NHA CET Exam Questions

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81.

What is diastole?

  • When the ventricles relax and fill with blood

  • When the ventricles contract, pushing the blood forward

  • When the atria contract

  • When the heart valves close

Correct answer: When the ventricles relax and fill with blood

Diastole is the phase of the cardiac cycle in which the ventricles relax and fill with blood. This is followed by systole, which expels the blood forward.

82.

Which type of rhythm is atrial fibrillation?

  • Irregular

  • Regular

  • Regular with a pause

  • Sinus rhythm

Correct answer: Irregular

Atrial fibrillation is an irregular and unpredictable rhythm without any pauses. It originates in the atrial tissue rather than the sinus.

83.

Violating the HIPAA Privacy Rule can lead to many consequences, including which of the following? 

  • Imprisonment

  • Fines ranging from 100 to 1,000 dollars

  • Suspension without pay 

  • A verbal warning from a supervisor

Correct answer: Imprisonment 

Serious consequences of violating the HIPAA Privacy rule include immediate termination (not suspension) from a place of employment, fines ranging from 100 to over one million dollars, a civil suit filed by the family, and even imprisonment.

84.

Identify the following heart rhythm.

  • Regular rhythm with a premature beat

  • Irregular rhythm with a pause

  • Regular rhythm with a pause

  • Irregular rhythm with a premature beat

Correct answer: Regular rhythm with a premature beat 

This is a rhythm with all the components of a sinus rhythm; however, it is interrupted by a premature beat. An example of this type of rhythm is a premature ventricular complex (PVC).

85.

What is the process of cardiac cells losing their resting polarity called?

  • Depolarization

  • Excitation-contraction coupling

  • Repolarization

  • Ventricular contraction

Correct answer: Depolarization

At rest, cardiac cells contain negative ions inside and keep positive ions on the outside. For electrical activity to occur, special channels in the membrane allow the exchange of these ions. When the cells lose their negativity or contain more positive ions than negative, depolarization occurs. 

Repolarization is the restoration of the cell's negative polarity.

Excitation-contraction coupling is the term given to the process of muscle cell contraction.

While depolarization plays a role in ventricular contraction, this question focuses more on the electrical activity that occurs.

86.

What is the ratio of chest compressions to breaths when performing two-rescuer CPR on an unconscious adult?

  • 30:2

  • 15:2

  • 15:1

  • 30:3

Correct answer: 30:2 

The AHA's 2020 CPR guidelines state that when performing CPR on an adult, give 30 compressions and then two breaths. For pediatric patients with two-rescuer CPR, give 15 compressions and then two breaths.

87.

What are two consecutive PVCs called?

  • Couplets

  • Bigeminy

  • Trigeminy

  • Fusion beats

Correct answer: Couplets 

Two consecutive PVCs in a rhythm are called couplets.

Bigeminy occurs when every other beat in a rhythm is a PVC. In trigeminy, every third beat is a PVC. Fusion beats occur when electrical impulses from several foci stimulate a ventricular chamber, causing QRS complexes that are very wide and will look like the merger of a sinus beat with a ventricular beat.

88.

An EKG technician is reviewing a patient’s 12-lead EKG and notes the presence of deep Q waves in leads II, III, and aVF. 

Which of the following is the most likely explanation for these abnormal Q waves?

  • The patient had a previous inferior wall myocardial infarction

  • The patient has recently experienced an anterior wall myocardial infarction

  • The patient is experiencing acute pericarditis

  • The patient has left ventricular hypertrophy

Correct answer: The patient had a previous inferior wall myocardial infarction

Abnormal Q waves are a hallmark sign of a previous myocardial infarction (MI), indicating areas of the myocardium that have become electrically inert due to scarring from infarction. Deep Q waves in leads II, III, and aVF specifically suggest an infarction that affected the inferior wall of the heart, which is typically supplied by the right coronary artery. 

Q waves in leads II, III, and aVF suggest an inferior wall MI, not an anterior wall MI. Anterior wall MI would present with Q waves in leads V1–V4.

Left ventricular hypertrophy usually presents with tall R waves in the left precordial leads (V5 and V6) and deep S waves in the right precordial leads (V1 and V2). It does not typically produce abnormal Q waves.

Pericarditis typically causes diffuse ST-segment elevation and PR-segment depression, not abnormal Q waves.

89.

Which of the following indicates a need for cardiac stress testing?

  • As a follow up after cardiac bypass surgery

  • To diagnose a third-degree AV block

  • To diagnose electrolyte abnormalities

  • As a follow up 24 hours after an MI

Correct answer: Follow up after cardiac bypass surgery 

Cardiac stress testing is indicated after CABG, to diagnose exercise-induced arrhythmias, and to assess/diagnose an individual with a family history of heart disease.

Contraindications for cardiac stress testing include patients with a high-degree AV block (second or third), patients with electrolyte imbalances (as the test carries the risk of lethal arrhythmias), and patients within 48 hours post-MI.

90.

The Health Insurance Portability and Accountability Act was passed into law in what year?

  • 1996

  • 2001

  • 1985

  • 1976

Correct answer: 1996

The Health Insurance Privacy and Portability Act was passed in 1996. The goals of creating this legislation were to help protect the personal information of citizens, reduce healthcare fraud, and provide easier access to health care.

91.

Which great vessel returns deoxygenated blood to the right atrium from the upper body?

  • Superior vena cava

  • Inferior vena cava

  • Aorta

  • Pulmonary artery

Correct answer: Superior vena cava 

The superior vena cava returns deoxygenated blood to the heart. It transports blood from the head, neck, upper chest, and arms.

The inferior vena cava transports deoxygenated blood from the lower half of the body. The pulmonary artery carries deoxygenated blood to the lungs from the right ventricle. The aorta carries oxygenated blood to the systemic circulation from the left ventricle. 

