Ch.4 Performing An Ecg Test Bank Docx nan

Electrocardiography for Healthcare Professionals, 5e (Booth)

Chapter 4 Performing an ECG

1) The first thing that is needed to perform an ECG is:

A) payment from the patient for the test.

B) a physician order for the test.

C) battery back-up power for the ECG machine.

D) a consent form signed by the patient.

2) What information must be included on the ECG requisition?

A) Signature or initials of the ECG technician

B) Patient address and phone number

C) Location and date of recording

D) Model of the ECG machine

3) You have an order to perform an ECG on a 76-year-old woman. You knock on the door to her hospital room, introduce yourself, and explain that you are going to perform an ECG. You explain the procedure, but the woman refuses to allow you to do the ECG. What should you say to the patient?

A) "Will you tell me why you don't wish to have an ECG done?"

B) "Don't worry; the ECG only takes a few seconds to do."

C) "Your doctor has ordered this test and it must be done."

D) "I will have to report you to my supervisor immediately."

4) While preparing to perform an ECG on a 15-year-old girl, you pull the curtain around her hospital bed. The patient becomes agitated and asks why you closed the curtain. What should you tell her?

A) It is loud and noisy in the hallway, and you need to work in a quiet environment.

B) The temperature of the room is too cold.

C) You are providing privacy for the patient.

D) You do not like co-workers watching you perform the procedure.

5) What must you always check prior to performing any procedure on a patient?

A) The patient's name and identification number

B) The method of payment for the procedure

C) The name of the physician who ordered the test

D) The availability of a patient gown

6) Which rib is located next to the angle of Louis?

A) First rib

B) Second rib

C) Third rib

D) Fourth rib

7) When properly positioning the chest lead electrodes, you should make sure that the electrode is placed on the ________ of the rib cage.

A) suprasternal notch

B) midclavicular line

C) intercostal space

D) angle of Louis

8) When applying the chest leads, you will place the V6 lead:

A) in line with V4 on the midaxillary line.

B) at the fourth ICS, right sternal border.

C) at the fifth ICS, left midclavicular line.

D) at the fourth ICS, left sternal border.

9) Which anatomical landmark starts in the middle of the axilla and runs down the side of the chest?

A) Midclavicular line

B) Anterior axillary line

C) Suprasternal notch

D) Midaxillary line

10) Which of the following chest leads are placed on the chest using specific anatomical landmarks?

A) V1, V3, V4, and V6

B) V1, V4, V5, and V6

C) V1, V2, V3, V4, and V6

D) V1, V2, V4, V5, and V6

11) When applying chest leads, you will place the V4 lead:

A) midway between V3 and V5.

B) at the fourth ICS, right sternal border.

C) at the fifth ICS, left midclavicular line.

D) at the fourth ICS, left sternal border.

12) When applying chest leads, you will place the V2 lead:

A) midway between V3 and V5.

B) at the fourth ICS, right sternal border.

C) at the fifth ICS, left midclavicular line.

D) at the fourth ICS, left sternal border.

13) How can you be certain you are attaching the lead wires to the electrodes properly?

A) Consult the physician

B) Check the manufacturer's directions in the instruction manual

C) Ask your supervisor or co-worker

D) Identify the colors of the individual leads.

14) You should place the limb electrodes before the chest electrodes because:

A) the ECG will not run at all without the limb leads attached.

B) they are closest to you and easiest to reach.

C) the limb leads rarely require a skin prep or cleansing.

D) placement of the chest electrodes depends on these leads.

15) The patient has a cast on his lower left leg. The limb electrode placement should be:

A) right leg electrode at the lower leg and left leg electrode at the inner thigh.

B) right leg electrode at the lower leg and left leg electrode on the top of the cast.

C) at equal levels on the thighs.

D) the same as if the patient did not have a cast.

16) When placing the chest electrodes on a female with large breasts, you must:

A) place the electrodes directly on the breast tissue to achieve the correct position.

B) lift the breast and place the electrodes in the closest position possible.

C) place the electrodes lower on the abdomen, away from the breast.

D) place the electrodes on the patient's back.

17) You are placing the electrodes for an ECG on a patient who weighs 342 pounds, and you cannot find the midclavicular line. What should you do to place lead V4?

A) Place the lead where you think it should go.

B) Place lead V3 and V5 first, then place lead V4 in the middle.

C) Use the clavicle as the landmark.

D) Use the nipple line as the guide.

18) Electrical safety is maintained while performing an ECG by all of the following except:

A) removing the plug from the electrical outlet by pulling it out by the prong connection.

B) ensuring that the bed or examination table is not touching the wall or any electrical equipment.

C) checking the insulation on the electrical cord for cracks or frays.

D) removing any electrical equipment from the patient's body.

