and measure the PR interval - CORRECT ANSWER B. Lead V1 is referenced, and if the QRS is positively deflected it is a RBBB, and if the QRS is negative, it is a LBBB 240. What happens when the pacemaker does not send electrical impulses to the myocardium? A. Malsensing (failure to sense) B. Loss of capture (failure to capture) C. Malfunctioning (failure to pace) D. Over-sensing - CORRECT ANSWER C. Malfunctioning (failure to pace) 241. Which pacemaker rhythm has a pacing spike before P waves? A. Atrial pacemaker rhythm B. Ventricular pacemaker rhythm C. Atrioventricular pacemaker rhythm D. Atriobiventricular pacemaker rhythm - CORRECT ANSWER A. Atrial pacemaker rhythm 242. What term refers to the ability of the heart muscle to respond to electrical stimulation and depolarize the myocardial tissue? A. Atrial kick B. Atrioventricular delay C. Complexes D. Capture - CORRECT ANSWER D. Capture 243. What portion of the heart do electronic pacemaker mimic? A. AV node B. SA node C. Purkinje fibers D. Bundle of HIS - CORRECT ANSWER B. SA node 244. Which pacemaker rhythm has a pacing spike before the QRS complex? A. Atrial pacemaker rhythm B. Ventricular pacemaker C. Atrioventricular pacemaker D. Atriobiventricular pacemaker - CORRECT ANSWER B. Ventricular pacemaker 245. Ventricular fibrillation is typically described as: A. Regular B. Absent C. Chaotic D. Wide and bizarre - CORRECT ANSWER C. Chaotic 246. Why does it take longer than normal to depolarize the ventricles during a ventricular dysrhythmia? A. Because the current is initiated within the Purkinje fibers, and the electrical stimulation occurs from the ventricular cell-to-cell conduction B. Because one or both of the ventricular pathways are damaged or delayed C. Because all the electrical impulses originating about the ventricles are blocked D. Because electrical conduction from the SA node to the AV node is delayed - CORRECT ANSWER A. Because the current is initiated within the Purkinje fibers, and the electrical stimulation occurs from the ventricular cell-to-cell conduction 247. What symptoms might a patient experience with PVC's? A. Hypertension, chest pain B. Edema, headache C. Dizziness, "thumping or skipping" sensation D. Frequent urination, paranoia - CORRECT ANSWER C. Dizziness, "thumping or skipping" sensation 248. What are PVC's that occur in varied shapes and forms called? A. Unifocal B. R on T PVCs C. Quadgeminy D. Multifocal - CORRECT ANSWER D. Multifocal 249. What is the condition in which impulses over the vagus nerve cause a decrease in heart rate? A. Ischemia B. Vagal tone C. Cardiac output D. Syncope - CORRECT ANSWER B. Vagal tone While a patient was wearing a 24-hour monitoring device, there was a period of time when the patient had passed out and was in the company of their spouse who had HIPAA clearance. When reviewing the patient diary it is noted that the details are very limited during that period of time. What would be the BEST next step when compiling the results of the monitor? A. Alter the verbiage of the patient diary entries B. Limit the information to only the details that are listed on the diary C. Request that a replacement monitor be worn and educate patient on keeping diary D. Contact the patient/spouse and review the information listed and try to get more details - CORRECT ANSWER D. Contact the patient/spouse and review the information listed and try to get more details What is the atrial rate on the rhythm strip in the image provided? - Regular- 5 complete cycles A. 50 B. 60 C. 70 D. 80 - CORRECT ANSWER A. 50 ECG preliminary findings are MOST frequently recorded by the... A. Nurse B. Physician C. Technician D. Supervisor - CORRECT ANSWER C. Technician A Parkinsonian tremor will typically manifest itself on an ECG tracing as... A. A flat line B. An erratic baseline C. Uniform small spikes D. A wandering baseline - CORRECT ANSWER B. An erratic baseline A regular rhythm with a narrow QRS complex with no noted P waves and rate between 40-60 bpm is known as... A. Junctional escape rhythm B. Accelerated junctional rhythm C. Idioventricular escape rhythm D. Premature ventricular contraction - CORRECT ANSWER A. Junctional escape rhythm The lead II ECG rhythm strip in the image provided demonstrates... - Irregular, no distinguishable P waves. A. Atrial fibrillation B. Sinus arrhythmia C. Junctional rhythm D. First degree AV block - CORRECT ANSWER A. Atrial fibrillation Which valves prevent the backflow