NHA CET Exam Questions

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121.

Which of the following is not a recommended treatment for atrial flutter?

  • Defibrillation

  • Adenosine

  • Cardioversion

  • Carotid massage

Correct answer: Defibrillation

Cardioversion, adenosine, and carotid massage are all treatments for atrial flutter. Defibrillation is a treatment for ventricular fibrillation or ventricular tachycardia.

122.

You are performing a cardiac stress test on a 51-year-old male with a history of stable angina. Which of the following would demonstrate a positive stress test? 

  • ST-segment elevation

  • Shortening PR interval

  • Tall P waves

  • Low-voltage QRS complexes

Correct answer: ST-segment elevation 

ST-segment elevation, ST depression greater than 1-1.5 mm at 0.08 seconds following the J point, or a U wave insertion indicate a positive stress test. 

Normal EKG changes during a stress test include a shortened PR interval, tall P waves, low-voltage QRS complexes, and an increased heart rate.

123.

Which of the following statements is true regarding sinus arrhythmia?

  • Its rate usually varies with the patient's breathing pattern

  • Immediate treatment with an antiarrhythmic is required

  • It is a regular rhythm

  • It contains repetitive P waves

Correct answer: Its rate usually varies with the patient’s breathing pattern

Sinus arrhythmia is an irregular rhythm that originates from the sinus node. Its pattern is cyclic and corresponds with the patient’s breathing pattern. It has an irregular P-P interval and one P wave for every QRS interval. There is no treatment required.

124.

A 25-year-old professional soccer player is undergoing an electrocardiogram (EKG). The Certified EKG Technician notes a heart rate of 46 beats per minute and a blood pressure of 95/60 mmHg. The patient is asymptomatic and denies any chest pain, dizziness, or shortness of breath. 

What should the EKG Technician do next?

  • Recognize these as normal and continue with the EKG

  • Stop the procedure and immediately notify the healthcare provider of bradycardia

  • Pause the procedure and re-check the patient’s heart rate in 5 minutes to ensure accuracy

  • Ask the patient to walk around to increase their heart rate before resuming the EKG

Correct answer: Recognize these as normal and continue with the EKG

Athletes often have lower resting heart rates (bradycardia) due to their high levels of cardiovascular fitness. A heart rate of 46 beats per minute and a blood pressure of 95/60 mmHg in a 25-year-old athlete can be considered normal, especially when the patient is asymptomatic. Therefore, no emergency intervention is necessary. 

Stopping the procedure incorrectly treats bradycardia as an emergency. 

Rechecking the heart rate in 5 minutes delays the procedure unnecessarily.

Asking the patient to walk around is inappropriate because artificially increasing the heart rate is not needed for the EKG test.

Understanding the difference between normal vital signs in athletes and emergency situations is essential for accurate interpretation.

125.

Determine the length of time of the following PR interval.

  • 0.12 seconds

  • 0.9 seconds

  • 0.16 seconds

  • 1 second

Correct answer: 0.12 seconds

The answer is determined by counting the small blocks between the beginning of the P and the beginning of the QRS complex, then multiplying that value by 0.04.

126.

What is the definition of a "vital sign"?

  • Measurement of the body's functions

  • Predictor of obesity obtained by measuring the weight and height of an individual

  • Evaluation of a patient's nervous system

  • Assessment of a patient's cardiac function by monitoring heart rate during strenuous exercise

Correct answer: Measurement of the body's functions

Vital signs are the measurement of the body's functions.

Body mass index (BMI) is a predictor of obesity obtained by measuring the weight and height of an individual. A neurological exam is a series of tests that evaluates a person's nervous system. A cardiac stress test monitors a patient's cardiac function by assessing their heart rate during strenuous exercise.

127.

A physician orders a pharmacologic stress test for a patient unable to perform a treadmill exercise test. Which of the following medications is most commonly used to simulate the effects of exercise during this type of test?

  • Adenosine

  • Digoxin

  • Atorvastatin

  • Acrivastine

Correct answer: Adenosine

Adenosine is a commonly used pharmacologic agent in stress testing for patients who cannot physically perform an exercise test. It works by dilating coronary arteries and increasing blood flow, mimicking the effects of exercise on the heart. 

Digoxin is used for heart failure and atrial fibrillation, but it is not used in stress testing. 

Acrivastine is an allergy medicine and is unrelated to stress testing. 

Atorvastatin is a cholesterol-lowering medication and is not used in simulating exercise during a stress test.

128.

What does the QRS complex represent?

  • Ventricular depolarization

  • Ventricular repolarization

  • Atrial depolarization

  • Atrial repolarization

Correct answer: Ventricular depolarization

The QRS complex represents ventricular depolarization.

The T wave represents ventricular repolarization. 

he P wave represents atrial depolarization.

Atrial repolarization is lost in the QRS complex.

129.

Stress testing is indicated for patients who have or are suspected to have which condition?

  • Atherosclerosis

  • Stroke

  • Asthma

  • Aortic stenosis

Correct answer: Atherosclerosis

Stress testing is used for patients with confirmed or suspected atherosclerosis.

Stress testing is not indicated for people with stroke or asthma since they are not cardiac conditions.

Stress testing is contraindicated (should not be performed) in individuals with severe aortic stenosis.

130.

An EKG technician is preparing to perform a 12-lead EKG on a patient. During the test, the EKG tracing shows significant artifact, making it difficult to interpret the results. 

Which of the following actions would best help minimize artifact and obtain a clear tracing?

