Electrocardiography And Pulmonary | Test Bank Docx Ch.49

Student name:__________

1) Calibration of a spirometer requires the use of a standardized measuring instrument called a(n) calibration __________ and should provide a reading on the spirometer within 3% of the stated volume.

2) The cardiac __________ is regulated by specialized tissues in the heart wall that transmit electrical impulses and cause the heart muscle to contract and relax.

3) Electrical impulses of the cardiac cycle produce a series of waves with peaks and valleys on an electrocardiogram that are called __________.

4) The electrical impulse that initiates a chain reaction resulting in contraction is __________.

5) A(n) __________ is the tracing made by an electrocardiograph.

6) Electrical impulse sensors placed on the body that detect and record the electrical activity of the heart are __________.

7) An electrocardiography device that includes a microchip recorder and records the heart rhythm over a 24-hour period is a(n) ambulatory monitor, often called a __________ monitor.

8) The impulses received through various combinations of electrodes constitute different __________, or views of the electrical activity of the heart, that are recorded on the ECG.

9) The condition of having two separate poles, one positive and the other negative, is called __________.

10) A licensed practitioner will order a(n) __________ function test to evaluate a patient’s lung volume and capacity.

11) A test used to measure breathing capacity is called __________.

12) An instrument called a(n) __________ measures the air taken in by and expelled from the lungs.

13) The __________ is a pen-like instrument that records the electrical impulses on the ECG paper.

14) The artifact pictured here is __________.

15) This artifact is caused by __________.

16) An ECG tracing for a patient who is shivering may have __________ interference, as shown in this tracing.

17) This arrhythmia is __________.

18) This arrhythmia is __________ and is caused by rapid, multiple electrical signals that fire from areas in the atria other than the SA node.

19) The __________ conduct electrical impulses down both sides of the interventricular septum.

20) A(n) __________ is a beat that originates from the ventricles of the heart, occurs early in the cycle, and is followed by a pause before the next cycle.

21) The process of using ultrasound to view the heart in motion is called __________.

22) In __________ echocardiography, an ultrasound transducer is moved around the patient's chest or abdomen to produce heart images.

23) The type of echocardiography in which the speed and direction of blood flow through the heart can be assessed is __________ echocardiography.

24) Irregularities in heart rhythm are called __________, also known as arrhythmias.

25) A somatic interference artifact is caused by __________ movement.

26) Which of the following is the process by which a graphic pattern is created from the electrical impulses generated in the heart as it pumps?

A) electroencephalography
B) electromyography
C) electrocardiography
D) electroneurography
E) electrogastrography

27) Which of the following measures and evaluates a patient's lung capacity and volume?

A) chest x-ray
B) pulmonary function test
C) bronchoscopy
D) lung scan
E) electroencephalogram

28) Where does the transmission of electrical impulses in the heart begin?

A) AV node
B) Purkinje fibers
C) bundle of His
D) bundle branches
E) SA node

29) Which of the following is the primary pacemaker of the heart?

A) AV node
B) bundle of His
C) SA node
D) Purkinje fibers
E) bundle branches

30) Which of the following delays the electrical impulse for muscle contraction, giving the atria time to contract completely and fill the ventricles with blood?

A) AV node
B) SA node
C) Purkinje fibers
D) bundle of His
E) bundle branches

31) Which of the following is the electrical impulse that initiates a chain reaction resulting in contraction?

A) repolarization
B) deflection
C) depolarization
D) artifact
E) polarization

32) Which of the following is a record of the waves of electrical impulses responsible for the cardiac cycle?

A) electrode
B) electrocardiogram
C) electrocardiograph
D) electroencephalograph
E) electroencephalogram

33) The instrument that measures and displays the electrical impulses responsible for the cardiac cycle is a(n) __________.

A) electrocardiograph
B) electroencephalograph
C) electrocardiogram
D) electroencephalogram
E) electrode

34) The electrical impulses responsible for the cardiac cycle that appear on an electrocardiogram as peaks and valleys are called __________.

A) electrodes
B) styluses
C) leads
D) deflections
E) probes

35) The different views recorded on an electrocardiogram that are produced by the electrical activity of the heart are __________.

A) leads
B) stylus
C) electrodes
D) deflections
E) probes

36) Which of the following is a pen-like instrument that records impulse movement on the ECG paper?

A) electrode
B) stylus
C) lead
D) deflection
E) probe

37) Which of the following is an erroneous mark or defect that may appear on an ECG strip?

