CCT CCI FINAL EXAM AND PRACTICE QUESTIONS 2024/2025 ACTUAL EXAM COMPLETE QUESTIONS WITH, Exams of Health sciences

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CCT CCI FINAL EXAM AND PRACTICE QUESTIONS

2024 /2025 ACTUAL EXAM COMPLETE QUESTIONS WITH

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Which statement is correct regarding premature ventricular complexes (PVCs)? PVCs originate from the atrium. PVCs may be unifocal or multifocal in origin. PVCs will not lead to ventricular tachycardia. PVCs only originate from one site in the ventricles. PVCs may be unifocal or multifocal in origin. A regular rhythm at a rate of 40-60 beats per minute, with narrow QRS complexes, and no visible P waves, is consistent with the presence of: atrial fibrillation. sinus bradycardia. junctional rhythm. idioventricular rhythm. junctional rhythm. What is the proper lead placement for a right side 12 lead ECG? limb leads only placed in a mirror image of a standard 12 lead ECG chest leads only placed in a mirror image of a standard 12 lead ECG leads V1, V2, V3 only placed in a mirror image of a standard 12 lead ECG leads V4, V5, V6 only placed in a mirror image of a standard 12 lead ECG chest leads only placed in a mirror image of a standard 12 lead ECG

When conducting a Lexiscan stress test on a patient who is on a stretcher, what safety precaution should be taken? run a 12-lead ECG have crash cart available ensure patient has a pillow place patient in Trendelenburg run a 12-lead ECG Per stress test protocol, exercise capacity should be reported in _____ of exercise. exact metastatic equivalents (METs) anatomic metaphysic electrons (AMEs) estimated metabolic equivalents (METs) approximated minutes of exercise (AMEs) estimated metabolic equivalents (METs) Left ventricular hypertrophy is indicated when the combined measured amplitude is greater than or equal to 35 mm in which of the following leads? V1 or V2 S-wave, II or AVF R-wave V1 or V2 S-wave, V3 or V4 R-wave V1 or V2 S-wave, V5 or V6 R-wave V3 or V4 S-wave, V5 or V6 R-wave V1 or V2 S-wave, V5 or V6 R-wave Lead V6 should be placed left mid-axillary line, 5th intercostal space. mid-clavicular level on the patient's right side. fifth intercostal space on the patient's right side.

mid-sternal level in the center of the patient's chest wall. left mid-axillary line, 5th intercostal space. Which of the following rhythms has an intrinsic rate of 40-60 beats per minute? SA nodal AV junctional idioventricular accelerated junctional AV junctional An exercise stress test performed to: evaluate disorders such as CHF. identify ischemic changes due to CAD. mimic the diastolic heart changes at rest. determine if a CABG procedure is necessary. identify ischemic changes due to CAD. You are beginning the warmup stage of a treadmill stress test and you observe a 3mm ST segment depression in leads I and aVL. What is the first thing you should do? continue with your pre-test activities initiate the first stage of the protocol stop the treadmill and notify the physician make a note and continue with the protocol stop the treadmill and notify the physician The intrinsic rate of the Purkinje network in the ventricles is: 20 to 40 beats per minute. 40 to 60 beats per minute.

60 to 100 beats per minute. 100 to 150 beats per minute. 20 to 40 beats per minute. What is the heart rate of an ECG with a constant R-R interval of 30mm recorded at a standard paper speed? 50 bpm RR duration = R-R interval/paper speed HR=60s / RR duration 30mm / 25mm/s = 1.2s 60s / 1.2 = 50bpm Which leads are routinely checked to detect left atrial abnormality? V1 and V V4 through V V1 and Lead II Lead III and AVF V1 and Lead II What is a common cause of somatic tremor? poor skin prep muscle movement wandering baseline electrical interference muscle movement Ventricular tachycardia in which depolarization impulses moving from one ventricle to the other, resulting in a "twisted ribbon" appearance on the ECG tracing is called

