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Cct Exam Practice (Ee2) With Complete Solutions Latest Update Of the following which would be the correct term for the abbreviation ICD? -Ice cool down -Improvise cardiac defibrillator -Implantable cardioverter defibrillator -Ice cardiac slow-down - correct answers Implantable cardioverter defibrillator With the three lead cardiac monitoring system, where would the black lead be placed? -Right arm -Left arm -Left leg -Right leg - correct answers Left arm The right arm lead would be white The right leg would be red/brown and is the ground lead The left arm lead would be black The 3 stages of a one heart beat include all of the following except? -Atrial and ventricular repolarization -Ventricular depolarization -Atrial and ventricular fibrillation -Atrial depolarization - correct answers Atrial and ventricular fibrillation The 3 stages include the atrial and ventricular depolarization and the atrial and ventricular repolarization Where would the precordial leads be placed on the patient? -Legs -Shoulders -Arms -Chest - correct answers Chest The chest is where the precordial leads are placed. The precordial leads are V1, V2, V3, V4, V5, and V6 The heart is a muscular organ. It constantly pumps blood to the different parts of the body.The cardiac muscles are strong and help to facilitate rhythmic contractions When giving instructions to the patient in preparation for the stress echocardiogram, the ECG technician should include all but which of the following? -The patient will have to exercise on a treadmill/supine bicycle for about 6-10 minutes -The patient will need to run approximately 100 yards -The patient would need to disrobe from the waist up and be provided a gown to wear -Wear tennis shoes or comfortable walking shoes - correct answers The patient will need to run approximately 100 yards This exam compares both the resting and exercise ultrasound images of the heart. Some of the instructions might include: The patient will have to exercise on a treadmill/supine bicycle for about 6-10 minutes The patient would need to disrobe from the waist up and provided a gown to wear Wear tennis shoes or comfortable walking shoes Wear comfortable clothes to exercise in Take medications as usual unless otherwise instructed The heart rate for sinus bradycardia would be considered which of the following? -Less than 100 beats per minute -Less than 50 beats per minute -Less than 40 beats per minute -Less than 60 beats per minute - correct answers Less than 60 beats per minute Athletes commonly have bradycardia. Problems that could occur with the lead wires used for the ECG that could cause artifact would not include? -Newly replaced lead wires -Breaks in the wires -Poor contact at the snap connection -Both B and C - correct answers Newly replaced lead wires If the lead wires have been replaced with new ones, they would probably not be the problem. Some of the conditions that can occur would include: Breaks in the wires Poor contact at the snap connection Loose pins at the cable end of the lead wires Breaks in the conductors of the lead wires/patient cables Which of the following would be the most correct statement about an organic disorder? -There would be no physical changes -With an organic disorder, there would be physical changes -It would be the nature of the disorder -It would be the latent period of the disease - correct answers With an organic disorder, there would be physical changes If there were no physical changes to explain the patients symptoms, it would be considered a functional disorder A diagnosis would be the nature of the disorder Incubation would be the latent period of the disease An organic disorder would present with physical changes To which of the four sections (chambers) of the heart does the vena cava carry blood? What is the least number of leads that is necessary to record an ECG? -12 -1 -3 -6 - correct answers 3 The 12-lead is standard. The minimum number of leads though would be 3 leads Which of the following can be considered characteristics of premature ventricular contractions? -They look wide -They look bizarre -They appear as early beats -All of the above - correct answers All of the above When interpreting an ECG strip, it is not difficult to identify premature ventricular contractions. They are wide, appear as early beats, and often look bizarre to the clinician Which of the following would be considered the most serious symptom of coronary heart disease (CHD)? -Fatigue -Chest pain -Abdominal pain -Headache - correct answers Chest pain The most serious symptom of coronary heart disease would be considered chest pain. CHD affects approximately 16 million people in the United States each year The Bundle of His and the Atrioventricular node form a combination of which of the following? -AV Junction -Q-T interval -RBB -SA node - correct answers AV Junction Q-T interval would be the time when the depolarization of the ventricles and the repolarization of the ventricles both occur The RBB would be right bundle branch SA node would be the Sinoatrial node or the natural pacemaker of the heart The AV junction is the combination of the AV node and the Bundle of His When the ECG technician is performing an ECG on a patient that has had a mastectomy, which of the following should be taken into consideration? -The patient's skin may be fragile -Standard lead placement would be used -Both A and B -None of the above - correct answers Both A and B If the patient has had a mastectomy, the ECG technician should be aware of: The patient's skin may be fragile Standard lead placement would be used