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Quiz Session - Attempts With Random Questions

NHA CET Exam Questions

Page 8 of 30

141.

Which characteristic of cardiac cells gives them the ability to send electrical impulses through the heart?

  • Conductivity

  • Contractility

  • Excitability

  • Automaticity

Correct answer: Conductivity

Conductivity is the ability to pass electrical impulses along neighboring cells.

Automaticity is the cell’s ability to create impulses without any outside stimulation.

Contractility is the ability to contract the cardiac muscle.

Excitability is the cell’s ability to respond to electrical impulses through depolarization.

142.

What does cardiac output equal?

  • Heart rate x stroke volume

  • Heart rate x ejection fraction

  • Stroke volume x ejection fraction

  • Respiratory rate x heart rate

Correct answer: Heart rate x stroke volume

Cardiac output (CO) = heart rate (HR) x stroke volume (SV)

143.

What does the term axis mean?

  • The direction of the mean electrical vector

  • The direction of the frontal plane

  • The direction of retrograde conduction

  • An increase in electrical activity

Correct answer: The direction of the mean electrical vector

An axis refers to the direction of the mean electrical vector.

The frontal plane is a way to look at the body from the front. It doesn’t describe the heart’s electrical activity.

Retrograde conduction is about electrical signals moving backward in the heart. It’s a specific pattern, not the overall direction of electrical activity.

An increase in electrical activity refers to the strength of electrical signals, not the direction they’re going.

144.

A patient experiences palpitations that occur infrequently and unpredictably, sometimes weeks apart. 

Which type of cardiac monitoring device would be most appropriate to capture these rare arrhythmic events?

  • Event monitor

  • Standard 12-lead EKG

  • Traditional Holter monitor

  • Patch-type ambulatory monitor worn for 2 weeks

Correct answer: Event monitor

For individuals who have occasional arrhythmias that short-term monitoring equipment can miss, an event monitor is the best option. 

In contrast to Holter monitors or two-week ambulatory patches, event monitors are worn continuously and are triggered by the patient at the onset of symptoms. This makes it more likely that the arrhythmic occurrence will be captured on camera when it occurs. 

A 12-lead EKG is unlikely to identify intermittent symptoms since it only captures a momentary snapshot of cardiac activity.

145.

A patient is being fitted with a Holter monitor to record heart activity for 24 hours. Which of the following instructions should you give to ensure they understand proper use of the monitor?

  • Keep a detailed journal of your activities and symptoms you feel throughout the day

  • Only remove the device at night before you go to sleep

  • Turn on the monitor when you wake up and turn it off at night to conserve the battery

  • Disconnect the monitor if you feel any discomfort and reconnect it after 30 minutes

Correct answer: Keep a detailed journal of your activities and symptoms you feel throughout the day

Patients wearing a Holter monitor should be instructed to keep a detailed log of their daily activities and any symptoms they experience, as this helps correlate the data collected by the monitor with their physical or emotional states. 

The monitor must be worn continuously, even during sleep, to capture a complete 24-hour recording. 

The monitor should be worn at all times, not just during physical activity. 

The monitor should not be disconnected during the monitoring period unless instructed by a healthcare provider.

146.

A 72-year-old patient undergoing an EKG suddenly complains of dizziness and feeling "faint." The technician measures the patient's vital signs and notes the following:

  • Blood pressure: 82/45 mmHg
  • Heart rate: 38 beats per minute
  • Respiratory rate: 20 breaths per minute
  • Oxygen saturation: 97% on room air

Based on these findings, which of the following best describes the patient's condition?

  • The blood pressure and heart rate are below normal ranges and could indicate a medical emergency

  • The heart rate and respiratory rate are within normal limits for an elderly patient

  • The vital signs are stable, and the symptoms are likely unrelated to the cardiovascular system

  • The blood pressure is normal, but the heart rate is elevated, indicating tachycardia

Correct answer: The blood pressure and heart rate are below normal ranges and could indicate a medical emergency

The following are considered normal parameters: 

  • SPO2: 92-100%
  • Heart rate: 70-100 beats per minute
  • Respirations: 16-20 breaths per minute
  • Blood pressure: under 120 mm Hg systolic or under 80 mm Hg diastolic
  • Temperature: 97.8-99 degrees Fahrenheit

In this case, the heart rate is significantly bradycardic at 38 beats per minute, and the blood pressure is hypotensive at 82/45 mmHg. These abnormal values could indicate hemodynamic instability or a serious underlying cardiac condition.

147.

For which of the following patients is stress testing contraindicated?