torsades de pointes. ventricular crossover. ventricular fibrillation. ideoventricular acceleration. torsades de pointes. An anterior wall myocardial infarction occurs when anterior myocardial tissue supplied by the _____ artery suffers injury due to lack of blood supply. right circumflex obtuse marginal left anterior descending left anterior descending Which ECG would you expect the doctor to order when the patient has dextrocardia? posterior 12 lead ECG standard 12 lead ECG right side 12 lead ECG dextrocardia right side 12 lead ECG right side 12 lead ECG P-P intervals in all heart block dysrhythmias are characteristically absent. regular. irregular. unidentifiable. regular. What rhythm has a normal atrial depolarization and a wide QRS complex with QR-R's pattern? ventricular fibrillation sinus rhythm with RBBB

atrial tachycardia with PVCs sinus tachycardia with LBBB sinus tachycardia with LBBB Beta-blockers are avoided in stress testing because they decrease heart rate: increase QRS voltage. decrease PR intervals. increase ST depression. decrease heart rate. In standard calibration, what are the paper speed and voltage settings? 5 mm/sec, 10 mm/mV 10 mm/sec, 25 mm/mV 25 mm/sec, 10 mm/mV 50 mm/sec, 25 mm/mV 25 mm/sec, 10 mm/mV A posterior myocardial infarction can be identified by which of the following abnormalities on a 12 lead ECG tracing? ST Elevation in II, III, aVF tall R wave and ST depression in V1-V tall T wave and elevation in leads I and aVL inverted P wave and elevation in V5 and V Tall R wave and ST depression in V1-V What is the key to successful recording of an ECG? HIPPA wearing PPE hand hygiene communication

communication Which of the following medications is used in the treatment of ventricular arrhythmias? digoxin lidocaine verapamil nitroglycerin lidocaine Verapamil

• calcium channel blocker
• has negative chronotropic and inotropic
• Treats HTN, angina and arrhyhmia After completing a standard 12 lead ECG on an adult patient, the physician requests that you include a tracing with a V4R electrode, as well. What is the physician MOST LIKELY looking for by adding this electrode? dextrocardia right bundle branch block right ventricular infarction right ventricular hypertrophy RV infarction Which of the following is an absolute exercise stress test termination criteria? leg pain headache moderate to severe angina moderate shortness of breath moderate to severe angina Vasodilation with exercise will result in:

increased afterload. decreased contractility. decreased systemic vascular resistance. increased pulmonary vascular resistance. decreased systemic vascular resistance. In the absence of a release form, a patient's health information may be shared with the patient's _____ without committing a HIPAA violation. child spouse physician verbally-reported power of attorney physician The fifth intercostal space, left midclavicular line is a landmark for what precordial electrode placement? V V V V V Exercise stress testing is MOST OFTEN used to evaluate: etiology of acquired heart disease. ischemic changes due to coronary artery disease. anatomic changes due to coronary artery disease. stunned myocardium with acute myocardial infarction. ischemic changes due to coronary artery disease. What would the heart rate be with an accelerated junctional rhythm?

40 to 60 bpm 41 to 100 bpm 101 to 150 bpm 150 to 250 bpm 41 to 100 bpm *actually60- 100 * What would require a need for chest lead modification for a 12 lead ECG? leg amputation poor electrode contact excessive breast tissue never modify chest leads excessive breast tissue The MOST CHARACTERISTIC feature of wandering atrial pacemaker is 3 or more different QT intervals. P-R intervals. QRS durations. P wave morphologies. P wave morphologies. Where would you place the electrodes during a Holter hookup to reduce artifact produced by muscular movements? over the ribs low on the arms between the ribs high on the arms over the ribs Which two leads are referenced when interpreting axis deviation? I and aVF

I and aVL II and III V1 and V I and aVF Which of the following leads normally produces a negative P wave and a predominantly negative QRS on the ECG? V V AVR lead II AVR The normal QRS axis of the heart is 0 to - 90 degrees. 0 to +90 degrees. +60 to - 60 degrees. +60 to +120 degrees. 0 to +90 degrees. Lead placement for V4R is located where on the patient? 4th intercostal space, right sternal border 5th intercostal space, right mid-axillary line 5th intercostal space, right mid-clavicular line 5th intercostal space, right anterior axillary line 5th intercostal space, right mid-clavicular line The sinoatrial node is located in the: left atrium. right atrium. left ventricle. right ventricle.

right atrium. When performing a 12 lead ECG you notice that leads I and II have a lot of artifact. Which electrode MOST LIKELY needs to be replaced? left leg left arm right leg right arm right arm The purpose for placing one of the exploring leads of the Holter monitor on or near the V5 position is to minimize QRS configuration. maximize QRS configuration. minimize P wave configuration. maximize P wave configuration. maximize QRS configuration. Which pacemaker site is the locus of stimulation for junctional rhythms? AV node SA node Purkinje fibers bundle branches AV node ECG PAPER provides measurement for speed and time. time and rhythm. time and voltage. rhythm and voltag time and voltage.

