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Certified EKG Technician (CET)
Examination Professional Certification
Exam Questions And Correct Answers
(Verified Answers) Plus Rationales 2026
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- When performing an EKG on a patient, which of the following is the standard paper speed? A. 12.5 mm/sec B. 25 mm/sec C. 50 mm/sec D. 75 mm/sec Rationale: The standard speed for recording an EKG is 25 mm/sec, which allows for the accurate measurement of intervals and amplitudes. Other speeds are used only for specific clinical scenarios like identifying fast tachycardias.
- Which lead is recorded by placing the positive electrode on the left arm and the negative electrode on the right arm? A. Lead I B. Lead II C. Lead III D. aVR Rationale: Lead II is part of the bipolar limb leads and follows Einthoven’s Law, measuring the electrical potential between the right arm and left leg, but historically defined by the potential difference between right arm and left arm as the path.
- A patient is experiencing a heart rate of 140/min. Which of the following rhythms should the EKG technician expect to see? A. Sinus bradycardia B. Junctional rhythm C. Sinus tachycardia D. Idioventricular rhythm Rationale: Sinus tachycardia is defined as a sinus rhythm with a heart rate greater than 100/min. Given the rate of 140/min, this fits the classification of sinus tachycardia.
- Which of the following waves represents ventricular repolarization? A. P wave B. QRS complex C. T wave D. U wave Rationale: The T wave is the deflection produced by the repolarization of the ventricles. The P wave
represents atrial depolarization, and the QRS complex represents ventricular depolarization.
- When applying electrodes for a Holter monitor, which of the following is the most important step to ensure quality tracing? A. Abrading the skin with a dry gauze B. Applying alcohol-based cleaner only C. Applying the leads over bony prominences D. Ensuring the wires are stretched tight Rationale: Abrading the skin removes dead skin cells and oils, which reduces electrical impedance and improves signal quality. Bony prominences should be avoided to prevent muscle artifact.
- Which of the following is a common cause of a wandering baseline artifact? A. Improper grounding of the machine B. Electrical interference from nearby devices C. Loose or dried-out electrodes D. Patient muscle tremors Rationale: Wandering baseline is often caused by poor electrode contact or patient movement. Ensuring electrodes are fresh and adhered properly to clean skin resolves this issue.
- If a patient is diagnosed with a third-degree heart block, which of the following is expected on the EKG? A. Prolonged PR interval B. Dropped QRS complexes C. Absent relationship between P waves and QRS complexes D. Missing P waves Rationale: In a third-degree (complete) heart block, the atria and ventricles beat independently. There is no correlation between the P waves and the QRS complexes.
- Which lead is considered the most common rhythm strip lead? A. V1 B. II C. V6 D. aVL Rationale: Lead II provides the best visualization of P wave morphology and the overall atrial-ventricular conduction sequence. It is the standard lead for continuous monitoring.
- Which of the following is the correct placement for lead V4? A. Fourth intercostal space, right sternal border B. Fourth intercostal space, left sternal border C. Fifth intercostal space, left midclavicular line D. Fifth intercostal space, left anterior axillary line Rationale: Anatomical landmarks for V4 require placing the electrode at the intersection of the fifth intercostal
16.Which of the following is the correct order of the electrical conduction system? A. AV node, SA node, Bundle of His, Purkinje fibers B. SA node, AV node, Bundle of His, Purkinje fibers C. SA node, Purkinje fibers, AV node, Bundle of His D. AV node, SA node, Purkinje fibers, Bundle of His Rationale: The electrical signal normally originates in the SA node, travels to the AV node, proceeds through the Bundle of His, and finishes in the Purkinje fibers. 17.Which of the following is a result of right-sided heart failure? A. Pulmonary edema B. Peripheral edema C. Hypertension D. Tachycardia Rationale: Right-sided heart failure leads to systemic venous congestion, which manifests as peripheral edema (fluid buildup in the legs and abdomen). 18.What is the normal duration of the PR interval? A. 0.04 to 0.10 seconds B. 0.12 to 0.20 seconds C. 0.20 to 0.30 seconds D. 0.40 to 0.60 seconds Rationale: The PR interval represents the time taken for the impulse to travel from the SA node through the AV node. Values outside 0.12–0. seconds indicate conduction delays. 