NHA CET Exam Questions

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1.

Which of the following is true regarding ventricular tachycardia?

  • It contains wide QRS complexes that are longer than 0.12 seconds.

  • It is an irregular rhythm.

  • It can occur at any rate.

  • It contains PR intervals that are shorter than 0.12 seconds.

Correct answer: It contains wide QRS complexes that are longer than 0.12 seconds 

Ventricular tachycardia is a regular rhythm and contains wide, bizarre QRS complexes that are greater than 0.12 seconds. There are no discernible P waves. PR intervals, if present, are variable. Ventricular tachycardia occurs at a rate over 100.

2.

Which leads are involved in forming the hexaxial diagram?

  • Leads I, II, III, aVR, aVL, and aVF

  • Leads aVR, aVL and aVF

  • Leads II and aVR

  • Leads I, II, and III

Correct answer: Leads I, II, III, aVR, aVL, and aVF 

The hexaxial diagram joins all the leads at the center (leads I, II, III, aVR, aVL, and aVF).

Leads I, II, and III form the triaxial diagram.

3.

Which of the following is true regarding ventricular tachycardia?

  • It is a medical emergency

  • It is a run of one PVC per two normal sinus beats

  • It is only serious in the setting of an acute myocardial infarction 

  • It is a benign rhythm that is sometimes seen during an acute infarction 

Correct answer: It is a medical emergency 

Ventricular tachycardia is a potentially lethal rhythm that can advance to ventricular fibrillation and cardiac arrest. Therefore, it is treated as a medical emergency regardless of the presence or absence of myocardial infarction.

Bigeminy is a rhythm that contains one PVC for every two sinus beats; it is usually a benign, self-limiting rhythm.

An accelerated idioventricular rhythm (ventricular rate between 40 and 120 bpm) is benign and may appear during or after a myocardial infarction.

4.

How many milliliters of blood are ejected each time the heart contracts?

  • 70 milliliters

  • 30 milliliters

  • 150 milliliters

  • 100 milliliters

Correct answer: 70 milliliters

Approximately 70 milliliters of blood is ejected each time the heart contracts and begins circulation. 

5.

Identify the rhythm.

  • Ventricular pacing

  • Atrial pacing

  • Dual-chamber pacing

  • Cardioversion

Correct answer: Ventricular pacing

The rhythm is being depolarized by a ventricular pacemaker, as evidenced by the spike followed by the wide QRS complex.

In atrial pacing, a spike precedes a P wave. Both of these spikes occur in dual-chamber pacing.

Cardioversion is used when a patient is in acute atrial flutter/atrial fibrillation.

6.

Which of the following is not a protocol used for a cardiac stress test?

  • Modified Naughton protocol

  • Bruce protocol

  • Modified Bruce protocol

  • Naughton protocol

Correct answer: Modified Naughton protocol 

The three main protocols (or instructions) used during the stress test are the Bruce protocol, the modified Bruce protocol, and the Naughton protocol. 

7.

Where is V5 placed on a patient?

  • Between V4 and V6

  • Between V2 and V4

  • In the fourth intercostal space to the right of the sternum

  • In the fifth intercostal space at the midclavicular line

Correct answer: Between V4 and V6

V5 is placed between V4 and V6 on a patient.

V1 is located in the fourth intercostal space to the right of the sternum.

V3 is placed between V2 and V4.

V4 is placed in the fifth intercostal space on the midclavicular line.

8.

What is considered elevated blood pressure?

  • 120-129 systolic and below 80 diastolic

  • 130-139 systolic and 80-89 diastolic

  • Below 120 systolic and below 80 diastolic

  • 140 or higher systolic and above 90 diastolic

Correct answer: 120-129 systolic and below 80 diastolic 

Elevated blood pressure is considered to be 120-129 systolic and below 80 diastolic.

Normal blood pressure is below 120 systolic and below 80 diastolic. Stage 1 is defined by a blood pressure of 130-139 systolic and 80-89 diastolic. Stage 2 is defined by pressure greater than 140 systolic and greater than 90 diastolic. 

9.

Which of the following is true regarding the oversensing of a pacemaker?

  • The pacemaker picks up skeletal muscle artifact and believes it is not supposed to fire

  • The pacemaker is firing too soon, resulting in a wandering pacemaker spike

  • The voltage of the pacemaker is too high

  • The heart is too damaged to respond to the electrical stimulus

Correct answer: The pacemaker picks up skeletal muscle artifact and believes it is not supposed to fire

When a pacemaker oversenses, it is picking up extra muscle artifact, believing it does not need to fire.

Undersensing is when the pacemaker is firing too soon. Pacemaker voltage or the condition of the heart does not cause oversensing.

10.

During continuous monitoring, what views does lead II provide?

  • P waves

  • Deflections

  • T waves

  • Artifact

Correct answer: P waves 

Lead II is used in continuous monitoring to provide high-quality views of atrial activity (shown as P waves) and ventricular activity (shown as QRS complexes).