Pacemaker stimuli is recorded on the ECG as a(n) upright wave. negative deflection. narrow vertical spike. straight horizontal line. narrow vertical spike. When performing an exercise stress test, 85% of the predicted maximum heart rate is used to determine the time to increase speed and elevation. end point of a submaximal exercise test. point at which continuous ECG recording begins. normal heart rate response for step II in the Bruce protocol. end point of a submaximal exercise test. Somatic tremor is an artifact found in Holter recordings due to stress loops that are too tight. an improper ground electrode. stress loops that are not secure. electrodes being placed over muscle. electrodes being placed over muscle. Which leads in a 12 lead ECG are referred to as augmented limb leads? I, II, III V1, V2, V V4, V5, V aVR, aVL, aVF aVR, aVL, aVF What BEST describes multifocal PVCs? normal appearing PQRST electrically separated atria and ventricles

different electrical conduction pathways in the atria different electrical conduction pathways in the ventricles different electrical conduction pathways in the ventricles A regular rhythm at a rate of 40-60 beats per minute, with narrow QRS complexes, and no visible P waves, is consistent with the presence of atrial fibrillation. sinus bradycardia. junctional rhythm. idioventricular rhythm. junctional rhythm. Continuous monitoring of a hospital inpatient with the ECG tracings transmitted to a central location, must begin with placement of a(n) event monitor. Holter monitor. telemetry monitor. transtelephonic monitor. telemetry monitor. A positive chronotropic effect will result in a decrease in heart rate. an increase in heart rate. a decrease in force of contraction. an increase in force of contraction. an increase in heart rate. Atropine is used to control bradycardia. tachycardia. ventricular arrhythmias. supraventricular arrhythmias.

bradycardia. Why might an ECG be performed? Choose two responses. diagnose changes in the heart rhythm detect blood flow through the arteries check for pressure changes in the heart determine how well the heart is pumping check for problems with the flow of electricity through the heart diagnose changes in the heart rhythm check for problems with the flow of electricity through the heart Which of the following is a normal response to exercise? increased arterial blood pressure decreased ventricular contractility decreased arterial oxygen saturation increased systemic vascular resistance increased arterial blood pressure The imaginary line that runs from the medial aspect of the armpit down the left side of the chest is called the: manubrium. midaxillary line. midclavicular line. anterior clavicular line. midaxillary line. Wolff-Parkinson-White is unique in what particular way? always fatal only arrhythmia with a delta wave induced with excessive salt consumption usually accompanied with bigeminal pvcs only arrhythmia with a delta wave

Which of the following is an absolute contraindication for exercise stress testing? unstable angina bradyarrhythmias artificial pacemakers patient taking digitalis unstable angina Which of the following atrial rates would need to be communicated to the physician? 75 85 195 305 195 With exercise, cardiac output increases due to increases in: heart rate and stroke volume. systolic and diastolic blood pressures. end diastolic and end systolic volumes. pulmonary and systemic vascular resistances. heart rate and stroke volume. The ability of a positive exercise stress test to correctly identify patients with documented coronary artery disease is known as the test: specificity. sensitivity. relative risk. predictive value. Sensitivity During an exercise stress test, a 2.0 mm down sloping ST segment was observed 6 minutes into the Bruce protocol. This would be considered a: positive test.