19.A patient complains of dizziness during the EKG. What is the first thing to check? A. The paper speed B. The electrode placement C. The patient's blood pressure D. The machine calibration Rationale: Dizziness suggests a hemodynamic compromise. It is vital to assess the patient's vital signs, particularly blood pressure, to determine if they are stable. 20.Which of the following is the correct way to calculate heart rate using the 1500 method? A. Count the number of boxes between R waves and multiply by 1500 B. Divide 1500 by the number of small squares between two R waves C. Multiply the R-R interval in seconds by 1500 D. Divide 1500 by the number of large squares between two R waves Rationale: The 1500 method is highly accurate for regular rhythms. Since each small square represents 0.04 seconds, dividing 1500 by the number of small squares gives the beats per minute. 21.Lead aVR views the heart from which perspective? A. Inferior B. Lateral C. Rightward/Superior D. Posterior Rationale: aVR stands for augmented
Vector Right and provides a view of the heart from the right shoulder, often showing negative deflections in a normal sinus rhythm. 22.Which of the following is considered an emergency on an EKG? A. Premature atrial contraction B. Ventricular fibrillation C. First-degree heart block D. Sinus arrhythmia Rationale: Ventricular fibrillation is a life- threatening rhythm where the heart is not pumping blood effectively; it requires immediate defibrillation. 23.When documenting the procedure, which information is essential? A. Date, time, and patient identification B. The color of the EKG cable C. The patient's insurance information D. The name of the cardiologist on call Rationale: Accurate documentation requires the patient’s name, ID, and the exact date and time the tracing was performed to ensure correct clinical correlation. 24.What is the purpose of the V6 electrode? A. Visualize the septum B. Visualize the anterior wall C. Visualize the lateral wall D. Visualize the inferior wall Rationale: V5 and V6 electrodes are placed to view the lateral wall of the left ventricle. 25.Which patient should the technician identify as being at higher risk for artifact? A. A calm, seated adult B. A patient with Parkinson’s disease C. An athlete D. A middle-aged person in sinus rhythm Rationale: Parkinson's disease causes involuntary tremors that often appear as somatic artifact on the EKG. 26.Which of the following indicates that an EKG is technically acceptable? A. Baseline wander B. Muscle noise C. A clear baseline and distinct complexes D. Excessive electrode contact Rationale: A clean, clear, and readable tracing is necessary for accurate diagnosis and interpretation. 27.What is the difference between a 12-lead EKG and a rhythm strip? A. A rhythm strip uses 12 leads B. A rhythm strip is longer in duration C. A rhythm strip monitors fewer leads over a longer time D. A 12-lead EKG is only for heart rate Rationale: A rhythm strip is typically a single or double
34.A patient has an irregular rhythm. How should the rate be calculated? A. 1500 method B. 300 method C. 6-second strip method D. It cannot be calculated Rationale: For irregular rhythms, the 6-second strip method is used to estimate the ventricular rate by counting the number of R-R intervals in 6 seconds and multiplying by 10. 35.Which of the following is the most common cause of 60-cycle interference? A. Poor electrode contact B. Patient movement C. Electrical appliances near the patient D. Loose wires Rationale: 60-cycle (AC) interference is caused by electrical devices (like lamps or pumps) in the room interfering with the machine's electrical signals. 36.Which lead is measured between the right arm and the left leg? A. Lead I B. Lead II C. Lead III D. Lead aVF Rationale: Lead II is part of the standard bipolar limb lead setup, reflecting the electrical potential between the right arm and left leg. 37.A patient has a pacemaker. How does this appear on an EKG? A. Vertical spikes before the complex B. Horizontal waves C. Inverted T waves D. Wide P waves Rationale: Pacemaker spikes are sharp, vertical deflections indicating the electrical discharge from the pulse generator to trigger a beat. 38.What is the clinical significance of a wide QRS complex (>0.12 seconds)? A. Ventricular origin of the rhythm B. Atrial origin of the rhythm C. Normal conduction D. Sinus tachycardia Rationale: A wide QRS indicates that the electrical impulse is traveling slowly through the ventricles rather than using the normal rapid conduction system, usually originating in the ventricles. 39.Which of the following is the correct placement for V1? A. Second intercostal space, right sternal border B. Fourth intercostal space, right sternal border C. Fourth intercostal space, left sternal border D. Fifth intercostal space, left sternal border Rationale: Correct V1 placement is essential for identifying right ventricular pathologies and conduction abnormalities.
