CET Certification Exam Review:
Where would you place electrodes on a patient with a left leg amputation? – torso, trunk
You notice small waves on the ECG, what could you do? - increase size by increasing the gain
The Angle of Louis reflects the location of the? – 2nd rib
A patient with a wide QRS is at risk for: - Ventricular arrhythmias
The first step during the operation of an AED is? – Turn the AED ON
You can reduce the presence of somatic tremor or artifact by: - covering the patient
How would you identify Atrial Flutter: the presence of SAW TOOTH waves (flutter waves)
When applying the chest electrodes and the patient has large breast, you should – ask the patient to lift the breast
How many electrodes are you applying to the patient to obtain a 12 lead ECG? – 10
The best way to identify the patient is to: - check the wrist ID band with the order, ask the patient name and DOB.
If someone like a friend or family member asks for a copy of the patient’s ECG, what would be the best response: PT records are confidential (HIPAA)
What is the significance of having the ECG in the EMR? – (baseline)diagnostic test that can be used for comparison in the future
How is the QT interval measured? – beginning of QRS to end of T wave
The name of the ECG machine control that would affect the amplitude is: - the gain button
You are applying electrodes for telemetry monitoring to a patient with sensitive skin, what should you do?-decrease pressure when abrading the skin
During a stress test, you should observe the patient for? – fatigue and/or hyperventilation
How do you identify atrial pacing? – a “P” wave following the spike
The ECG represents the: electrical activity of the heart
You are calculating the heart rate using the 1500 method and counted 35 small boxes on the tracing, the heart rate is: 43 Bradycardia
Do not leave the EMR open to avoid: violation of the HIPAA law
Dyspnea reflects which vital sign: respirations
ST elevation on the ECG indicates: Acute Myocardial Infarct (current of injury)
Other conditions that create ST elevation on the ECG: pericarditis, aneurysms
You will place V3 on the right side of the chest when the patient has: dextrocardia
The small box on the ECG paper when measuring horizontally is equal to: 0.04 seconds
If the patient has excessive hair and you need to apply telemetry electrodes, you should: dry shave, clip hair
On the ECG tracing you can identify the rhythm as SR by: a positive small “P” wave
To avoid loss of telemetry signal you should: use new batteries
Three monitoring has: three leads I, II, III Standard Leads
What is the first negative wave after “P” wave: Q wave
What does the “P” wave represent? Atrial depolarization
What does a wide QRS and a heart rate of 20-40 means? Ventricular rhythm (IVR)
The standard speed of the paper is? 25 mm/sec
What would you tell a patient who is going for a stress test? “You might experience mild SOB and fatigue
A patient wearing a HOLTER monitor needs to: record on a diary all activities and symptoms
How do you identify a junctional rhythm? Narrow QRS, inverted “P” wave or no “P” wave
Stress testing is contraindicated if: the patient is taking beta-blockers- may not reach target HR
The following conditions are contraindicated for stress testing: abnormal heart rhythms, recent MI, unstable angina, pericarditis or myocarditis, uncontrolled HTN, Severe AOS, aneurysm, thrombophlebitis, and systemic or pulmonary embolism, CHF, acute infection, psychosis, a change in the resting ECG
The normal PR interval is: 0.12 – 0.20 sec, QRS 0.06-0.11 sec, QT 0.36-0.44 sec – varies with HR
What is the HR when you have 35 small boxes on the ECG paper – use 1500 method- HR 1500/35= 43 bpm
What does the T wave represent? Ventricular repolarization
V4 is located at: 5th ICS and MCL
With telemetry monitoring, electrodes are placed on: anterior chest or thorax
How is the target rate calculated before stress testing? 220-AGE = target rate 220-50 YEAR OLD = 170 bpm
A patient with Parkinson disease will exhibit “somatic tremor” on the ECG tracing
What part of the cardiac cycle comes before the QRS? The PR interval - PR segment is after P wave & before QRS
If you are performing a 12 lead ECG on a patient who had a mastectomy six months ago, where would you place the electrodes? Apply electrodes on the right side of the chest
How do you describe 2nd degree AV block, Type I: Sinus P, progressive prolongation PR then one dropped QRS
How do you apply electrodes for a patient with Dextrocardia? Chest electrodes mirror image on the right and reverse the limb lead placement
How do you prevent electrode crowding on a small child? Place V3 on the right side of the chest
If you have a 3 second time interval on the ECG paper, what is the speed of the paper? 25mm/sec
The normal calibration of the ECG paper is: 10mm or 1 Mv – two large boxes
The augmented unipolar lead that produces a negative QRS is: aVR. (p and t waves will be negative also)
A QRS that measures less than 3 small boxes, is: normal duration
If lead I and AVL are no longer seen, you would: check the left arm electrode
A red line on the paper indicates: the end of the paper, prepare to replace it
The location for V6 is: 5th ICS and MAL
Telemetry monitoring usually requires ____ number of electrodes: 5 five
What would the result of applying dried out electrodes? A wandering line artifact on the ECG
Lead I measures? Electrical activity from the right arm to the left arm
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