negative test. false positive test. false negative test. positive test. Which ventricular response would be MOST CONSISTENT with uncontrolled atrial flutter? 60 bpm 75 bpm 90 bpm 120 bpm 120 bpm Left bundle branch block is characterized by _____ in lead V1. P wave absent, QRS complex measuring less than 0.12 seconds P wave present, QRS complex measuring less than 0.12 seconds P wave absent, QRS complex measuring 0.12 seconds or greater P wave present, QRS complex measuring 0.12 seconds or greater P wave present, QRS complex measuring 0.12 seconds or greater When the excitation impulse is propagated from cell to cell within the heart, it is known as: excitability. rhythmicity. conductivity. automaticity. conductivity. How long is a Holter monitor normally attached to the patient in order to record an adequate ECG? 12 hours 24 to 48 hours 21 days 30 days 24 to 48 hours

When transferring a patient from a bed to a stretcher, which of the following techniques should be employed? Put the head of the bed down and adjust the bed height. Instruct the patient to place their arms down at their sides. Place a slide-board under the entire patient prior to transfer. Place the patient in a prone position in their bed to easily facilitate transfer. Place a slide-board under the entire patient prior to transfer. What is the standard calibration for an ECG machine compared to the standard sweep speed while performing an ECG? 5 mm/mV for calibration compared to 25 mm/mV for performing ECG 10 mm/mV for calibration compared to 25 mm/mV for performing ECG 25 mm/mV for calibration compared to 50 mm/mV for performing ECG 100 mm/mV for calibration compared to 50 mm/mV for performing ECG 10 mm/mV for calibration compared to 25 mm/mV for performing ECG Which of the following would be acceptable to correct somatic tremor artifact on a 12 lead ECG tracing? Plug ECG machine into a different electrical outlet. Replace loose electrodes and remove wire tension. Move patient's bed away from electrical sources such as elevator. Have patient place hands under buttocks, instructing him/her not to move Have patient place hands under buttocks, instructing him/her not to move. Which of the following is an absolute contraindication to administering Lexiscan (regadenosine)? COPD severe hypertension third degree heart block known coronary artery disease third degree heart block

Which waveform on an ECG represents ventricular repolarization? P wave R wave T wave U wave T wave You are explaining the Bruce protocol and post-test expectations to your patient. Which of the following BEST describes what should occur after the patient reaches the THR? The treadmill will slow for one minute and then stop. The treadmill will be immediately stopped and the patient will sit down. The treadmill will be stopped when the patient's heart rate returns to less than 100 beats per minute. The treadmill will slow, then stop and the patient will continue to have vital signs monitored for 10- 15 minutes. The treadmill will slow, then stop and the patient will continue to have vital signs monitored for 10- 15 minutes. An ECG technician who is following universal precautions will: wash his/her hands but not wear gloves before performing any ECG. wear gloves but not wash his/her hands before performing any ECG. wash his/her hands and wear gloves when there is possible exposure to blood. wear gloves but not wash his/her hands when there is possible exposure to blood. wash his/her hands and wear gloves when there is possible exposure to blood. What should be checked on the ECG machine to ensure it is working properly? Choose two responses. check for paper gather enough electrodes

inspect cables for damage look for gel build-up on electrodes inspect cables for damage look for gel build-up on electrodes The PR interval results from a delay in conduction at what level of the conduction system? sinoatrial node purkinje network atrioventricular node right and left bundle branches atrioventricular node You obtain a baseline ECG for your patient prior to stress testing. What other information is helpful to obtain for the doctor to use for comparison? patient's last chest X-ray patient's last ECG reading patient's advance directive time the patient last had any food patient's last ECG reading When reviewing a remote monitoring ECG, the QRS voltage is low, making it difficult to review. What can be done to better view the QRS complex? decrease gain. increase the gain. increase the paper speed. nothing, no manipulation will improve tracing. increase the gain. What necessary equipment should be available for a standard exercise stress test? electrodes, treadmill, calipers, 21g IV calipers, 21g IV, IV pump, surgical mask

electrodes, treadmill, BP cuff, ECG machine electrodes, defibrillator, surgical mask, disinfectant electrodes, treadmill, BP cuff, ECG machine Which type of atrioventricular block tends to progress quickly to third degree AV block or complete heart block? first degree AV block second degree AV block, Mobitz type I second degree AV block, Mobitz type II second degree AV block, Mobitz type III second degree AV block, Mobitz type II Which of the following is a single early electrical impulse that originates in the atrioventricular junctional tissue, occurring before the next expected sinus impulse? junctional tachycardia junctional escape rhythm supraventricular tachycardia (SVT) premature junctional complex (PJC) premature junctional complex (PJC) Sagittal plane (medial) divides body into left and right Coronal plane (frontal) divides body into front and back transverse plane (horizontal) horizontal division of the body into upper and lower portions Proximal Near the attachment of an extremity to the trunk or a structure, closer to any point of reference such as origin of a structure or center of body

