Question: 1
Identify the following artifact.
Latest Version: 6.0
A. Artifact from defibrillation or cardioversion
B. Artifact from performing CPR
C. Baseline sway
D. 60-cycle interference
Explanation:
Answer: B
The chest compressions during CPR are picked up by the electrodes, resulting in an abnormal rhythm. Artifact from defibrillation/cardioversion, baseline sway, and 60 cycle interference are more irregular and bizarre than CPR artifact.
Question: 2
In what position should the patient be placed for a 12-lead EKG?
A. Standing
B. Right lateral
C. Supine
D. Prone
Explanation:
Answer: C
For an accurate interpretation, the patient should be lying supine during the EKG reading. You may slightly elevate the head in a semi-Fowler’s position.
Question: 3
Which of the following is an example of compliance with the HIPAA Privacy Rule?
A. Opening a patient's chart even though you are not taking care of them
B. Complaining about a rude patient with coworkers in the cafeteria
C. Logging off your work computer every time you leave, even if you plan to return shortly
D. Throwing protected health information in the trash because the shredding box is full
Answer: C
Explanation:
Healthcare facilities take the HIPAA privacy rule seriously and implement strict adherence. Maintaining compliance with HIPAA includes ensuring you log off your computer every time you leave the work
station, avoiding discussions of patients in an open area, properly disposing of protected health information, and only looking up information about patients you are treating.
Question: 4
Which of the following is true regarding Holter monitoring?
A. A Holter monitor is typically used in an inpatient or emergency room setting
B. A Holter monitor can detect cardiac arrhythmias otherwise missed by a 12-lead EKG
C. Standard Holter monitoring involves six leads across the chest and one lead on each limb
D. A Holter monitor cannot be used on a patient with a pacemaker device
Answer: B
Explanation:
Holter monitors are typically used in an outpatient setting and are used to rule out arrhythmias that can be missed by a 12-lead EKG. The patient is hooked up to five or more leads on the chest, instead of the limbs, to rule out an error or artifact.
Holter monitors can be used for syncope, near-syncopal episodes, chest pain, shortness of breath, palpitations, dizzy spells, or skipped beats. They can also demonstrate the effectiveness of a pacemaker and do not harm a pacemaker when used.
Question: 5
Which lead is the most helpful in identifying a ventricular rhythm?
A. Lead II
B. Lead V1
C. Lead V6
D. Lead aVL
Explanation:
Answer: B
Lead V1 (also known as MCL) is the best lead to use to search for ventricular rhythms. Left ventricular PVCs will have an upward deflection in V1, while right ventricular PVCs will have a downward deflection in V1. Left ventricular PVCs are more dangerous than right PVCs, so correct identification is crucial.
Question: 6
You are performing a cardiac stress test on a 51-year-old male with a history of stable angina. Which of the following would demonstrate a positive stress test?
A. ST-segment elevation
B. Low-voltage QRS complexes
C. Tall P waves
D. Shortening PR interval
Explanation:
Answer: A
ST-segment elevation, ST depression greater than 1-1.5 mm at 0.08 seconds following the J point, or a U wave insertion indicate a positive stress test.
Normal EKG changes during a stress test include a shortened PR interval, tall P waves, low-voltage QRS complexes, and an increased heart rate.
Question: 7
There are five types of arrhythmias. Which type causes the electrical current to bypass the normal conduction pathways by directing them to shortcuts?
A. Arrhythmias of sinus origin
B. Preexcitation syndromes
C. Ectopic rhythms
D. Conduction blocks
Explanation:
Answer: B
Preexcitation syndromes form a shortcut from normal pathways to accessory pathways. An ectopic rhythm is activity that occurs from a focus that is not the sinus node. Arrhythmias of sinus origin contain the same conduction path but are irregular, too fast, or too slow. Reentrant arrhythmias can occur anywhere in the heart and have a varied array of electrical activity, depending on anatomic issues with the heart. Conduction blocks are sinus rhythms that are either delayed or blocked completely from their path.
Question: 8
Ventricular depolarization results in the contraction of the ventricles. This is illustrated on the EKG by which waveform?
A. PR interval
B. QRS complex
C. T wave
D. P wave
Explanation:
Answer: B
The QRS complex illustrates the complex activity of ventricular depolarization and contraction.
The P wave illustrates atrial depolarization. The PR interval measures the time between the start of atrial depolarization and the start of ventricular depolarization. The T wave represents ventricular repolarization.
Question: 9
What is the defining characteristic of ventricular fibrillation?
A. Lack of electrical activity
B. Lack of QRS complexes
C. Three or more consecutive PVCs
D. Rate of between 120 and 200 beats per minute
Answer: B
Explanation:
The hallmark of ventricular fibrillation is the lack of QRS complexes; rather than beating, the ventricular walls are quivering instead of pumping.
Because there is no cardiac output occurring, tachycardia does not appear during ventricular fibrillation. Three or more consecutive PVCs are typically seen in ventricular tachycardia. Asystole is the total lack of electrical activity and is illustrated by a line with no waves.
Question: 10
Which group of cells is responsible for regulating ventricular contraction?
A. Actin
B. Atrioventricular (AV) node
C. Purkinje system
D. Sinoatrial (SA) node
Explanation:
Answer: B
The AV node receives the initial impulses generated by the SA node. It is responsible for regulating the impulses sent to the ventricles to prevent arrhythmias.
The SA node is a group of cells located in the right atrium; it is responsible for generating electrical impulses that pass through the heart and stimulate contraction. Purkinje fibers receive the signal from the AV node and send the signal to the ventricles, stimulating contraction. Actin is a protein supports the physical act of muscle contraction.