of blood from the aorta and pulmonary arteries into the ventricles during diastole? A. Semilunar B. Sinoatrial C. Eustachian D. Atrioventricular - CORRECT ANSWER A. Semilunar The first negative deflection noted in the QRS complex is which wave? A. Q wave B. R wave C. S wave D. T wave - CORRECT ANSWER A. Q wave Which of the following is demonstrated in the rhythm strip provided? - Irregular, every 3rd beat is early, wide, and bizarre. A. PVC triplets B. Bifocal PVCs C. PVC couplets D. Trigeminy PVCs - CORRECT ANSWER D. Trigeminy PVCs While conducting a routine transtelephonic pacemaker check, the patient states he is short of breath, and atrial fibrillation is noted in the presenting rhythm strip. The technician's next step should be to... A. Put the patient on hold and call his cardiologist B. Put the patient on hold and call the pacemaker nurse C. Finish up with the patient and move on to the next patient D. Compare test results with past tests while the patient is on the phone - CORRECT ANSWER D. Compare test results with past tests while the patient is on the phone A regular rhythm with a rate of 158 bpm and with a narrow QRS complex is BEST described as... A. Ventricular tachycardia B. Supraventricular tachycardia C. Paroxysmal atrial tachycardia D. Atrial fibrillation with a rapid ventricular response - CORRECT ANSWER B. Supraventricular tachycardia The main cause of sinus arrhythmia in adults is... A. Respiration B. Hypokalemia C. Ectopic beats D. Caffeine intake - CORRECT ANSWER A. Respiration What is the rhythm in the image provided? - Regular, 5 complete cycles A. Sinus rhythm B. Atrial fibrillation C. Sinus bradycardia D. Multiformed atrial rhythm - CORRECT ANSWER C. Sinus bradycardia The normal gain setting for ECG acquisition is _____ mm/mV. A. 5 B. 10 C. 15 D. 20 - CORRECT ANSWER B. 10 A patient with a transtelephonic monitor (TTM) suddenly begins slurring his words and complaining that he has tingling in his left arm. What is the MOST APPROPRIATE action? A. Activate EMS B. Drive to the hospital C. Call the referring doctor D. Call the TTM call center - CORRECT ANSWER A. Activate EMS In standard calibration ECG graph paper, a deflection of the tracing upward or downward by one large box (outlined by thick, dark lines) from baseline represents... A. 0.25 millivolt B. 0.5 millivolt C. 1.0 millivolt D. 1.0 volt - CORRECT ANSWER B. 0.5 millivolt Which of the following are types of artifact that need to be recognized during rhythm analysis? Choose four responses. A. Somatic tremor B. AC interference C. Junctional baseline D. Paced interference E. Wandering baseline F. Interrupted baseline - CORRECT ANSWER A. Somatic tremor B. AC interference E. Wandering baseline F. Interrupted baseline What is the BEST method for obtaining a good recording from a handheld, ambulatory, post event cardiac monitor? A. Press all four electrodes lightly slightly left of the sternum B. Press the upper two electrodes firmly in the center of the sternum C. Ensure all four electrodes are pressed firmly in the center of the sternum D. Ensure two of the four electrodes are pressed gently to the left of the sternum - CORRECT ANSWER C. Ensure all four electrodes are pressed firmly in the center of the sternum What cardiac rhythm is shown in this rhythm strip provided from a transtelephonic pacemaker check? - Regular, no distinguishable P waves, no pacing spikes A. Sinus rhythm B. Atrial fibrillation C. Paced atrial rhythm D. Paced ventricular rhythm - CORRECT ANSWER B. Atrial fibrillation Which cardiac chamber contains MOST of the muscle mass of the heart? A. Left atrium B. Right atrium C. Left ventricle D. Right ventricle - CORRECT ANSWER C. Left ventricle Atrial tachycardia is BEST described as a rapid arrhythmia which... A. Is irregular and occurs paroxysmally B. Causes a ratio of conduction to the ventricles C. Is regular and occurs paroxysmally, or sustained D. Is associated with poor atrioventricular conduction - CORRECT ANSWER C. Is regular and occurs paroxysmally, or sustained Which of the following rhythms may be characterized by regular P-P and regular R-R intervals occurring at different rates? A. Wenckebach B. Atrial fibrillation C. Complete heart block D. First degree heart block - CORRECT ANSWER C. Complete heart block What type of rhythm is indicated by the image provided? - Regular, P wave then a spike before the QRS complex. A. Paced atrial rhythm B. Pacemaker inhibition C. AV