  • A patient who had an acute myocardial infarction within the past 48 hours

  • A patient with stable angina

  • A patient who takes medication for congestive heart failure and has been asymptomatic

  • A patient with a family history of heart disease

Correct answer: A patient who had an acute myocardial infarction within the past 48 hours

The following are contraindications to cardiac stress testing: an acute MI within 48 hours, uncontrolled symptomatic heart failure, unstable angina, severe aortic stenosis, a dissecting aneurysm, an acute pulmonary embolism, and acute myocarditis/pericarditis. 

Indications for stress testing include, but are not limited to, evaluation for post CABG, diagnosis of exercise-induced arrhythmias, follow up for cardiac rehab, and a family history of heart disease and two or more heart disease risk factors.

148.

Identify the following rhythm.

  • Asystole

  • Artifact masked as asystole

  • CPR artifact

  • Atrial fibrillation

Correct answer: Asystole

This rhythm is true asystole. In asystole, the EKG attempts to pick up a heart rhythm and will be visualized as a slightly waving line, rather than a completely straight line.

The line on the rhythm strip indicates that the EKG leads are attempting to pick up electrical activity and not finding one. Therefore, this is true asystole.

149.

Which lead is the most helpful in identifying a ventricular rhythm?

  • Lead V1

  • Lead III

  • Lead aVL

  • Lead V6

Correct answer: Lead V1

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.

150.

A bundle branch block is diagnosed by looking at the width and configuration of the QRS complexes. Which of the following is not part of the criteria for a left bundle branch block (LBBB)?

  • RSR' (rabbit ears) or a tall R wave in V1 and V2 with ST-segment depression and T-wave inversion

  • Left axis deviation 

  • Broad or notched R wave with prolonged upstroke in leads V5, V6, I, and aVL, as well as ST-segment depression and T-wave inversion

  • QRS complex widened to greater than 0.12 seconds

Correct answer: RSR' (rabbit ears) or a tall R wave in V1 and V2 with ST-segment depression and T-wave inversion

RSR′ in leads V1 and V2 (rabbit ears) are seen in right bundle-branch blocks (RBBBs).

The criteria for an LBBB include:

  • QRS complex widened to greater than 0.12 seconds
  • Broad or notched R wave with prolonged upstroke in leads V5, V6, I, and aVL, plus ST-segment depression and T-wave inversion
  • Reciprocal changes in V1 and V2 

Left axis deviation may be present.

151.

Which of the following is true regarding Holter monitoring?

  • A Holter monitor can detect cardiac arrhythmias otherwise missed by a 12-lead EKG

  • Standard Holter monitoring involves six leads across the chest and one lead on each limb

  • A Holter monitor cannot be used on a patient with a pacemaker device

  • A Holter monitor is typically used in an inpatient or emergency room setting 

Correct answer: A Holter monitor can detect cardiac arrhythmias otherwise missed by a 12-lead EKG 

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.

152.

A patient presents with sharp chest pain that worsens when lying down and improves when sitting up. An EKG shows diffuse ST-segment elevation across multiple leads. The physician suspects pericarditis. 

Which of the following best describes the role of the pericardium in this condition?

  • The pericardium is a double-layered sac that surrounds the heart and can become inflamed, causing pain and ST-segment changes

  • The pericardium is a muscular layer responsible for contracting and pumping blood throughout the body

  • The pericardium is the inner lining of the heart chambers that prevents blood from leaking into the myocardium

  • The pericardium is the innermost layer of the heart that provides a smooth surface for blood flow and minimizes turbulence

Correct answer: The pericardium is a double-layered sac that surrounds the heart and can become inflamed, causing pain and ST-segment changes

The pericardium is a double-layered sac that encases the heart, protects it, and restricts movement within the chest cavity. It consists of two main layers: the fibrous pericardium (outer layer) and the serous pericardium (inner layer).

Inflammation of the pericardium, known as pericarditis, can lead to sharp chest pain that worsens with certain body positions (e.g., lying down) and improves when sitting up or leaning forward. Pericarditis can cause characteristic EKG findings, such as diffuse ST-segment elevation across multiple leads.

The pericardium is not a muscular layer responsible for pumping blood; that is the function of the myocardium.

The inner lining of the heart chambers is called the endocardium, not the pericardium.

The innermost layer of the heart is the endocardium, which lines the heart chambers and minimizes turbulence.

153.

There are three types of EKG leads. Which type is placed on the limbs and contains only one positive pole?

  • Augmented leads

  • Bipolar leads

  • Precordial leads

  • Electrodes

Correct answer: Augmented leads

Augmented leads are unipolar leads that are placed on the limbs, while precordial leads are unipolar leads that are placed on the chest.

Bipolar leads contain a positive pole and a negative pole.

Electrodes are sensors that are placed on the patient’s skin.

154.

What is the best course of action following the identification of this rhythm?