A) electrolyte
B) deflection
C) stylus
D) lead
E) artifact

38) Which of the following is appropriate when preparing the room and equipment for an electrocardiogram?

A) Select a room away from all other electrical equipment.
B) Perform the procedure in an X-ray department.
C) Place the patient on a metal table.
D) Set the room's temperature control to a very cool setting.
E) Check the ECG paper after preparing the patient.

39) Which communication would alleviate a patient’s anxiety about having an electrocardiography?

A) Tell the patient that the procedure will last 1 hour.
B) Explain to the patient that a small amount of electricity passes through the body.
C) Describe to the patient what disease or abnormality the physician is looking for.
D) Encourage the patient to ask questions and verbalize her concerns.
E) Tell the patient that although ECGs are unpleasant, they are necessary.

40) Possible causes for a wandering baseline are __________.

A) the use of paper clips, wet hands, or improper mounting
B) loose wires or a short circuit in the wires
C) improper grounding or cardiac arrest
D) poor skin preparation, dangling wire, or improper application of electrodes
E) wrong selector switch setting or crossed wires

41) Which precordial electrode is located by counting to the fourth intercostal space to the right of the sternum?

A) V₁
B) V₂
C) V₃
D) V₄
E) V₆

42) Which precordial electrode is placed in the fourth intercostal space to the left of the sternum?

A) V₆
B) V₁
C) V₄
D) V₂
E) V₃

43) Which precordial electrode is placed in the fifth intercostal space, where it intersects an imaginary line drawn straight down the middle of the clavicle?

A) V₆
B) V₂
C) V₄
D) V₁
E) V₃

44) Which precordial electrode is placed in the fifth intercostal space, directly below the middle of the armpit?

A) V₁
B) V₂
C) V₄
D) V₆
E) V₃

45) If a lead does not appear on an ECG tracing, what step should be taken before repeating the tracing?

A) Re-center the stylus.
B) Set the sensitivity selector to 2.
C) Reconnect the wire.
D) Increase the paper speed to 50 mm per second.
E) Move the ECG table away from the wall.

46) Which test is utilized to measure the heart’s conduction system during exercise, when the demand for oxygen is increased?

A) Holter monitoring
B) electrocardiography
C) pulmonary function test
D) stress testing
E) encephalography

47) Which of the following is used to assess the electrical activity of a patient's heart over a 24-hour period of normal activity?

A) stress testing
B) pulmonary function testing
C) ambulatory monitoring
D) electrocardiography
E) echocardiography

48) Which of the following would be included in the patient’s instructions regarding ambulatory monitoring?

A) Encourage the patient to shower while the device is in place.
B) Tell the patient that using an electrical blanket is permissible.
C) Instruct the patient to record all activities, emotions, symptoms, and medications taken.
D) Tell the patient to wear tight-fitting clothing to keep the monitor in place.
E) Instruct the patient to remove any electrodes that seem loose.

49) Which of the following results in a flat line on the ECG tracing?

A) poor skin preparation
B) dirty electrodes
C) detached/loose wire
D) muscle movement
E) electrical interference

50) The greatest volume of air that can be expelled when a person performs a rapid, forced expiration is the __________.

A) inspiratory capacity
B) forced vital capacity
C) peak expiratory flow rate
D) residual volume
E) peak flow zone

51) Which of the following is a measurement taken to determine the amount of air that can be quickly forced from the lungs?

A) maximal voluntary ventilation
B) tidal volume
C) forced vital capacity
D) peak expiratory flow rate
E) peak flow zone

52) Which of the following would you include in patient preparation for a pulmonary function test?

A) Tell the patient that eating and smoking are permitted up until the time of the test.
B) Instruct the patient to sit in a chair with legs crossed.
C) Instruct the patient to slightly elevate the chin and slightly extend the neck.
D) Tell the patient to bite down firmly on the mouthpiece.
E) Encourage the patient to perform the test even if he has a viral infection.

53) An instrument used to measure the air taken in by and expelled from the lungs is the __________.

A) peak flow meter
B) calibration syringe
C) spirometer
D) stylus
E) respirator

54) Pulmonary function tests are useful in monitoring which condition?

A) myocardial infarction
B) chronic obstructive pulmonary disease
C) angina pectoris
D) arrhythmias
E) congestive heart failure

55) Electrical impulse sensors used to obtain an electrocardiogram are called __________.

