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Quiz Session - Attempts With Random Questions

NHA CET Exam Questions

Page 3 of 30

41.

An EKG technician observes a patient’s heart rate consistently at 45 beats per minute, but the patient has no symptoms and reports feeling healthy. 

Which of the following best explains this finding?

  • The patient’s heart rate may be normal if they are an athlete

  • The patient likely has sinus tachycardia, and further monitoring is needed

  • The patient is experiencing a dangerous arrhythmia that requires immediate intervention

  • The patient needs a pacemaker

Correct answer: The patient’s heart rate may be normal if they are an athlete 

In well-trained athletes, a resting heart rate as low as 35–40 beats per minute is not uncommon and can be considered normal due to enhanced vagal tone, which increases parasympathetic activity and lowers the heart rate. This condition is known as athletic bradycardia and does not typically indicate any pathology. 

In the absence of symptoms or other abnormal findings, a heart rate of 45 beats per minute may be a benign finding.

42.

On an EKG strip, what is counted to determine a patient’s heart rate?

  • The number of QRS complexes

  • The number of P waves

  • The number of PR intervals

  • The number of T waves

Correct answer: The number of QRS complexes

The heart rate is the same value as the ventricular rate when examined on an EKG strip. Therefore, the heart rate can be quickly determined by counting the number of QRS complexes.

43.

What effect does the atria functioning as the original pacemaker have on the heart?

  • Increased heart rate

  • Decreased heart rate

  • Irregular heart rhythm

  • Cardiac arrest

Correct answer: Increased heart rate 

When the atria take over as the pacemaker, they fire the conduction signal at a faster rate than the sinus node. Therefore, the heart rate will increase to the point where the patient becomes symptomatic.

44.

A hypothermic adult is brought to the emergency department after being found unconscious in freezing temperatures. An electrocardiogram (EKG) reveals asystole—a flat line in all leads. 

Considering the patient's condition, which of the following is the most appropriate course of action?

  • Initiate aggressive resuscitation efforts because hypothermic patients have a better chance of survival from asystole

  • Declare death immediately, as asystole indicates a non-survivable condition

  • Wait for the patient to warm up naturally before beginning any resuscitation efforts

  • Focus on notifying the family, as survival rates are zero in asystolic patients outside the hospital

Correct answer: Initiate aggressive resuscitation efforts because hypothermic patients have a better chance of survival from asystole

In cases of asystole, the general survival rate is very low. However, hypothermic patients have a better chance of recovery because the low body temperature can slow metabolism and protect vital organs, including the brain. The principle "they are not dead until they are warm and dead" applies here. Therefore, initiating aggressive resuscitation efforts, including rewarming techniques and advanced cardiac life support, is appropriate.

Declaring death without attempting resuscitation ignores the potential for survival. 

Passive rewarming delays potentially lifesaving measures. 

Survival rates are low, but not zero.

45.

Which of the following is true regarding P-wave asystole?

  • Only the sinus node is firing

  • All of the heart’s pacemakers have failed

  • It is an irregular rhythm

  • A prolonged PR interval is present

Correct answer: Only the sinus node is firing 

Asystole is the complete failure of the heart’s pacemakers; there is no rate or rhythm, and the EKG view is only a flat line. P-wave asystole is asystole with the sinus node firing; however, the signal is blocked to the ventricles, and depolarization does not occur.

P waves will still be present in P-wave asystole, but there is no PR interval, QRS, or T wave. There is no heart rate or rhythm present.

46.

What is a more subjective criterion referring to the shape and appearance of a wave?

  • Configuration

  • Duration

  • Amplitude

  • Segment

Correct answer: Configuration

Configuration is a more subjective criterion referring to the shape and appearance of a wave.

The segment is a straight line connecting two waves.

Duration is a measurement in fractions of a second.

Amplitude is measured in millivolts.

47.

What course of action is recommended for this rhythm?

  • Immediate cardiopulmonary resuscitation

  • Immediate cardioversion

  • Immediate defibrillation

  • Immediate cardiac catheterization

Correct answer: Immediate cardiopulmonary resuscitation 

This rhythm is asystole, a lack of electrical activity of the heart. An artifact would present as a completely straight line from an asymptomatic patient. In asystole, the patient will be unresponsive and require immediate CPR.

48.

Which of the following is indicated as a treatment for atrial fibrillation lasting less than 48 hours?

  • Cardioversion

  • Defibrillation

  • Anticoagulants

  • IV heparin

Correct answer: Cardioversion 

The goal of treatment for atrial fibrillation that lasts under 48 hours is to convert the rhythm back to sinus rhythm. Treatment options include beta-blocker therapy, calcium channel blockers, and cardioversion. 

Anticoagulants and IV heparin are indicated for atrial fibrillation rhythms that persist longer than 48 hours. Defibrillation is a treatment for ventricular fibrillation and ventricular tachycardia.

49.

Which of the following is true about Holter monitoring?

  • A negative Holter shows no signs of cardiac abnormalities

  • A positive Holter shows an absence of abnormalities

  • A positive Holter will only show tachycardia and ST elevation

  • A negative Holter includes pauses and bradycardia

Correct answer: A negative Holter shows no signs of cardiac abnormalities

A negative Holter has no arrhythmias or ST changes. A positive Holter may reveal abnormalities like tachycardia, bradycardia, pauses, and ST-segment changes.