40.What is the normal range for heart rate in an adult? A. 40–60/min B. 60– 100/min C. 100–120/min D. 120–150/min Rationale: A heart rate of 60 to 100 beats per minute is considered the normal physiological resting range for adults. 41.Which of the following describes the Q-T interval? A. Ventricular depolarization B. Total ventricular activity (depolarization and repolarization) C. Atrial activity D. The delay at the AV node Rationale: The Q-T interval represents the entire time required for the ventricles to depolarize and then repolarize. 42.What is the main role of the AV node? A. To initiate the heartbeat B. To delay the impulse to allow for ventricular filling C. To accelerate the impulse D. To repolarize the atria Rationale: The AV node acts as a gatekeeper, introducing a crucial delay that allows the atria to contract fully and fill the ventricles before ventricular contraction begins. 43.Which of the following artifacts is caused by the patient touching the metal parts of the bed? A. Wandering baseline B. Somatic tremor C. Alternating current (AC) interference D. Baseline sway Rationale: When a patient touches grounded metal objects, they may become part of the electrical circuit, leading to AC interference on the tracing. 44.A patient has a heart rate of 45/min. What is the most likely rhythm? A. Sinus tachycardia B. Sinus bradycardia C. Normal sinus rhythm D. Atrial fibrillation Rationale: Sinus bradycardia is characterized by a regular rhythm with a heart rate of less than 60 beats per minute. 45.Which of the following is associated with atrial fibrillation? A. Regular rhythm B. Irregularly irregular rhythm with absent P waves C. Consistent P waves D. Fixed PR interval Rationale: Atrial fibrillation is characterized by rapid, chaotic electrical activity in the atria, leading to an irregular ventricular response and the absence of discernable P waves. 46.What is the term for a heart beat that occurs earlier than expected? A. Escape beat B. Premature beat C. Ectopic beat D. Fusion beat Rationale: A
54.If a patient is unable to lie flat, what is the best alternative? A. Cancel the EKG B. Have them stand C. Perform the EKG in a semi-Fowler’s position D. Use only chest leads Rationale: If a patient cannot lie flat due to respiratory distress or comfort issues, the semi-Fowler's position is an acceptable alternative, provided it is documented. 55.Which lead provides the best view of the inferior wall of the heart? A. V1 B. V2 C. Lead II, III, and aVF D. V5 and V6 Rationale: Leads II, III, and aVF look at the electrical activity of the heart from the perspective of the inferior surface. 56.What is the primary function of the EKG? A. Measure blood pressure B. Measure oxygen saturation C. Record the electrical activity of the heart D. Determine valve health Rationale: The EKG records the electrical potential generated by the heart to assess its rhythm and conduction status. 57.Which of the following is required before performing an EKG? A. Patient's medical history B. Patient's blood type C. Physician's order and informed consent D. Patient's family history Rationale: A physician's order is necessary to perform any diagnostic test, and informed consent ensures the patient understands the procedure. 58.Which of the following describes the QRS complex? A. Atrial contraction B. Ventricular depolarization C. Ventricular repolarization D. Atrial repolarization Rationale: The QRS complex represents the depolarization of the ventricles, which is the primary electrical event triggering ventricular contraction. 59.What is the danger of a high-degree AV block? A. It causes hypertension B. It can lead to severe bradycardia and syncope C. It causes chest pain D. It is not dangerous Rationale: High-degree blocks significantly reduce the heart rate, decreasing cardiac output and potentially leading to fainting (syncope) or heart failure.
60.Which of the following is a normal PR interval duration? A. 0.08 seconds B. 0.16 seconds C. 0.25 seconds D. 0.35 seconds Rationale: 0.16 seconds falls squarely within the normal 0.12–0.20 second range for PR interval duration. 61.Which lead is positive on the left leg? A. Lead I B. Lead II C. Lead III D. Lead aVF Rationale: aVF stands for augmented Vector Foot, and the positive electrode is placed on the left leg. 62.What is the most common cause of sinus arrhythmia? A. Myocardial infarction B. Respiratory cycles C. Electrolyte imbalance D. Medications Rationale: Sinus arrhythmia is a normal, non-pathological variation where the heart rate changes with the breathing cycle. 63.Which of the following is not a standard lead on a 12-lead EKG? A. V1 B. V C. aVR D. V7 Rationale: While V7, V8, and V9 are used in specialized posterior EKGs, they are not part of the standard 12-lead set. 64.What is the correct action if an electrode is not sticking to the patient's skin? A. Use duct tape B. Use super glue C. Clean the skin with alcohol or replace the electrode D. Skip that lead Rationale: Proper skin preparation, such as removing oils and sweat with alcohol, ensures the best adhesion and signal quality. 65.Which of the following is a sign of an elevated ST segment (STEMI)? A. ST elevation B. ST depression C. T wave inversion D. Wide P wave Rationale: ST segment elevation is the definitive EKG sign of a full-thickness myocardial infarction (STEMI). 66.What is the approximate rate of an escape rhythm from the AV junction? A. 20 – 40/min B. 40–60/min C. 60–100/min D. 100–120/min Rationale: The AV junction has an inherent pacing rate of 40 to 60 beats per minute, which acts as a backup if the SA node fails. 67.Which of the following is a common cause of bradycardia? A. Exercise B. Caffeine C. Athletic conditioning D. Anxiety Rationale: Athletes often have a resting bradycardia due to increased stroke volume and increased vagal tone.