Document on the ECG that the patient has had a mastectomy and which breast it was Which of the following would be the correct term for an external piece of equipment that is non-invasive and will deliver an electrical shock that is meant to restore a persons heart to a normal rhythm? -0.4 mm -1 mm - correct answers 1 mm In order to be considered a myocardial infarction, there needs to be an elevation of the ST segment in how many of the ECG leads? -One -Three -Four -Two - correct answers Two This might vary according to the type of myocardial infarction, but typically there should be an ST elevation in at least 2 of the leads. This elevation needs to be at least one small box. An example would be with an inferior wall MI, there should be changes in at least 2 of the leads II, III or aVF Of the following, which would be considered a standard cardiac lead? -Lead 3 -aVL -V3 -aVF - correct answers Lead 3 Lead 3 would be a standard lead aVL and aVF would be augmented leads V3 would be a precordial lead The ECG consists of which of the following leads? -Six unipolar chest leads V1-V6 -Three bipolar standard leads I, II, and III -Six augmented unipolar leads -Both A and B - correct answers Both A and B The ECG consists of leads: Six unipolar chest leads V1-V6 Three bipolar standard leads I, II, and III Three augmented, unipolar leads: aVR, aVL, and aVF The ECG technician should have the knowledge that all of the following cardiac disorders might be detected by an ECG except? -Pericarditis -Myocardial infarction -Atrial hypertrophy -Drug effects such as insulin - correct answers Drug effects such as insulin The cardiac disorders which might be detected by an ECG would be considered: Pericarditis Myocardial infarction Atrial hypertrophy Arrhythmias Ventricular hypertrophy Drug effects such as digitalis Congenital heart disease If the right arm and left leg leads are reversed, which of the following would not be seen on the electrocardiogram? -Lead II becomes inverted -Lead aVL is reversed -Leads I and III become inverted and switch places -Leads aVR and aVF switch places - correct answers Lead aVL is reversed -Wave -None of the above - correct answers Segment A segment can be defined as the space between two waves. The terms segment and isoelectric interval are often used interchangeably After the ECG has been completed, which of the following should the ECG technician do? -Discard supplies such as electrodes -Take the ECG tracing to the physician if they are present -Remove the electrodes and help the patient to sit if applicable -All of the above - correct answers All of the aboveThe ECG technician should: Discard supplies such as electrodes Take the ECG tracing to the physician if they are present Remove the electrodes and help the patient to sit if applicable Remove the machine from the room Wash hands Document With the 3 lead system for continuous cardiac monitoring, the white lead is placed where? -Left arm (chest) -Right arm (chest) -Both A and B -Left leg - correct answers Right arm (chest) The left arm (chest) lead would be black. The right arm (chest) lead would be white. The left leg is red or sometimes brown, according to the facility. Although these are called left and right arm, they are placed on the left and right chest. The term "whiteon the right" helps nurses to remember lead placement The past medical history of the patient includes which of the following? -Patient allergies -Present illnesses -Past surgeries -All of the above - correct answers All of the above The past medical history would include: Patient allergies Medications Present illnesses Major illnesses Past surgeries The abbreviation BPM would be? -Bedrest -Beats per minute -Blood pressure -None of the above - correct answers Beats per minute Bedrest would be BR Blood pressure would be BP Beats per minute would be BPM Which of the following rates might be considered correct for an accelerated idioventricular rhythm? -40-100 beats per minute -20-40 beats per minute -30-50 beats per minute (typically 24-72), the technician then removes the tape from the monitor and places it in a scanner. They then print the information for the physician so it can be interpreted later Aortic aneurysm is considered which of the following? -A ballooning of the aorta -Softening of the heart -Enlargement of the heart -Heart pain - correct answers A ballooning of the aorta Softening of the heart would be cardiomalacia Enlargement of the heart would be cardiomegaly Heart pain would be cardiodynia A ballooning of the aorta would be an aneurysm Which of the following statements would be considered the most correct regarding teenage athletes and bradycardia? -The patient would need an immediate cardiac workup -Teenage athletes typically experience bradycardia -The patient should be taken for an immediate cardiac catheter -None of the above - correct answers Teenage athletes typically experience bradycardia If any patient is experiencing bradycardia, they should be assessed for symptoms. It is typical for teenage athletes to experience bradycardia Which of the following organs is located in the mediastinal cavity and right behind the sternum? -Kidneys -Clavicle -Heart -Intestines - correct answers Heart The mediastinal cavity is between the two lungs. It lays more to the left side of the sternum Of the following cardiac rhythms, which would typically not be life-threatening? -Asystole -Ventricular tachycardia -Ventricular fibrillation -First degree AV block - correct answers First degree AV block The other 3 options above are definitely life-threatening situations. In addition to these would be such rhythms