sequential paced rhythm D. P-wave synchronous, ventricular paced rhythm - CORRECT ANSWER D. P-wave synchronous, ventricular paced rhythm The relationship between the conducted P waves and the QRS complexes in a sinus arrhythmia is... A. Not discernable B. One P wave per QRS complex C. Displaying varying conduction patterns D. Display a distinct ratio greater than one P wave per QRS - CORRECT ANSWER B. One P wave per QRS complex What is the MOST COMMON paper speed used for a standard ECG? A. 12.5 mm/sec B. 25.0 mm/sec C. 50.0 mm/sec D. 100.0 mm/sec - CORRECT ANSWER B. 25.0 mm/sec Normal sinus rhythm ranges from... A. 40-80 bpm B. 60-100 bpm C. 80-120 bpm D. 100-140 - CORRECT ANSWER B. 60-100 bpm Which of the following essential tools are required to begin remote cardiac device monitoring? Choose four responses. A. Batteries B. Electrodes C. Rubber band D. Adhesive tape E. Cardiac device F. Education leaflet - CORRECT ANSWER A. Batteries B. Electrodes E. Cardiac device F. Education leaflet The atrial rate for the rhythm strip shown in the image provided is ____ per minute. - 22 small boxes between P waves. A. 50 B. 60 C. 70 D. 90 - CORRECT ANSWER C. 70 The BEST interpretation of the rhythm in the image provided is sinus rhythm with a _____. - Regular, with a single early beat. A. PAC B. PAV C. PJC D. PVC - CORRECT ANSWER A. PAC What are the BEST educational material formats to recommend to patients regarding their cardiac monitoring device? Choose two responses. A. Phone app B. WebMD website C. Youtube videos D. Manufacturer's website E. Educational booklet with the device - CORRECT ANSWER D. Manufacturer's website E. Educational booklet with the device A PVC that occurs during the relative refractory period is referred to as... A. Bigeminy B. A couplet C. Bundle branch block D. R-on-T phenomenon - CORRECT ANSWER D. R-on-T phenomenon Which of the ECG strips in the provided image demonstrate sinus arrest? - A. Irregular, dropped beat. B. Irregular, dropped beat. C. Regular with a long pause. D. Irregular with a dropped beat. - CORRECT ANSWER C. Regular with a long pause. The BEST interpretation of the rhythm in the image provided is sinus rhythm with a... - Regular with an early beat A. PAC B. PAV C. PJC D. PVC - CORRECT ANSWER A. PAC The dysrhythmia in the image provided is... - Irregular, no distinguishable P waves A. Atrial flutter B. Atrial fibrillation C. Ventricular flutter D. Ventricular fibrillation - CORRECT ANSWER B. Atrial fibrillation Which of the following BEST describes idioventricular rhythm? A. Heart rate 40-60 bpm, irregular, no P waves preceding a wide QRS B. Heart rate 20-40 bpm, irregular, no P waves preceding a narrow QRS C. Heart rate 20-40 bpm, almost always regular, no P waves preceding a wide QRS D. Heart rate 40-60 bpm, almost always regular, no P waves preceding a narrow QRS - CORRECT ANSWER C. Heart rate 20-40 bpm, almost always regular, no P waves preceding a wide QRS Patient education in self-monitoring includes which of the following? Choose three responses. A. When to disconnect the device B. Who to call in case of an emergency C. How to wear the device while driving D. What to do when the device emits an alert sound E. What type of symptoms to record during the monitoring period - CORRECT ANSWER B. Who to call in case of an emergency D. What to do when the device emits an alert sound E. What type of symptoms to record during the monitoring period Where should the ECG tracing be placed after it has been obtained? A. In patient's room B. With a family member C. Per facility guidelines and protocols D. On unit administrative professional's desk - CORRECT ANSWER C. Per facility guidelines and protocols The ECG rhythm shown in the image provided demonstrates... - Regular, P-P march A. Complete heart block B. Wenckebach C. First degree heart block D. Second degree AV block, mobitz type II - CORRECT ANSWER A. Complete heart block The lead II ECG rhythm strip in the image provided demonstrates... -Regular, long PRI A. Complete heart block B. First degree heart block C. Second degree AV block, Mobitz type I D. Second degree AV block, Mobitz type II - CORRECT ANSWER B. First degree heart block If a dual chamber pacemaker's ventricular lead senses a non-cardiac signal what is MOST LIKELY to occur? A. Atrial under sensing B. Failure to ventricular pace C. Failure to capture ventricle D. Inappropriate atrial pacing - CORRECT ANSWER B. Failure to ventricular pace