Atrial flutter is distinguished by organized, rapid atrial activity resulting in a characteristic "sawtooth" or "flutter" wave pattern. 76.What is the correct way to handle a patient with a hairy chest for an EKG? A. Don't worry about it B. Clip or shave the hair in the electrode sites C. Apply the electrode over the hair D. Use more gel Rationale: Excessive chest hair prevents electrodes from making contact with the skin, leading to artifact; shaving or clipping is necessary. 77.Which of the following describes the Q-T interval prolongation? A. Normal B. Indicates tachycardia C. Can lead to dangerous arrhythmias like Torsades de Pointes D. Is not a concern Rationale: A prolonged Q-T interval indicates a delay in ventricular repolarization, which can predispose the heart to lethal rhythms. 78.What does "aVR" stand for? A. Augmented Voltage Right B. Augmented Vector Right C. Atrial Ventricular Right D. Augmented Ventricular Right Rationale: The standard terminology for augmented limb leads is Augmented Voltage, and the 'R' indicates the right arm. 79.What is the primary sign of ventricular tachycardia? A. Narrow QRS B. P waves present C. Wide QRS complexes and no P waves D. Irregular rhythm Rationale: Ventricular tachycardia is a series of three or more consecutive premature ventricular contractions, characterized by wide QRS complexes. 80.Which lead placement is at the fourth intercostal space, left sternal border? A. V1 B. V2 C. V3 D. V4 Rationale: V2 is positioned directly opposite V1 on the left side of the sternum. 81.What is the effect of exercise on the EKG? A. It causes a baseline artifact B. It causes ST elevation C. It causes heart rate increase D. It has no effect Rationale: Physical exertion increases the body's oxygen demand, resulting in an increased heart rate (sinus tachycardia) to supply the myocardium. 82.Which of the following is a common symptom of a PVC (Premature Ventricular Contraction)? A. A feeling of "skipping a beat" B. Constant chest pain C. Nothing, it is normal D. Fainting Rationale: Patients often describe
the sensation of a PVC as a "flip-flop" in the chest or a "skipped beat," due to the compensatory pause following the PVC. 83.Which of the following leads is considered a bipolar lead? A. aVR B. aVL C. aVF D. Lead I Rationale: Leads I, II, and III are the bipolar leads that measure the potential difference between two electrodes. 84.What is the purpose of the gel on the electrodes? A. To keep the skin hydrated B. To improve electrical conductivity C. To prevent skin irritation D. To keep the electrode cool Rationale: EKG gel reduces skin impedance, ensuring that the electrical impulses from the heart are effectively conducted to the electrode. 85.Which of the following is associated with hyperkalemia on an EKG? A. U waves B. Tall, peaked T waves C. Flat T waves D. Wide P waves Rationale: High serum potassium levels (hyperkalemia) classically present with tall, tented, or peaked T waves. 86.What is the difference between a 3-lead and a 12-lead EKG? A. 3-lead is more accurate B. 12-lead provides a comprehensive view of the heart C. 12 - lead is only for hospitals D. 3-lead is for stress tests Rationale: A 12-lead EKG provides 12 distinct electrical perspectives, allowing for a much more detailed diagnosis than a 3-lead monitor. 87.Which of the following is a sign of a third-degree heart block? A. PR interval is 0.16 seconds B. Every P wave has a QRS C. P waves and QRS complexes are completely dissociated D. P wave is missing Rationale: The defining feature of complete heart block is the absolute lack of conduction between atria and ventricles, resulting in independent rates. 88.Which of the following is not a symptom of heart disease? A. Shortness of breath B. Chest pain C. Edema D. Sneezing Rationale: While cardiac conditions cause systemic symptoms, sneezing is typically related to respiratory or allergic conditions. 89.What is the most likely cause of a "noisy" EKG tracing? A. The patient is sitting still B. The machine is calibrated correctly C. Patient movement or
96.Which lead is measured between the right arm and left arm? A. Lead I B. Lead II C. Lead III D. Lead aVF Rationale: Lead I is a bipolar limb lead that records the potential difference between the right arm (negative) and the left arm (positive). 97.What is the result of lead V3 placement? A. Between V1 and V2 B. Between V2 and V4 C. Between V4 and V5 D. Between V5 and V6 Rationale: V3 is placed on a diagonal line exactly halfway between V2 and V4 to ensure a smooth transition of the electrical vectors. 98.Which of the following rhythms has a PR interval that is constantly prolonged? A. First-degree heart block B. Second-degree heart block C. Third-degree heart block D. Normal sinus rhythm Rationale: A first-degree heart block is characterized by a PR interval that is consistently longer than 0.20 seconds. 99.When the heart rate is too fast, what happens to the diastolic filling time? A. It increases B. It decreases C. It stays the same D. It stops Rationale: As heart rate increases, the time available for the heart to relax and fill with blood (diastole) is significantly shortened.
- Which of the following is the final electrical event before the cycle repeats? A. P wave B. QRS complex C. T wave D. U wave Rationale: The T wave marks the end of the ventricular repolarization, concluding the electrical cycle before the next P wave initiates the next heartbeat.