as idioventricular, complete heart block, and accelerated idioventricular. First degree AV block would not be life- threatening In order to help the ECG machine to function properly, which of the following should be done? -The exterior of the machine should be routinely cleaned including the front panel controls -Calibrate the stylus -Replace the batteries when needed -All of the above - correct answers All of the above The proper functioning of an ECG machine depends on how well it is cared for. Some of this care should include: The exterior of the machine should be cleaned including the front panel controls Calibrate the stylus Replace the batteries when needed The recorder mechanism and paper drive should be lubricated as per the protocol of the manufacturer -Two -Four -One -None of the above - correct answers Two Although the heart has four chambers, it is still considered to be a two-sided pump.The atrium as one and the ventricles as the second. The atria pump together and the ventricles pump together Which of the following is a protein that is released into a persons blood stream when a heart attack is occurring? -Hemoglobin -Troponin -Potassium -Sodium - correct answers Troponin Hemoglobin, potassium, and sodium would be incorrect. The protein that is released in the patients blood stream during a heart attack would be troponin If the patient has a pacemaker, which of the following might the electrocardiogram help assess? -The motions of the pacemaker -The regularity of the pacemaker -Both A and B -None of the above - correct answers Both A and B When the patient has a pacemaker, the electrocardiogram helps to assess: The motions of the pacemaker The regularity of the pacemaker If the pacemaker is capturing If the patient has a normal heart rate and rhythm, which of the following will be seen directly after each P wave? -QRS complex -T wave -U wave -None of the above - correct answers QRS complex If the heart is functioning correctly, there will be a QRS complex after each P wave. If there is not a QRS present the patient would be in ventricular standstill Which of the following is not one of the 4 basic sinus mechanism rhythms? -Sinus tachycardia -Normal sinus rhythm -Sinus congestion -Sinus arrhythmia - correct answers Sinus congestion The 4 basic types of sinus mechanism rhythms include the 3 other options above and sinus bradycardia Implantable permanent pacemakers use lithium batteries. How long do these batteries last? -6 months -1 to 2 years -5 to 10 years -15 to 20 years - correct answers 5 to 10 years When a permanent pacemaker is implanted, the batteries have to be changed. Most lithium batteries last approximately 5 to 10 years -No conduction at all -None of the above - correct answers Conducting away from If an impulse is conducting toward, it would be considered afferent An ECG is typically performed on a patient for which of the following reasons? -Prior to some surgeries -Part of a routine physical examination -If a patient is experiencing chest pain -All of the above - correct answers All of the above If a patient has any cardiac history, an ECG is typically performed If the patient is over the age of 40, they would be at a higher risk for problems, especially if they are having surgery, so an ECG is usually ordered and at some facilities it is policy Some of the drugs which are often used for the treatment of premature ventricular contractions (PVC's) could include all of the following except? -Amiodarone -Lidocaine -Anti-coagulants -Beta blockers - correct answers Anti-coagulants Some of the drugs which are often used for the treatment of PVC's would include: Amiodarone Lidocaine Beta-blockers Procainamide Others Which of the following cardiac characteristics of a pulmonary embolus might be seen on a 12-lead electrocardiogram? -An ST depression in Lead II -Inverted T waves in leads V1 through V4 -Wide S wave in lead I -All of the above - correct answers All of the above In addition to the 3 options above, an acute right BBB may be seen. In lead III, there may be inverted T waves and a large Q wave If the physician is unable to determine the cause of a condition, it would be considered which of the following? -Infarct -Hypertension -Idiopathic -None of the above - correct answers Idiopathic Infarct would be the area of the heart when the tissue is permanently damaged because of not enough oxygen supply Hypertension is elevated blood pressure Idiopathic is no known cause If the physician is suspecting an inferior wall infarct, they may order an ECG with extra leads. Which of the following leads might be needed? -V4 may be placed in the middle of the right clavicle -The V3-V6 leads may be placed in the same place but mirrored on the chest -Category capture -Content category -None of the above - correct answers Chief complaint The chief complaint would be considered the reason the patient went to see the physician. The chief complaint should be short but specific covering both subjective/objective data During a code, an Automated External Defibrillator (AED) needs to be applied. Which of the following would be considered the first step? -The pads should be applied to the patient's chest -The patient should be assessed for any bleeding -Both A and B -None of the above - correct answers The pads should be applied to the patient's chest During a code, if an AED needs to be applied, the first step would be to apply the pads. Without the pads, the AED machine will not be able to function. The pads should be applies, the machine connected and turned on and then the machine will diagnosis the rhythm of the patient and shock when necessary. If