  • Ensure that the patient’s skin is clean, dry, and free of lotions or oils before applying the electrodes

  • Keep up a lively conversation to relieve the patient’s anxiety during the test

  • Instruct the patient to hold their breath for the duration of the test

  • Use extra adhesive tape to secure the EKG leads more tightly to the patient’s skin

Correct answer: Ensure that the patient’s skin is clean, dry, and free of lotions or oils before applying the electrodes

This helps improve electrode adhesion and conductivity, reducing interference and movement that can cause artifacts.

Conversing with the patient, encouraging them to speak, or asking the patient to hold their breath throughout the test may introduce muscle tension artifacts and movement artifacts.

Using extra adhesive tape to secure the leads more tightly may not improve the quality of the tracing and could cause skin irritation without addressing the root cause of the artifact.

131.

Polymorphic ventricular tachycardia with a prolonged QT interval is known as:

  • Torsades de Pointes

  • SVT

  • VFIB

  • Asystole

Correct answer: Torsades de Pointes

Polymorphic ventricular tachycardia with a prolonged QT interval is known as Torsades de Pointes, which means "twisting of the points". The rhythm has a twisting appearance around the isoelectric line.  SVT is supraventricular tachycardia and has a narrow or shortened QT interval. VFIB is ventricular fibrillation, and the QT interval is often not discernable. Asystole is the absence of electric impulse in the heart.

132.

Which of the following ECG leads are considered lateral leads?

  • V6

  • V1

  • V3

  • V4

Correct answer: V6

Lateral leads include leads I, V5, and V6. Leads V1 and V2 are septal, and V3 and V4 are anterior leads.

133.

Which leads are involved in forming the triaxial diagram?

  • Leads I, II, and III

  • Leads I, III, aVR, and aVF

  • Leads aVR, aVL, and aVF

  • Leads I and aVR

Correct answer: Leads I, II, and III 

The triaxial diagram is made up of leads I, II, and III, which are joined in the middle.

The hexaxial diagram is made by joining leads I, II, III, aVR, aVL, and aVF in the middle.

134.

Which type of cell is responsible for initiating depolarization?

  • Pacemaker cells

  • Myocardial cells

  • Electrical-conducting cells

  • Purkinje fibers

Correct answer: Pacemaker cells

Pacemaker cells are responsible for initiating depolarization in the SA node. For this reason, they are considered the powerhouse of the heart.

Myocardial cells are responsible for the contraction of the heart muscle.

Electrical-conducting cells carry the electric currents created by depolarization to the walls of the heart.

Purkinje fibers are electrical-conducting cells that innervate the walls of the ventricles.

135.

What is required to correct the following artifact?

  • Changing the position of the pacemaker

  • Turning off all the monitors in the room

  • Placing a new pacemaker

  • Heart transplant surgery

Correct answer: Changing the position of the pacemaker

The artifact pictured is a loss of capture, which is caused by a weak signal, sometimes because the pacing catheter has lost contact with the wall of the heart chamber. Sometimes a position change by the patient can fix this, or minor surgery to reposition the catheter would be required.

A new transplant is not necessary, and monitors or a new battery do not change a loss of capture.

136.

Which of the following statements is true regarding atrial flutter?

  • The atrial rate will be between 250 and 350

  • P waves are still present

  • PR intervals are shorter

  • The ventricular rate will be between 100 and 200

Correct answer: The atrial rate will be between 250 and 350 

Atrial flutter is a rhythm that occurs when the atrium fires so rapidly that a fluttery pattern is produced instead of P waves. In atrial flutter, the ventricular rate depends on the conduction ratio, while the atrial rate stays about 250–350 beats per minute. P waves are replaced by fluttery waves, and there are no PR intervals.

137.

Which of the following is included in the rules of malignancy for PVCs?

  • Runs of consecutive PVCs

  • One PVC per every normal sinus beat

  • Two normal sinus beats for every PVC

  • Any isolated PVC in an asymptomatic heart

Correct answer: Runs of consecutive PVCs

The rules of malignancy for PVCs include the following:

  • The rhythm has frequent PVCs.
  • The PVCs run consecutively, at least three or more in a row.
  • The PVCs will vary in their appearance (also known as multiform PVCs).
  • PVCs will fall on the T wave of the last beat. This symptom places the patient in danger of entering ventricular tachycardia.
  • Any PVC in the setting of an acute MI is considered malignant.

138.

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

  • Brown lead to chest

  • Red lead to right arm

  • White lead to left leg

  • Black lead to right leg

Correct answer: Brown lead to chest

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

139.

For continuous monitoring, where is lead II placed?

  • Left abdomen

  • Right leg

  • Left leg

  • Right posterior shoulder

Correct answer: Left abdomen

Lead II is typically used as a bipolar lead and placed on the left leg. However, for continuous monitoring, lead II is placed on the abdomen instead of the limbs.

The MCL lead (V1) is placed on the fourth intercostal space at the right sternal border. A grounding electrode is placed on either the right or left shoulder.

140.

What is the definition of blood pressure?

  • The force of the blood pushing against the arterial walls

  • The force of the blood pushing against the venous walls

  • The heart rate

  • The amount of blood pumped out of the heart per minute

Correct answer: The force of the blood pushing against the arterial walls 

Blood pressure measures the force of the blood pushing against the arterial walls. It does not measure the pressure of the venous walls.

The measurement of the amount of blood pumped out of the heart per minute is called cardiac output.