EKG Final Review

An EKG technician is entering a patient's history into the electronic health record. Which of the following statements by the patient should the technician enter into the social history section?

"I have smoked cigarettes for a long time."

A patient has a prescription to wear a Holter monitor for 24 hr. Which of the following statements by the patient indicates an understanding of home care instructions?

"I should record spontaneous symptoms unrelated to an activity."

Which of the following responses should an EKG technician make to a patient in an outpatient clinic who is upset that the technician cannot share the results of the tracing?

"I understand your frustration. My role as the technician is to conduct the test correctly. The provider is qualified to interpret the results."

Which of the following statements made by an EKG technician correctly prepares the patient for telemetry monitoring?

"I will clean your skin with an alcohol pad."

An EKG technician working at a central monitoring station notes that a patient has a rhythm of ventricular tachycardia. Which of the following actions should the technician take first?

Notify a licensed practitioner to evaluate the patient.

During an exercise stress test, the patient reports fatigue. The EKG technician observes the tracing below. Which of the following actions should the technician take?

Notify the provider.

An EKG technician is instructing a patient about the use of a transtelephonic monitor with loop memory. Which of the following instructions should the technician include?

"Press the record button on the device when you begin to feel dizzy or have chest pain."

Which of the following statements should an EKG technician include when preparing a patient for an upcoming exercise stress test?

"Refrain from caffiene, smoking, or alcohol for at least 3 hours prior to the test."

An EKG technician observes varying R-R intervals on an EKG for a 2-year-old patient. Which of the following statements made by the technician would be correct?

"The irregularity is normal and is a result of respiration."

An EKG technician is caring for a patient in a provider's clinic who asks why the technician performs a standard 12-lead EKG as part of the physical examination. Which of the following response should the technician make?

"The results can be used to determine if changes have occurred since your last EKG."

An EKG technician should recognize that a PR interval that spans four small boxes on the EKG paper has which of the following durations?

0.16 seconds

Which of the following is the duration of the QT interval in the tracing below?

0.52 seconds (The QT interval is measured from the beginning of the Q wave to the end of the T wave. In the tracing, the QT interval is 13 boxes and each box is 0.04 seconds in duration: 13 x 0.04 = 0.52 seconds.)

An EKG technician is obtaining a pulse rate for a 2-year-old patient. Which of the following pulse rates should the technician recognize as within the expected reference range for this patient?

120/min

An EKG technician is performing a standard 12-lead EKG for a patient who is experiencing accelerated junctional rhythm. Which of the following speed settings should the technician use?

25 mm/second

An EKG technician should recognize that which of the following is the most commonly used paper speed for an EKG?

25 mm/second

An EKG technician is preparing to perform a standard 12-lead EKG tracing on a patient who has a heart rate of 150/min. Which of the following speed controls should the technician select?

50 mm/second

An EKG technician notes periods of sinus arrest on a patient's EKG tracing. The technician should consider the sinus arrest to be a medical emergency when the arrest reaches which of the following durations?

6 seconds

Which of the following methods can be used to calculate both regular and irregular rhythms?

6-second method

Calculate the heart rate in the tracing below using the 1500 method.(22)

68/min

When performing a stress test, an EKG technician should recognize that the test can be stopped when the patient reaches what percentage of their target heart rate?

85% to 100%

For which of the following patients should an EKG technician expect to see somatic interference on the EKG tracing?

A 20-year-old patient who is experiencing a seizure

For which of the following patients should an EKG technician expect the provider to prescribe a chemical stress test?

A patient who is 40 years old and is unable to walk due to the presence of a full leg cast

Which of the following vital sign changes during an exercise stress test should indicate to an EKG technician that an adult patient is experiencing distress?

An increase in respirations from 18 to 36/min

In which of the following situations is it acceptable for an EKG technician to share a patient's protected health information?

An inquiry for training purposes from the quality assurance office

An EKG technician is caring for a patient who is admitted to an inpatient facility for chest pain. Which of the following actions should the technician take when performing a series of EKG readings for this patient?

Apply silver electrodes that can be checked daily.

An EKG technician is educating a patient about home use of an ambulatory monitor. Which of the following actions should the technician instruct the patient to take if any electrodes become loose?

Apply surgical tape to the electrodes to keep them in place.

An EKG technician has a prescription to perform an EKG tracing on an older adult patient who is unconscious upon arrival at the emergency department. Which of the following actions should the technician take?

Assume implied consent because the patient's condition is considered critical.

A thin spike before the P wave indicates that a pacemaker has been implanted to pace which of the following?

Atria

Identify the rhythm in the tracing below.

Atrial fibrillation (AF)

Which of the following is the arrhythmia shown in the EKG tracing below?

Atrial flutter

An EKG technician is caring for a patient who is experiencing heart palpitations. Which of the following interventions should the technician expect the provider to prescribe?

Holter monitor

Which of the following sections of the EKG tracing should an EKG technician use to measure the QRS complex?

Beginning of the Q wave to the end of the S wave.