19) Approach the patient from the patient's ________ if possible when performing an ECG.

A) left side

B) right side

C) top

D) bottom

20) Which of these tasks does not necessarily need to be done before operating the ECG machine?

A) Identify and communicate with the patient.

B) Prepare the room and equipment.

C) Attach the electrodes and leads.

D) Enter the correct ICD-10 code.

21) You are about to record an ECG on a patient who has Parkinson's disease. What measures can you take to prevent somatic tremors from being recorded on the ECG recording?

A) Have the patient put his or her hands, palms down, under the buttocks.

B) Remove tension from the lead wires.

C) Apply electrodes securely.

D) Move the patient's bed away from the wall.

22) Which of the following problems can cause wandering baseline on the ECG tracing?

A) Improperly applied electrodes or poor skin preparation

B) Patient talking while the ECG is being recorded

C) Improper grounding

D) Electrical interference

23) What type of artifact is shown in the figure?

A) Wandering baseline

B) Somatic tremor

C) Alternating current interference

D) Baseline shift

24) Which of the following causes AC interference artifact?

A) Voluntary movement, such as talking or chewing gum

B) Lead wires crossed and not pointed toward the hands and feet

C) Oil, lotion, dirt, or hair under the electrodes

D) Involuntary movement due to Parkinson's disease

25) What type of artifact is shown in the figure?

A) Somatic tremor

B) AC interference

C) Wandering baseline

D) Involuntary movement

26) What type of artifact is shown in the figure below?

A) Somatic tremor

B) AC interference

C) Wandering baseline

D) Involuntary movement

27) If the ECG was ordered stat, what must be done with the results?

A) Give the results directly and immediately to the physician.

B) Place the results on the physician's desk.

C) Place the results at the nursing station.

D) Fax the ECG to a central database.

28) How should you clean the cables and electrode clips on the ECG machine?

A) Soak them in a disinfectant solution.

B) Use a soft cloth moistened with disinfectant or packaged wipes.

C) Place them in an autoclave or heat sterilization unit.

D) Rub them vigorously with a cloth moistened with acetone.

29) You are preparing to perform a 12-lead ECG on a 7-year-old child. When communicating with this patient, you should:

A) use technical words to make the child feel like a grownup.

B) avoid using technical words.

C) address the parents instead of the child.

D) make the parents leave the room.

30) For infants and small children, where may you have to place lead V3 to prevent crowding of the chest electrodes?

A) On the patient's back

B) On the right side of the chest

C) In the same location by overlapping the electrodes

D) Parallel with V2

31) Placing lead V3 on the right side of the chest is known as:

A) V3R.

B) V3P.

C) V3L.

D) V3C.

32) What is the difference between continuous cardiac monitoring and a routine ECG?

A) Nondisposable electrodes are used.

B) Only three electrodes are used.

C) Placement of the electrodes is different.

D) The recording speed is different.

33) You are recording an ECG tracing on a female patient who has had a mastectomy. Your responsibilities include:

A) documenting this information on the ECG tracing.

B) using the other side of the woman's chest.

C) moving the limb leads to the patient's shoulders and thighs.

D) placing the electrodes on the patient's back.

34) If your patient is in a permanent fetal position with her arms drawn tightly over the chest, where do you position the electrodes?

A) On the upper chest and lower abdomen

B) On the right side of the chest

C) On the back

D) Place V1 and V2 higher on the chest

35) If you record more than one ECG during a Code Blue emergency, it is important to note which of the following?

A) How many times the ECG was performed

B) Indicate on tracing "repeat ECG-same lead placement"

C) Location of the normal electrode placement

D) How long you were in the patient's room

36) Which landmark is an imaginary line on the chest that runs vertically through the center of the clavicle?

A) Anterior axillary line

B) Midaxillary line

C) Angle of Louis

D) Midclavicular line

37) The standardization mark on a manual ECG machine should be inserted:

A) aligned with a T wave.

B) aligned with a P wave.

C) between the T wave of one complex and the P wave of the next.

D) at the midpoint of an ST segment.

38) Which lead is typically used during continuous cardiac monitoring to provide the best view of the P wave?

A) I

B) II

C) III

D) V6

39) While preparing to perform an ECG on a patient, you ask her if she is on any medications. She replies that she is taking Lipitor and Norpace. You should:

A) ask the physician if the patient should stop taking the medications prior to the ECG.

B) tell the patient to stop taking the medications and come back tomorrow for the ECG.

C) write the names of the medications on the ECG report.

D) inform your supervisor of the patient's medications.

40) After you have prepared the ECG machine and attached the electrodes and leads to the patient, what is the next thing you do if you are using an automatic ECG machine?

A) Make sure the machine is set to lead I.