92.

On a 12-lead ECG, which leads would likely show ST-segment elevation for a posterior heart attack?

  • Leads V7 and V9, reciprocal changes in the anterior leads, or tall R waves in V1, V2, or V3

  • II, III, and aVF

  • V3 and V4

  • V1 and V4, if used on the right side of the patient

Correct answer: Leads V7 and V9, reciprocal changes in the anterior leads, or tall R waves in V1, V2, or V3

In a posterior heart attack, look for ST-segment elevation in leads V7 and V9, reciprocal changes in the anterior leads, or tall R waves in V1, V2, or V3.

II, III, and aVF are inferior leads. V3 and V4 are anterior leads.

V1 and V4, if used on the right side of the patient, indicate a right ventricular heart attack.

93.

What is diaphoresis?

  • Sweaty, clammy skin

  • Low blood pressure

  • Inadequate blood flow to the body

  • Chest pain

Correct answer: Sweaty, clammy skin 

Diaphoresis is sweaty and clammy skin; it can be a symptom of decreased cardiac output (inadequate blood flow to the body) or low blood pressure (hypotension). It can also occur in response to chest pain during a heart attack.

94.

The location of a myocardial infarction can be pinpointed by the affected leads. 

Even though there are no leads directly overlying the posterior wall, an occlusion of the right coronary artery (posterior infarction) can be made by looking for changes in which leads?

  • The anterior leads

  • Leads I, aVL, V5, and V6

  • Leads II, III, and aVF

  • Leads I, aVL, and any precordial leads

Correct answer: The anterior leads

A posterior infarction occurs on the posterior surface of the heart. It is usually caused by a blockage of the right coronary artery. Because there are no leads on the back, look for reciprocal changes in the precordial leads, especially V1; these leads will show EKG changes during this infarction.

Leads II, III, and aVF will respond to an inferior infarction on the surface of the heart that faces the diaphragm.

Meanwhile, the anterior leads (or the precordial leads) V1-V6 will change in response to a posterior infarction.

95.

Which of the following lead placements is correct on a five-lead EKG?

  • Green lead to right leg

  • Brown lead to right arm

  • Black lead to chest

  • Red lead to right arm

Correct answer: Green lead to right leg

In a five-lead EKG, lead placement is as follows: 

  • White lead: Right arm
  • Black lead: Left arm
  • Green lead: Right leg
  • Red lead: Left leg
  • Brown lead: Chest

96.

What is the collection of electrical conducting cells that innervate the ventricles called?

  • Purkinje system

  • Atrioventricular (AV) node

  • Sinoatrial (SA) node

  • Myocardial cells

Correct answer: Purkinje system 

The Purkinje system is a group of fibers that innervate the walls of the ventricles. They receive electrical impulses from the AV node and stimulate muscle contraction of the ventricles.

The SA node is a group of cells located in the right atrium. The SA node is responsible for generating electrical impulses that pass through the heart and stimulate contraction.

The AV node receives the initial impulses generated by the SA node. It is responsible for regulating the impulses sent to the ventricles to prevent arrhythmias. Myocardial cells are muscular tissue responsible for the contraction and relaxation of the heart.

97.

Which of the following is true regarding how to calculate the heart rate?

  • The heart rate is the same as the ventricular rate

  • The heart rate is the same as the atrial rate

  • The most accurate method of calculating the rate is the six-second strip method

  • The "little block method" is the fastest method of calculating the heart rate

Correct answer: The heart rate is the same as the ventricular rate

To calculate the heart rate, look at the number of QRS complexes that occur in one minute. This is equal to the ventricular rate.

The six-second strip method is the least accurate method to calculate. The fastest way to calculate the heart rate is the memory method, not the little block method.

98.

Where are the dominant pacemaker cells located in the heart?

  • Right atrium

  • Right ventricle

  • Left atrium

  • Left ventricle

Correct answer: Right atrium

Dominant pacemaker cells are located in the right atrium, specifically in the sinoatrial (SA) node. The SA node is the natural pacemaker of the heart, setting the rhythm for the heart by generating electrical impulses that spread throughout the heart, initiating each heartbeat.

The right ventricle is responsible for pumping blood to the lungs and does not contain the heart’s natural pacemaker cells. It plays a role in the conduction system but not as the primary pacemaker.

The left atrium receives oxygenated blood from the lungs and does not house the primary pacemaker cells. While it has its own conduction pathways, it does not control the heart's rhythm.

The left ventricle pumps oxygenated blood to the rest of the body. Like the right ventricle, it is crucial in the heart's function but does not contain the primary pacemaker cells.

99.

Which is the best method to calculate the heart rate of an irregular rhythm?

  • Calculating the range

  • The 10-second strip method

  • Using the memory block method

  • Using the memory method

Correct answer: Calculating the range 

The range of an irregular heart rate can be determined by calculating the heart rate of the QRS complexes closest together and the QRS complexes furthest apart. The two rates can be calculated using the block or memory method. There is not a 10-second method of interpreting ECG rates.

100.

Systole can be broken into four phases. During which phase do the ventricles relax and the valves close?

  • Isovolumetric relaxation

  • Protodiastole

  • Diastasis

  • Ventricular ejection

Correct answer: Isovolumetric relaxation

The phases of systole are as follows:

  1. Isovolumetric contraction - The ventricles contract, increasing pressure on the semilunar valves.
  2. Ventricular ejection - The semilunar valves open, blood pours into the aorta and pulmonary artery.
  3. Protodiastole - Pressures between the ventricles and two vessels equalize.
  4. Isovolumetric relaxation - The ventricles relax, and the aortic/pulmonic valves close.

Diastasis is a phase of diastole.