  • Notify the MD and prepare to pace the patient 

  • Notify the MD and prepare to cardiovert the patient

  • Notify the MD and prepare to defibrillate the patient

  • Perform no action at this time

Correct answer: Notify the MD and prepare to pace the patient 

This rhythm is a 2:1 AV block, which requires transcutaneous pacing to relieve symptoms and revert to sinus rhythm.

Cardioversion is used for atrial fibrillation and atrial flutter. Ventricular defibrillation is used for ventricular fibrillation and ventricular tachycardia.

155.

Which of the following statements is true regarding sinus tachycardia?

  • Causes include an overproduction of thyroid hormones

  • It is an irregular rhythm

  • The rate is defined as over 150 beats per minute

  • There is no treatment unless the patient is symptomatic

Correct answer: Causes include an overproduction of thyroid hormones

Sinus tachycardia is a sinus rhythm between 101 and 160 beats per minute. Causes include congestive heart failure, anxiety, pulmonary embolism, and thyrotoxicosis, a medical emergency in which an overproduction of thyroid hormones results in increased heart rate, blood pressure, and temperature. 

This condition is treated by determining and treating the underlying cause.

156.

Which of the following is not considered protected health information?

  • Diagnosis

  • Name

  • Social security number

  • Date of birth

Correct answer: Diagnosis 

A diagnosis is not considered an individually identifiable piece of protected health information.

157.

In electrocardiography, Lead II is generated by analyzing the electrical currents detected when:

  •  The leg electrodes are positive, and the right arm is negative with an angle of orientation of 60 degrees

  • The leg electrodes are positive, and the left arm is negative with an angle of orientation of 120 degrees

  • The left arm electrodes are positive, and the other limbs negative with an angle of orientation of -30 degrees

  • The left arm electrode is positive and the right arm is negative with an angle of orientation of 0 degrees

Correct answer: The leg electrodes are positive, and the right arm is negative with an angle of orientation of 60 degrees

Lead II is created by making the leg electrodes positive and the right arm negative. Its angle of orientation is 60 degrees. 

Lead I is created by making the left arm electrode positive and the right arm negative. Its angle of orientation is 0 degrees. 

Lead III is created by making the leg electrodes positive and the left arm negative. Its angle of orientation is 120 degrees. 

aVL is created by making the left arm electrode positive and the other limbs negative. Its angle of orientation is -30 degrees. 

158.

Select the correct pathway of blood pumping through the heart.

  • Right Atrium → Right Ventricle → Lungs → Left Atrium → Left Ventricle 

  • Left Atrium → Left Ventricle → Lungs → Right Atrium → Right Ventricle

  • Right Atrium → Right Ventricle → Systemic Circulation → Left Atrium → Left Ventricle

  • Right Atrium → Right Ventricle → Lungs → Left Ventricle → Left Atrium

Correct answer: Right Atrium → Right Ventricle → Lungs → Left Atrium → Left Ventricle 

This is the correct pathway of blood as it passes through the heart and lungs. It is important to know the anatomy and physiology of the heart to understand its relation to EKG readings. 

159.

A Certified EKG Technician is preparing to perform an electrocardiogram (EKG) on a patient. While doing so, the technician notices another patient's EKG results left on the monitor screen. 

Which of the following actions best complies with HIPAA regulations?

  • Log out of the system or clear the previous patient's data before proceeding

  • Continue with the current EKG and inform the supervisor afterward

  • Minimize the screen and proceed with the current patient's EKG

  • Leave the previous patient's data on the screen since it’s in a secure area

Correct answer: Log out of the system or clear the previous patient's data before proceeding

According to HIPAA regulations, protected health information (PHI), including EKG results, must be protected from unauthorized access. Before starting the current patient’s EKG, the technician should log out or clear the previous patient’s data to ensure confidentiality. 

Minimizing the screen or leaving the data on the screen are incorrect since these actions increase the risk of a privacy violation.

160.

You are performing a 12-lead EKG in an outpatient clinic. Before entering the room, you use an alcohol-based gel to sanitize your hands. During the procedure, the patient coughs, and you decide to wear gloves to complete the EKG. After finishing, you remove your gloves and notice your hands are not visibly soiled. 

What are the correct steps to follow next to ensure adherence to standard precautions?

  • Use alcohol-based gel, clean the EKG machine, and exit the room

  • Exit the room, then use an alcohol-based gel before seeing the next patient

  • Apply clean gloves, clean the EKG machine with disinfectant, and exit the room

  • Use an alcohol-based gel after removing gloves, clean the EKG machine, and use an alcohol-based gel again before seeing the next patient

Correct answer: Use alcohol-based gel, clean the EKG machine, and exit the room

Standard precautions are a universal measure to protect patients and healthcare staff from the risk of infection. Steps include using alcohol gel when you enter and exit the room, washing hands between patient visits, washing hands when they are visibly soiled, using an alcohol-based gel when removing gloves, and cleaning the EKG machine after use.

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