Distal farther from the attachment of an extremity to the trunk or a structure, farther from point of reference Anterior near the front of the body (ventral) Posterior Near the back of the body (dorsal) supine lying o n the back with face upward or denoting the position of the hand with the palm facing downward prone lying horizontal with face downward, or denoting the hand with palms turned upward Dark line method heart rate determination method that can only be used when the heart rate is regular. This method can be a very accurate way to determine heart rate or to generate a close estimate 1500 method Count number of small squares between two consecutive R-waves and divide that number by 1500, it is the most accurate method of obtaining the heart rate but can only be used on regular rhythms. 6 second method The number of QRS Complexes between 6 sec marks on the EKG paper is multiplied by 10. Used generally for estimating slow or irregular rhythms. atrioventricular valves Valves located between the atrial and ventricular chambers on each side of the heart, prevent backflow into the atria when the ventricles are contracting. semilunar valves

pulmonary and aortic valves located between the right ventricle and the pulmonary artery and between the left ventricle and the aorta Hexaxial Reference System The system of intersecting lines of the standard limb leads and three other intersecting lines of reference: I, II, III, aVR, aVL, and aVF leads. Normal is 0- 90 Two-Lead method of axis determination Lead I and aVF Right Bundle Branch Block

• QRS >0.12 seconds
• RSR pattern with final R in V1(bunny ear)
• QRS pattern with final wide S in V6
• Right chest lead will show T wave inversion
• Complete RBBB, QRS >0.12
• Incomplete RBBB, QRS is 0.10 to 0.12 seconds Left Bundle Branch Block
• QR pattern
• QRS> 0.12 seconds in V1
• Wide tall R wave in V6 V1: Dominant S waveV 6: broad, notched ('M'-shaped) R wave
• Septal depolarization is right to left Digitalis Effect at normal Therapeutic levels Increases contractility
• shortened ventricular depolarization and repolarization time
• shortened QT interval
• scooping of the ST-T complex
• Flat, inverted, or biphasic T waves

Einthoven's triangle the leads between the three limb electrodes "standard lead I, II and III" referring to the two arm electrodes and the left leg electrode. Epicardium Serous membrane that makes up the outer surface of the heart Captopril (capoten) First ACE inhibitor approved for use in the US

• HTN tx What is the normal pressure of the Right Atria? 6 mmHg What is the normal pulmonary artery pressure? 25/8 mmHg Positive inotropic agents often: block calcium entry Which is not a source of peripheral resistance? volume turbulence vascular tone viscosity volume Which of the following will respond to changes in oxygen levels, blood pH and cerebrospinal fluid? chemoreceptros carotid sinuses baroreceptros central receptors chemoreceptors

baroreceptors monitor the stretching of major arteries and veins caused by the pressure of the blood flowing through them The Resistance to blood flow primarily caused by friction within the vessel walls is called: Peripheral Resistance Systemic resistance vascular resistance pulmonary resistance Peripheral Resistance Contractility amount of force produced during a contraction, independent of preload The sympathetic and parasympathetic division of the autonomic nervous system provide intervention to the heart via the: coronary arteries cardiac plexus circumflex branch coronary sinus cardiac plexus Which of the following is toward the body's longitudinal axis? medial distal lateral proximal medial Superficial near, at or close to the body surface

Flutter is a HR between: 100 - 150bpm 150 - 250bpm 250 - 350bpm 350 - 450bpm 250 - 350bpm Ventricular hypertrophy is diagnosed with R wave changes in leads: V2 & V4 V1 & V5 V3 & V6 V1 & V2 V1 & V5 Atrial Hypertrophy is best seen in which lead? V1 aVF II V5 V1 The cardiac Centers of the _________________ contain the autonomic headquarters for cardiac control> medulla oblongata pons cerebrum cerebellum medulla oblongata How would you recognize that a lead may be reversed on an ECG? lead II QRS is negative aVR QRS is negative