A) leads
B) styluses
C) electrodes
D) artifacts
E) probes

56) The deflections that occur on an ECG are labeled with the letters __________.

A) A, B, C, D, E, and F
B) P, Q, R, S, T, and U
C) H, I, J, K, and L
D) V, W, X, Y, and Z
E) M, N, O, P, and Q

57) Which of the following is a small upward curve that represents the sinoatrial node impulse, wave of depolarization through the atria, and resultant contraction?

A) P wave
B) S wave
C) S-T segment
D) Q wave
E) R wave

58) Which of the following represents the time it takes for the ventricles to contract and recover, or repolarize?

A) P-R interval
B) S-T interval
C) Q-T interval
D) U wave
E) QRS complex

59) Which of the following represents the time between contraction of the ventricles and recovery?

A) P wave
B) Q wave
C) S-T segment
D) P-R interval
E) QRS complex

60) The time it takes for electrical impulses to travel from the SA node to the AV node is the __________.

A) S-T segment
B) Q wave
C) R wave
D) P-R interval
E) Q-T interval

61) Which of the following refers to the contraction of the ventricles following depolarization?

A) QRS complex
B) T wave
C) Q-T interval
D) S-T segment
E) P wave

62) The impulse that travels through both ventricles is the __________.

A) R wave
B) Q wave
C) S wave
D) P wave
E) T wave

63) When pressed, which of the following should cause the stylus to move up 10mm (10 small squares) and remain there for 0.08 second (2 small squares or 2 mm)?

A) speed selector
B) standardization control
C) centering control
D) sensitivity control
E) stylus temperature control

64) Which control is used to adjust the position of the stylus on the ECG?

A) centering control
B) sensitivity control
C) marker control
D) standardization control
E) stylus temperature control

65) Which of the following is a correct statement about the stylus temperature control?

A) A lower temperature produces a heavier line.
B) It has no effect on the ECG tracing.
C) A higher temperature produces a heavier line.
D) Lower temperatures cause smearing.
E) A higher temperature produces a thinner line.

66) Electrodes for limb leads should be attached to __________.

A) a bony area on each limb
B) a highly vascular area
C) fleshy portions of the limbs
D) the wrists and ankles
E) the knees and elbows

67) If a patient is uncomfortable lying flat on the examining table for an ECG test, he can be placed in the __________.

A) prone position
B) supine position
C) Fowler's position
D) Sims' position
E) proctologic position

68) After preparing the ECG machine, you explained the procedure to Mrs. Thomas, connected the electrodes, and began the tracing, as shown in the picture. You rechecked the electrodes and they are all placed correctly. None of the wires are loose. However, you notice that Mrs. Thomas's skin smells fragrant, as though she has used a body lotion recently. Which of the following describes the problem, its possible cause, and the correct solution?


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A) Extraneous marks caused by paper clips; remove the paper clips.
B) Somatic interference caused by patient shivering; offer a warm blanket.
C) Wandering baseline caused by lotion on the skin; re-prep the skin with isopropyl alcohol.
D) AC interference caused by nearby equipment; turn equipment off.
E) Flat line caused by crossed wires; reconnect the wires correctly.

69) The urgent care center where you work is being remodeled, and the room usually used for obtaining ECGs is currently unavailable. The ECG equipment has been moved around the corner to the room next to the X-ray room. When you begin your first patient ECG of the day, the tracing looks as shown in the figure. What problem is present and how can you fix it?


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A) Extraneous marks; avoid using paper clips on the graph paper.
B) Somatic interference; ask the patient to be very still while you record the ECG.
C) Wandering baseline; check and reconnect loose leads.
D) Flat line; check for crossed wires or loose leads.
E) AC interference; move the ECG equipment to a room farther from other electric equipment.

70) You are attempting to record an ECG for Mr. Potter, a 72-year-old patient who has Parkinson's disease. Knowing this, you automatically place the limb electrodes close to the trunk. However, the tracing looks as shown in the picture. What artifact is present and what can you do to fix it?


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A) Extraneous marks; avoid using paper clips on the graph paper.
B) Somatic interference; wait until Mr. Potter's tremors subside.
C) wandering baseline; check for loose electrodes.
D) AC interference; turn off nearby electrical equipment.
E) Flat line; check pulse and respiration, then begin CPR.

