MA Chapter 49

When using pulse oximetry long-term, you should move the sensor to a new site every ____.

4 hours

A patient is not hypoxemic if his pulse oximetry reading is ____ percent.

97

Which of the following is a correct statement about the stylus temperature control?

A higher temperature produces a heavier line.

The urgent care center where you work is being remodeled, and the room usually used for obtaining ECGs is currently unavailable. The ECG equipment has been moved around the corner to the room next to the X-ray room. When you begin your first patient ECG of the day, the tracing looks as shown in the figure. What problem is present and how can you fix it?

AC interference; move the ECG equipment to a room farther from other electric equipment

Which of the following delays the electrical impulse for muscle contraction, giving the atria time to contract completely and fill the ventricles with blood?

AV node

Which of the following delays the electrical impulse to give time for the atria to complete contraction and the ventricles to fill?

AV node

Which of the following is an erroneous mark or defect that may appear on an ECG strip?

Artifact

Which of the following can prevent a wandering baseline?

Be sure the skin is prepared adequately

Which of these allow you to adjust the position of the stylus?

Centering control

Which of the following is the electrical impulse that initiates a chain reaction resulting in contraction?

Depolarization

Which of the following results in a flat line on the ECG tracing?

Detached/loose wire

Which of the following is a record of the waves of electrical impulses responsible for the cardiac cycle?

Electrocardiogram

Which of the following is the process by which a graphic pattern is created from the electrical impulses generated in the heart as it pumps?

Electrocardiography

Which of the following would you do to alleviate a patient's anxiety about having an electrocardiography?

Encourage the patient to ask questions and verbalize her concerns

Which of the following measures the patient's response to a constant or increasing workload?

Exercise ECG

Gillian is a cheerful, active teenager who is having an ECG as part of a physical required by her school to participate in cheerleading activities. You explain that she needs to remain very still while you record the ECG. You begin the tracing, as shown in the picture. Although Gillian remains still, when she sees the look on your face, she asks, "What's wrong?" What abnormality is visible in lead V6, and what is your best choice of action?

Flat line; look for loose or disconnected wires

If a patient is uncomfortable lying flat on the examining table for an ECG test, he can be placed in the ____.

Fowler's position

How do you prepare patients for spirometry?

Have them wear a nose clip

Which of the following is used to assess the electrical activity of a patient's heart over a 24-hour period of normal activity?

Holter monitoring

Which of the following would you include in the patient teaching for a patient with a Holter monitor?

Instruct the patient to record all activities, emotions, symptoms, and medications taken

Which of the following would you include in patient preparation for a pulmonary function test?

Instruct the patient to slightly elevate the chin and slightly extend the neck

Which of these is a component of an acceptable maneuver for spirometry?

Minimum of 6 seconds

How do you determine the heart rate from a regular ECG tracing?

Multiply the number of QRS complexes in a 6-second strip by 10

Which of the following is a small upward curve that represents the sinoatrial node impulse, wave of depolarization through the atria, and resultant contraction?

P wave

The deflections that occur on an ECG are labeled with the letters ____.

P, Q, R, S, T, and U

The time it takes for electrical impulses to travel from the SA node to the AV node is the ____.

P-R interval

Which of these arrhythmias is due to a heartbeat originating in the ventricles that occurs early in the cycle and is followed by a pause before the next cycle?

PVCs

Which of the following is a measurement taken to determine the amount of air that can be quickly forced from the lungs?

Peak expiratory flow rate

Which of the following measures and evaluates a patient's lung capacity and volume?

Pulmonary function test

Which of the following represents the time it takes for the ventricles to contract and recover, or repolarize?

Q-T interval

Which of the following refers to the contraction of the ventricles following depolarization?

QRS complex

If a lead does not appear on an ECG tracing, what should you do before you repeat the tracing?

Reconnect the wire

How do you prevent somatic interference on an ECG tracing?

Remind the patient to lie still and to refrain from talking

The impulse that travels through both ventricles is the ____.

S wave

Which of the following represents the time between contraction of the ventricles and recovery?

S-T segment

The ____ send(s) out electrical impulses to initiate depolarization.

SA node

Transmission of electrical impulses in the heart begins in the ____.

SA node

Which of the following is the primary pacemaker of the heart?

SA node

Which of the following would you include when preparing the room and equipment for an electrocardiogram?

Select a room in which all electrical equipment is turned off

You are attempting to record an ECG for Mr. Potter, a 72-year-old patient who has Parkinson's disease. Knowing this, you automatically place the limb electrodes close to the trunk. However, the tracing looks as shown in the picture. What artifact is present and what can you do to fix it?

Somatic interference; wait until Mr. Potter's tremors subside

When pressed, which of the following should cause the stylus to move up 10mm (10 small squares) and remain there for 0.08 second (2 small squares or 2 mm)?

Standardization control

Which of the following assesses the heart's conduction system during exercise, when the demand for oxygen is increased?

Stress testing

Which of the following is a pen-like instrument that records impulse movement on the ECG paper?

Stylus

Which of the following may result in extraneous marks on the ECG tracing?

Use of paper clips

Which precordial electrode is located by counting to the fourth intercostal space to the right of the sternum?

V1

Which precordial electrode is placed in the fourth intercostal space to the left of the sternum?

V2

Which precordial electrode is placed in the fifth intercostal space, where it intersects an imaginary line drawn straight down the middle of the clavicle?

V4

Which precordial electrode is placed in the fifth intercostal space, directly below the middle of the armpit?

V6

Which of these is a life-threatening arrhythmia that results in no cardiac output?

Ventricular fibrillation

After preparing the ECG machine, you explained the procedure to Mrs. Thomas, connected the electrodes, and began the tracing, as shown in the picture. You rechecked the electrodes and they are all placed correctly. None of the wires are loose. However, you notice that Mrs. Thomas's skin smells fragrant, as though she has used a body lotion recently. Which of the following describes the problem, its possible cause, and the correct solution?

Wandering baseline caused by lotion on the skin; re-prep the skin with isopropyl alcohol

Which peak flow zone indicates that large airways are beginning to narrow?

Yellow zone

The arrhythmia in which P waves cannot be identified because of rapid multiple electrical signals that fire from areas of the atria other than the SA node is ____.

atrial fibrillation

Pulmonary function tests are useful in monitoring ____.

chronic obstructive pulmonary disease

The peaks and valleys of the electrical impulses responsible for the cardiac cycle are called ____.

deflections

The instrument that measures and displays the electrical impulses responsible for the cardiac cycle is a(n) ____.

electrocardiograph

Electrical impulse sensors used to obtain an electrocardiogram are called ____.

electrodes

Electrodes for limb leads should be attached to ____.

fleshy portions of the limbs

The greatest volume of air that can be expelled when a person performs a rapid, forced expiration is the ____.

forced vital capacity

If the patient has good control of her asthma, her peak flow rate is in the ____,

green zone

The different views recorded on an electrocardiogram that are produced by the electrical activity of the heart are ____.

leads

AC interference can be prevented by ____.

making sure lead wires are not crossed and following the contour of the body

Possible causes for a wandering baseline are ____.

poor skin preparation, dangling wire, or breathing movement

The peak flow zone that requires immediate medical treatment is the ____.

red zone

Instruct the patient to slightly elevate the chin and slightly extend the neck

spirometer