the ECG technician is to understand the ECG, they need to have knowledge of how the heart functions. How many chambers does the heart have? -Five -Six -Two -Four - correct answers Four Hypertension is considered to be a risk for the development of cardiovascular disease. Which of the following risk factors would be considered correct for developing hypertension? -Excessive alcohol use -Family history of premature CVD -Renal disease -All of the above - correct answers All of the above Risk factors includes: Excessive alcohol use Family history of premature CVD Physical inactivity Renal disease Excessive dietary sodium intake Insufficient dietary potassium intake Which lead is placed on the right side of the sternum at the fourth intercostal rib space? -V5 -V1 -V4 -V2 - correct answers V1 The V leads are V1-V6. The V1 lead is placed on the right side of the sternum at the fourth intercostal rib space Of the following, which would be the correct abbreviation for an atrial septal defect? -AS -ASC -ASAP -ASD - correct answers ASD AS: aortic stenosis No P waves/P waves may be present if SA node is functional Bizarre QRS complexes greater than 0.12 with T waves pointing in the opposite direction from the main QRS direction Of the following, which is considered to be a necessary electrolyte that helps to initiate the electrical activity in the heart? -Potassium -Chlorine -Calcium -Both A and C - correct answers Both A and C The electrolytes that are mandatory for heart functioning would be the potassium, calcium, magnesium, and sodium. If one or more of these are lacking, the heart does not function well. Chlorine, combining with sodium, is needed to perform various cellular activities in the body. It carries electric charges from one cell to another. It is also needed for conduction of nerve impulses and muscle function Of the following, which would be considered the correct rate for junctional tachycardia? -40 to 60 beats per minute -100 to 200 beats per minute -200 to 300 beats per minute -100 to 300 beats per minute - correct answers 100 to 200 beats per minute AVR, aVL, and aVF would be considered which type of limb leads? -Bipolar -Unipolar -Both A and B -None of the above - correct answers Unipolar Unipolar leads would: aVR-the right arm positive aVL-the left arm positive aVF-the left leg positive Which of the following is considered to be one of the 4 valves that regulate the blood flow in the heart? -Tricuspid -Bicuspid -Aortic valve -All of the above - correct answers All of the above All of the above are considered heart valves. In addition to these 3, there is also the pulmonic valve The abbreviation for nausea and vomiting would be which of the following? -N&V -NWB -NYD -NTG - correct answers N&V NWB would be no weight bearing NYD would be not yet diagnosed NTG would be nitroglycerine N&V would be nausea and vomiting Sometimes n/v is also used If the heart is in the resting phase, it is considered which of the following? -Depolarized -None of the above - correct answers Irregular rhythm Normal sinus rhythm will have a regular rhythm. The rate should be between 60 and 100. The QRS should be < 0.12 seconds and there should be a P wave before each QR Which of the following statements would not be considered correct for third degree heart block? -With third degree heart block, there is no relationship between the P waves and the QRS complexes -Although the P waves are normal, there is no measurable PR intervals -With this rhythm, the P waves are regular and the ventricular rhythm is regular but there is no relationship to each other -The rate of the P waves and the QRS complexes are identical - correct answers The rate of the P waves and the QRS complexes are identical With third degree heart block, there is no relationship between the P waves and the QRS complexes. Although the P waves are normal, there is no measurable PR intervals. With this rhythm, the P waves are regular and the ventricular rhythm is regular but there is no relationship to each other The elevation of the ST segment is one of the ways to diagnose a heart attack. This elevation needs to be which of the following in order to be consistent with a heart attack? -3 small boxes in 3 leads -1 small box in 2 leads -1 large box in 2 leads -3 large boxes in 1 lead - correct answers 1 small box in 2 leads According to which type of myocardial infarction the patient is experiencing, there needs to be an elevation of the ST segment in a least 2 of the leads. For example, with an inferior wall MI, changes will be seen in leads II, III, and aVF. At least two of these leads should have an ST elevation Which of the following functions does the coronary arteries perform? -They carry oxygenated blood to the muscles of the heart -They carry nutrients to the muscles of the heart -Both A and B -None of the above - correct answers Both A and B The coronary arteries are the transporters of the heart. They carry oxygenated blood to the myocardium (muscles of the heart), but also carry nutrients to the heart The eligibility for a biventricular pacemaker would include? -This patient should be taking medications for treatment of heart failure -Heart failure -Would the patient benefit from a biventricular pacemaker -All of the above - correct answers All of the above This type of pacing would also be considered cardiac resynchronization therapy.This eligibility would include: This patient should be taking medications for treatment of heart failure Heart failure Would the patient benefit from a biventricular pacemaker Which of the following are heart valves that are between the atrium and the ventricles?