When performing an EKG on an infant, in which of the following locations should the EKG technician place the electrode for lead V3R?

Between V2 and V4 on the right side of the chest

An EKG technician is recording a patient's radial pulse rate and finds the pulse to be irregular. The provider then takes the patient's apical pulse. The technician should recognize that which of the following locations is used for this assessment?

Between the fifth and sixth ribs, at the left midclavicular line

Which of the following activities should an EKG technician instruct a patient to record in the Holter monitor diary?

Bike riding

An EKG technician has performed an EKG on a patient. Which of the following actions by the technician would protect the patient's health information in accordance with HIPAA regulations?

Hand-delivering the EKG to the patient's provider

Which of the following pulse points is most frequently used to check an adult patient's pulse during cardiopulmonary resuscitation (CPR)?

Carotid

After completing a standard 12-lead EKG on a patient, which of the following actions should an EKG technician take next?

Check that the tracing is free from artifacts and then disconnect the patient from the machine.

An EKG technician is reviewing an EKG tracing and notes asystole. Which of the following actions should the technician take first?

Check the patient

Which of the following methods should an EKG technician use when removing hair from electrode placement sites for telemetry monitoring?

Clippers

Which of the following findings is consistent with bradycardia?

Cold and clammy skin

Which of the following patient findings indicates myocardial infarction?

Cyanosis

An EKG technician is preparing to perform an EKG for a patient who does not speak the same language as the technician. Which of the following actions should the technician take to avoid miscommunication with the patient?

Have a bilingual staff member translate.

An EKG technician is speaking with a patient on the phone. The patient is wearing a Holter monitor and reports severe chest pain and shortness of breath. Which of the following actions should the technician take?

Have someone call emergency services while remaining on the call with the patient.

Which of the following is the most effective technique for an EKG technician to use to verify that a patient understands the Holter monitor instructions?

Have the patient repeat the instructions back.

An EKG technician is performing a stress test for a patient. Which of the following EKG changes indicates that the patient is beginning to show signs of myocardial ischemia?

Depressed ST segment

An EKG technician is performing an exercise stress test for a patient who exhibits ventricular fibrillation on the EKG tracing. Which of the following actions should the technician take first?

Determine if the patient is responsive.

Which of the following methods should an EKG technician use to a calculate a patient's heart rate from the EKG tracing?

Divide 300 by the number of large boxes between two R waves.

An EKG technician is performing a standard 12-lead EKG for a patient. The technician should identify that which of the following information is recorded by lead I?

Electrical activity between the right arm and left arm

An EKG technician applies electrodes for a 12-lead EKG and obtains the initial tracing shown below. Which of the following actions should the technician take?

Ensure that the ground wire is attached to the patient properly.

When applying a Holter monitor, how many monitor leads are placed on the patient?

Five

Which of the following EKG machine functions should an EKG technician use to control and regulate the height of EKG waveforms on the tracing?

Gain

Which of the following factors can produce an artifact that appears as uniform, small spikes on an EKG tracing?

Improper grounding

Which of the following methods should an EKG technician use to store electrodes when not in use?

In the original, foil-lined packaging

Which of the following leads is created between the left arm and left leg?

Lead III

Which of the following leads is created when an EKG technician places the electrode to the right of the patient's sternum at the fourth intercostal space?

Lead V1

An EKG technician notes a standard 12-lead EKG tracing shows an uninterrupted baseline. The technician knows that this artifact is most likely caused by which of the following?

Lead corrosion

Which of the following lead groups are bipolar leads?

Leads I, II, and III

Which of the following lead groups forms Einthoven's triangle?

Leads I, II, and III

An EKG technician is preparing a patient for a standard 12-lead EKG. Which three leads should the technician place at the same horizontal level?

Leads V4, V5, and V6

When performing a posterior EKG, which of the following is the correct location for placement of lead V8?

Left midscapular line

Which of the following actions should an EKG technician perform for a patient immediately before an exercise stress test?

Measure blood pressure and obtain an EKG while the patient is supine, sitting, and standing up.

An EKG technician should recognize that which of the following signs are often present when a patient is experiencing ventricular tachycardia?

Multiple premature ventricular contractions in a row

During an exercise stress test, a patient reports heaviness on his chest and becomes diaphoretic. The EKG technician should recognize these findings as manifestations of which of the following conditions?

Myocardial infarction

In which of the following locations should an EKG technician place the electrode for lead V5?

On the left anterior axillary line, horizontal to lead V4

An EKG technician is working with a patient who has a below-the-knee amputation of the left leg. In which of the following locations should the technician place the right leg electrode?

On the lower right abdomen

When placing electrodes on the patient for telemetry, in which of the following locations should an EKG technician place the ground electrode?

On the right lower leg

Which of the following is the result of atrial depolarization?

P wave

Which of the following describes a complete cardiac cycle in a healthy heart?