11.

In reference to HIPAA's privacy rules, what does use mean?

  • How information is used in a health care facility

  • How information is captured in a health care facility

  • How a patient uses their information while in a health care facility 

  • How a patient's employer uses the information in a health care facility

Correct answer: How information is used in a health care facility

Under HIPAA privacy rules, use is based on information's role in a health care facility.

12.

If both the sinoatrial node and AV node fail to generate an impulse, the ventricles will take over as the pacemaker of the heart. How is this reflected in an EKG strip?

  • There is no P wave

  • There is no T wave

  • There is no QRS complex

  • There is no effect 

Correct answer: There is no P wave 

The P waves represent atrial depolarization, which occurs when the atria receive the initial impulse from the sinus node. When the AV node takes over, it sends electrical signals back to the atria. However, if the ventricle is serving as the pacemaker, there is no signal to the atria and no P wave.

13.

Cardiac pacemaker cells possess a unique property that sets them apart from other cardiac muscle cells. 

Which of the following best describes this property?

  • They spontaneously depolarize due to a gradual rise in membrane potential after reaching a minimal negative potential.

  • They only depolarize when stimulated by action potentials from neighboring cells.

  • They require external neurohormonal input to initiate each action potential.

  • They maintain a stable resting membrane potential of approximately -90 mV without spontaneous depolarization.

Correct answer: They spontaneously depolarize due to a gradual rise in membrane potential after reaching a minimal negative potential.

Cardiac pacemaker cells are unique because they do not have a true resting membrane potential. Instead, after reaching a minimal negative potential of approximately −60 mV, they gradually depolarize due to their innate electrical properties until they reach the threshold for another action potential. This allows them to spontaneously depolarize without external stimulation, initiating the heart's rhythmic contractions.

14.

Which of the following is true about agonal rhythms?

  • It is caused by prolonged hypoxia

  • The rate is below 40

  • The AV node is the last remaining pacemaker

  • The PR interval is wide and bizarre

Correct answer: It is caused by prolonged hypoxia

Agonal rhythms are caused by severe injury to the heart, usually due to prolonged hypoxia. All higher pacemakers have failed to generate a signal, which leaves the ventricle as the remaining pacemaker to save the heart. However, the cardiac output will be incompatible with life, and immediate cardiopulmonary resuscitation is required. There is no PR interval because there are no P waves, and the QRS complexes are more than 0.12 seconds.

15.

Where is lead aVR located?

  • Right arm

  • Left arm

  • Right leg

  • Left leg

Correct answer: Right arm 

The aVR lead is placed on the right arm. "aV" stands for augmented voltage, and "R" is the right arm.

16.

Baseline sway, a type of artifact, can be caused by which of the following?

  • A patient breathing deeply

  • A patient experiencing tremors

  • A broken wire

  • A patient using their phone

Correct answer: A patient breathing deeply

Baseline sways are related to a patient’s breathing pattern. 

Somatic tremors are caused by patient tremors or anything that shakes the electric wires. A 60-cycle interference is caused by electrical interference. A broken recording is caused by a frayed or broken wire.

17.

Broken recording, a type of artifact, is caused by which of the following?

  • A broken wire

  • Electrical interference

  • A low battery

  • A patient breathing too deeply

Correct answer: A broken wire

A broken recording is caused by a frayed or broken wire. 

Somatic tremors are caused by patient tremors or anything that shakes the electric wires. Baseline sways are related to a patient’s breathing pattern. A 60-cycle interference is caused by electrical interference.

18.

Identify the following rhythm.

  • Sinus rhythm progressing to ventricular tachycardia

  • Sinus rhythm progressing to ventricular fibrillation

  • Sinus rhythm with type 2 AV block

  • Sinus rhythm progressing to sinus tachycardia

Correct answer: Sinus rhythm progressing to ventricular tachycardia

Ventricular tachycardia is characterized by wide, bizarre QRS complexes with an absence of any real rhythm. Prompt treatment is required to revert the patient to sinus rhythm. 

19.

On a 12-lead ECG, which leads would likely show ST-segment elevation in an anterior heart attack?

  • V3 and V4

  • V1 and V4 used on the patient's right side

  • V1 and V2

  • II, III, and aVF

Correct answer: V3 and V4

ST-segment elevation would appear in leads V3 and V4 for an anterior heart attack.

20.

What does an increase in duration on an EKG wave represent?

  • Prolonged depolarization in a hypertrophic heart chamber

  • Prolonged repolarization in a hypotrophic heart chamber

  • Decreased current, resulting in a larger voltage

  • Decreased amplitude

Correct answer: Prolonged depolarization in a hypertrophic heart chamber 

The EKG wave is sensitive to ventricular hypertrophy. One of the effects of this is that the chamber takes longer to depolarize; this is illustrated by an increased duration of the EKG wave. 

Other signs include increased amplitude, a larger electric current, and the shifting of the electrical axis.