71) Gillian is a cheerful, active teenager who is having an ECG as part of a physical required by her school to participate in cheerleading activities. You explain that she needs to remain very still while you record the ECG. You begin the tracing, as shown in the picture. Although Gillian remains still, when she sees the look on your face, she asks, "What's wrong?" What abnormality is visible in lead V₆, and what is your best choice of action?


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A) Somatic interference; ask Gillian again to remain still.
B) Wandering baseline; check for loose electrodes.
C) AC interference; turn off nearby electrical equipment.
D) Flat line; check pulse and respirations and begin CPR.
E) Flat line; look for loose or disconnected wires.

72) Which of the following can prevent a wandering baseline?

A) Avoid the use of paper clips on the tracing.
B) Make sure all the leads are connected properly.
C) Eliminate other sources of electricity in the room.
D) Be sure the skin is prepared adequately.
E) Make sure the temperature of the room is comfortable.

73) AC interference can be prevented by __________.

A) keeping the patient warm to prevent shivering
B) making sure lead wires are not crossed and following the contour of the body
C) making certain that a lead has not been disconnected from the electrode
D) preparing the patient's skin adequately
E) avoiding the use of paper clips

74) How is somatic interference on an ECG tracing prevented?

A) Make sure lead wires follow the contour of the body.
B) Ground the machine.
C) Prepare the skin properly.
D) Remind the patient to lie still and to refrain from talking.
E) Unplug other electrical devices in the room.

75) How is the heart rate from a regular ECG tracing determined?

A) Count the number of ST segments in a 60-second strip.
B) Multiply the number of QRS complexes in a 6-second strip by 10.
C) Multiply the number of QRS complexes in a 10-second strip by 10.
D) Count the P waves in a 20-second strip.
E) Count the number of QRS complexes in a 30-second strip.

76) What is the arrhythmia pictured here?


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A) atrial fibrillation
B) PVCs
C) ventricular fibrillation
D) bundle branch block
E) cardiac arrest

77) The arrhythmia pictured here is __________.

A) atrial fibrillation
B) PVCs
C) ventricular fibrillation
D) bundle branch block
E) cardiac arrest

78) What is the arrhythmia pictured here?


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A) atrial fibrillation
B) PVCs
C) ventricular fibrillation
D) bundle branch block
E) cardiac arrest

79) The __________ send(s) out electrical impulses to initiate depolarization.

A) bundle branches
B) AV node
C) Purkinje fibers
D) SA node
E) bundle of His

80) Which of the following is a life-threatening dysrhythmia that results in no cardiac output?

A) atrial fibrillation
B) PVCs
C) ventricular fibrillation
D) bundle branch block
E) ventricular tachycardia

81) Which of the following dysrhythmias is due to a heartbeat originating in the ventricles that occurs early in the cycle and is followed by a pause before the next cycle?

A) atrial fibrillation
B) PVCs
C) ventricular fibrillation
D) bundle branch block
E) ventricular tachycardia

82) The dysrhythmia in which P waves cannot be identified because of rapid multiple electrical signals that fire from areas of the atria other than the SA node is known as __________.

A) atrial fibrillation
B) PVCs
C) ventricular fibrillation
D) bundle branch block
E) ventricular tachycardia

83) Which of the following delays the electrical impulse to give time for the atria to complete contraction and the ventricles to fill?

A) bundle of His
B) SA node
C) bundle branches
D) AV node
E) Purkinje fibers

84) Which of the following measures the patient's response to a constant or increasing workload?

A) Holter monitor test
B) exercise ECG
C) resting ECG
D) ultrasound
E) peak expiratory flow rate

85) How do you prepare patients for spirometry?

A) tell them to wear tight clothing
B) have them stand for the test
C) have them wear a nose clip
D) have them bite down on the mouthpiece
E) have them eat a light meal immediately before the test

86) Which of these is a component of an acceptable maneuver for spirometry?

A) slow and easy start
B) variable flow
C) coughing
D) quick, light breath
E) minimum of 6 seconds

87) Which peak flow zone indicates that large airways are beginning to narrow?

A) green zone
B) yellow zone
C) red zone
D) blue zone
E) orange zone

88) The peak flow zone that requires immediate medical treatment is the __________.

A) green zone
B) yellow zone
C) red zone
D) blue zone
E) orange zone

89) If the patient has good control of her asthma, her peak flow rate is in the __________,

A) green zone
B) yellow zone
C) red zone
D) blue zone
E) orange zone

90) When a PVC appears on the ECG, which wave is missing?

A) Q
B) R
C) S
D) P
E) T