P wave, QRS complex, and T wave

An EKG technician is reviewing the EKG tracing of a patient who has a ventricular pacemaker and notes that the patient's heart rate is 76/min. The pacemaker is set to a rate of 70/min. Which of the following should the technician expect to observe on the patient's tracing if the pacemaker is operating as intended?

Pacer spikes do not appear on the tracing

An EKG technician should recognize that which of the following situations is an allowable disclosure of patient information according to HIPAA guidelines?

Patients write their names on a basic sign-in sheet at the registration desk.

An EKG technician is measuring the intervals on an EKG tracing. Which of the following is an expected finding of impaired conduction through the AV node?

Prolonged PR interval

Which of the following waves should an EKG technician use to determine the regularity of the ventricular rate?

R wave

An EKG technician should recognize that which of the following is characteristic of the EKG tracing for a patient who has atrial fibrillation?

R-R interval is irregularly irregular

Which of the following arteries is the best location for an EKG technician to use to measure the heart rate for an adult patient following an exercise stress test?

Radial

An EKG technician is preparing to enter an inpatient room to perform a standard 12-lead EKG. Which of the following actions should the technician take for a patient who is prescribed contact precautions?

Remove gloves before leaving the patient's room.

An EKG technician should follow which of the following recommendations regarding infection control practices in health care settings?

Remove soiled gloves prior to touching uncontaminated surfaces.

An EKG technician is called to the emergency department to perform a standard 12-lead EKG on a patient. When the technician arrives, the patient is attached to a 5-lead monitor. Which of the following actions should the technician take?

Remove the electrodes for the 5-lead monitor before attaching the electrodes for the 12-lead EKG.

An EKG technician is monitoring a patient who is undergoing an exercise stress test. Which of the following findings should indicate to the technician that the patient is experiencing an adverse reaction?

Report of tingling sensations in the lower extremities

An EKG technician is performing an exercise stress test to evaluate a patient for coronary vascular disease. Which of the following actions should technician take regarding this procedure?

Report unexpected dysrhythmias during the test.

An EKG technician is performing an exercise stress test when the patient becomes unresponsive with no breathing or pulse. The technician uses an automated external defibrillator (AED) to administer a shock to the patient. Which of the following instructions should the technician expect next?

Resume performing CPR on the patient.

While performing a standard 12-lead EKG, an EKG technician notices that none of the leads are giving a reading. Which of the following limbs should the technician check first when correcting this problem?

Right leg

An EKG technician is performing a standard 12-lead EKG on a patient who is 4 years old. In which of the following locations should the technician place the V6 electrode?

Right midaxillary line

In a healthy adult patient, which of the following is the expected shape and direction of the P wave in lead II?

Rounded and upright

Which of the following positions is appropriate for a patient during a nuclear stress test while the camera is scanning?

Supine with the arms above the head

Which of the following is cause for discontinuing a stress test?

ST segment elevation

An EKG technician is performing an exercise stress test for a patient and observes the following rhythm on the monitor. Which of the following accurately describes the rhythm?

Second-degree AV heart block Mobitz type II (A second-degree AV heart block Mobitz type II has some P waves without a QRS complex, but the PR interval is constant.)

An EKG technician hears another staff member making derogatory comments about a patient's appearance. This is an example of which of the following torts?

Slander

An EKG technician is performing a standard 12-lead EKG for an adult patient who is in the hospital. The patient becomes unresponsive, stops breathing, and does not have a pulse. Which of the following actions should the technician take first?

Start chest compressions.

An EKG technician is preparing to explain the EKG procedure to a pediatric patient. Which of the following terms should the technician use when explaining the electrodes?

Stickers

An EKG technician is preparing to perform a standard 12-lead EKG for a healthy adult patient. In which of the following positions should the technician place the patient for testing?

Supine position

Which of the following sites is the most accurate for an EKG technician to use when measuring a patient's body temperature?

Temporal

Which of the following findings on the tracing should an EKG technician identify as an unexpected finding?

The ST segment elevation

An EKG technician is performing a second standard 12-lead EKG on a patient immediately following the first test. For which of the following reasons should the technician recognize that resting tab electrodes should not be used for than two consecutive EKG tracings?

The electrodes will not conduct accurately after two EKG tracings.

For which of the following types of heart block should an EKG technician observe the patient for signs and symptoms of decreased cardiac output that could lead to cardiac arrest?

Third-degree AV block

For which of the following reasons should an EKG technician instruct a patient to wear loose-fitting clothing while wearing a Holter monitor?

To reduce artifact on the tracing

An EKG technician is preparing a patient for a scheduled standard 12-lead EKG. Which of the following actions should the technician take?

Use an alcohol pad to cleanse the electrode placement sites

A serial EKG tracing shows a rhythm that does not match the last tracing that the EKG technician performed. Which of the following actions should the technician take first?

Verify proper lead placement.

Which of the following artifacts is shown in the tracing below?

Wandering baseline

An EKG technician is reviewing a tracing for a patient who has a ventricular pacemaker. Which of the following rhythm patterns should the technician expect after a pacing spike?

Wide QRS interval