50.

Which of the following arrhythmias does not cause a decrease in cardiac output?

  • Premature atrial complexes

  • Multifocal atrial tachycardia

  • Supraventricular tachycardia

  • Atrial fibrillation

Correct answer: Premature atrial complexes

Premature atrial complexes are benign in the absence of side effects. The other rhythms increase the heart rate to dangerous levels, which can cause a decrease in cardiac output.

51.

There are several legal exceptions when healthcare professionals can breach confidentiality without permission. Which of the following is not one of these exceptions? 

  • If the patient is a minor

  • If the patient has a stab wound

  • If there is suspected child abuse

  • If there is a reportable disease

Correct answer: If the patient is a minor

There are several legal exceptions when healthcare professionals can breach confidentiality without permission. These include stab wounds, gunshot wounds, injuries sustained in a crime, child/elderly abuse, and infectious, communicable, and reportable diseases. 

52.

A 50-year-old male arrives at the clinic for a stress test to be performed on a bike. What is the minimum heart rate he would have to achieve for the test to be valid?

  • 145

  • 200

  • 170

  • 187

Correct answer: 158 

For the test to be properly read, the patient has to achieve at least 85% of his target heart rate. The target heart rate of a patient can be calculated by subtracting the patient's age from 220, then multiplying by 0.85.

220 - 50 = 170

85% of 170 (170 x 0.85) = 144.5 or 145

53.

Which of the following is not measured by pulse rate?

  • Blood pressure

  • Heart rate

  • Heart rhythm

  • Pulse strength

Correct answer: Blood pressure 

Measuring the pulse rate assesses three aspects of the heart: heart rate, heart rhythm, and pulse strength.

Blood pressure is measured by a blood pressure cuff.

54.

During diastole, the atria slightly contract to squeeze the remaining amount of blood into the ventricles. What is this phase called?

  • Atrial kick

  • Atrial systole

  • Diastole

  • Ventricular kick

Correct answer: Atrial kick

Atrial kick is the final phase of diastole, in which the atria contract the remaining amount of blood into the ventricles before the closure of the heart valves. Atrial systole and ventricular kick are non-existent terms.

55.

Which of the following is true about normal sinus rhythm?

  • All P waves have the same shape

  • The P waves are inverted in most leads except lead V1

  • Rate is between 40 and 100

  • QRS intervals are greater than 0.12 seconds

Correct answer: All P waves have the same shape 

In a normal sinus rhythm, the rate is between 60 and 100, the rhythm is regular, the QRS intervals are below 0.12 seconds, and the P waves are upright in most leads, except for V1 where they may be inverted. All P waves in a normal sinus rhythm must be matched.

56.

Which of the following is true regarding an accelerated junctional rhythm?

  • The heart rate is usually between 60 and 100 beats per minute

  • It is exclusively an escape rhythm

  • It occurs only because of usurpation

  • It is an irregular rhythm

Correct answer: The heart rate is usually between 60 and 100 beats per minute

Accelerated junctional rhythms occur due to either escape or usurpation. This regular rhythm occurs at a rate of between 60 and 100 per minute. There are usually no adverse effects because the heart is working at a normal rate.

57.

A patient’s EKG shows a characteristic pattern of a normal QRS complex followed by a longer-than-usual pause before the next QRS complex appears. 

Which part of the heart’s conduction system is primarily responsible for transmitting impulses to the ventricles and may be contributing to this observation?

  • Bundle of His

  • Sinoatrial (SA) node

  • Interatrial tracts

  • Internodal tracts

Correct answer: Bundle of His

The longer-than-usual pause after the QRS complex suggests a delay in the conduction of impulses to the ventricles. The Bundle of His (atrioventricular bundle) transmits signals from the AV node to the ventricles. 

The SA node is the heart's natural pacemaker. SA dysfunction typically doesn't cause delays after a normal QRS complex. Issues with the SA node may result in irregular P waves or changes in overall heart rate.

Problems with the internodal or interatrial tracts would possibly alter the P wave, but would not cause a prolonged pause after the QRS complex.

58.

There are five sections, or titles, in HIPAA. Which title discusses the HIPAA Privacy Rule?

  • Title II

  • Title I

  • Title III

  • Title IV

Correct answer: Title II

The Privacy Rule can be found under title II of the HIPAA document. Titles I, III, and IV discuss healthcare accessibility, the integration of electronic documentation (III), and incorporating new healthcare reforms into insurance plans (IV).

59.

In what type of current do the QRS complexes start in the precordial leads?

  • Negative

  • Positive

  • Isoelectric

  • Bipolar

Correct answer: Negative 

In the precordial leads, the current is negative in V1 and V2, turns isoelectric in V3 and V4, and becomes positive in V5 and V6.

60.

What causes hypertrophy?

  • Pressure overload

  • Volume saturation 

  • Increase in electrical impulses

  • Increase in the size of a vessel

Correct answer: Pressure overload

Pressure overload causes hypertrophy. Hypertrophy refers to an increase in muscle mass. The wall of a hypertrophic ventricle is thick and powerful. Most hypertrophy is caused by pressure overload, in which the heart is forced to pump blood against an increased resistance.

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