B) Run a few complexes and insert a standardization mark.

C) Set the machine to print an interpretation along with the tracing.

D) Press the Run or Auto button on the ECG machine.

41) You have begun performing an ECG on a patient, and the tracing appears as a flat line. What is the first thing you should do?

A) Call for help because the patient has no heartbeat.

B) Ask your supervisor for suggestions.

C) Remain calm and check the patient.

D) Remove and replace the lead wires and cables.

42) When you have completed a routine ECG, how should you report the results?

A) Hand the results personally to the physician who ordered the ECG.

B) Place the report in the patient's chart.

C) Place the report on the physician's desk.

D) Use the method required by the facility where you are working.

43) An ICD-10 code is a(n)

A) diagnostic code used by the billing department.

B) interpretation of the ECG tracing.

C) trouble code used to identify ECG malfunctions.

D) patient identification number.

44) In most facilities, who is responsible for everyday care and maintenance of the ECG machine?

A) Administrative personnel

B) The facility's maintenance personnel

C) The ECG technician

D) The department supervisor

45) Which of the following is not commonly performed as part of routine maintenance of an ECG machine?

A) Wiping patient cables and lead wires with a damp cloth

B) Sterilizing the electrodes

C) Wiping the machine dry with a soft cloth

D) Checking cables and wires for cracks or fraying

46) If a patient has breast implants, what modification may be necessary when you place the chest electrodes?

A) Place the electrodes directly on the breast.

B) Place the electrodes on the patient's back.

C) Place V1 and V2 a little higher on the chest.

D) Place V3, V4, and V5 a little higher on the chest.

47) How should you position a pregnant woman for an ECG?

A) Rolled slightly to her right side

B) Sitting upright

C) Lying flat on her back

D) Rolled slightly to her left side

48) For which of the following patients might a physician order a right-side 12-lead ECG?

A) A geriatric patient

B) A pregnant patient

C) A patient with dextrocardia

D) A patient in a permanent fetal position

49) Where should you place V7 when you are performing a posterior 12-lead ECG?

A) In a straight line from V6 on the left posterior axillary line

B) In a straight line from V8 at the left midscapular line

C) In a straight line from V6 at the left paraspinous line

D) In a straight line from V9 at the right paraspinous line

50) If a patient has a seizure while you are performing an ECG, you should:

A) restrain the patient to prevent harm.

B) protect the patient from injury.

C) go out to the main desk and call for emergency help.

D) continue to record the ECG and note on the tracing that the patient had a seizure.

51) Using proper body mechanics includes: 

A) using the muscles in your back to lift heavy objects. 

B) following proper hand hygiene. 

C) using movements that maintain your posture. 

D) holding heavy objects as far from your body as possible.

52) The purpose of practicing proper body mechanics is primarily to:

A) control the spread of infection.

B) reduce artifacts on the ECG tracing.

C) prevent injuries to yourself or the patient.

D) reduce wear and tear on the ECG machine.

53) You need to perform an ECG on a patient who weighs 285 pounds. The patient is brought into the room in a wheelchair and informs you that she cannot move to the ECG table without assistance. You do not have the strength to lift the patient onto the table. What should you do?

A) Politely explain to the patient that unless she can move to the table, you cannot perform the ECG

B) Ask a coworker to assist you in moving the patient

C) Perform the ECG on the patient without moving her from the wheelchair

D) Inform your supervisor that you cannot perform the ECG

54) You are trying to perform an ECG on an infant, but the infant is scared and is crying hysterically. The parents have tried to calm him, but without success. What is your best course of action?

A) Wait until the infant falls asleep

B) Ask the parents to restrain the infant so that you can place the electrodes

C) Inform the parents that the ECG cannot be done at this time

D) Ask a coworker to hold the infant while you place the electrodes

55) Why are lead II or a modified chest lead the preferred leads for continuous cardiac monitoring?

A) The electrodes for these leads can be placed in inconspicuous areas on the patient's chest.

B) The electrodes for these leads are easiest and fastest to apply.

C) These leads provide the best ability to view the T wave.

D) These leads provide the best ability to view the P wave.

56) As you are preparing to perform an ECG on a 47-year-old patient, the patient has a seizure. The patient is not yet on the ECG table; she is standing beside the table in the procedure room. Which of the following actions should you take?

A) Hold the patient as still as possible to minimize injury

B) Place a bite stick in the patient's mouth to prevent her from biting her tongue

C) Remove any objects in the area that may cause injury

D) Provide an emesis basin in case the patient vomits

57) Which of the following may be a cause of somatic tremor? 

A) Contacting the bed rail. 

B) Wireless device in the patient's pocket. 

C) Shivering from being cold. 

D) Power cord is contacting the ECG machine.