Exam Questions nan Cardiac Stress Testing Ch.12

Electrocardiography for Healthcare Professionals, 5e (Booth)

Chapter 12 Cardiac Stress Testing

1) What is the term for a procedure that does not require entrance into a body cavity, tissue, or blood vessel?

A) Invasive procedure

B) Intensive procedure

C) Noninvasive procedure

D) Nuclear procedure

2) Which of the following is not another name for exercise electrocardiography?

A) Exercise tolerance test

B) Echocardiogram

C) Cardiac stress test

D) Treadmill stress test

3) Why might a physician order exercise electrocardiography for a patient?

A) The patient has symptoms of cardiac problems that do not show up on a resting ECG.

B) The patient has hypertension.

C) The patient has mitral valve prolapse.

D) The patient had an abnormal chest x-ray.

4) As an exercise stress test progresses, what happens to the level of exertion of exercise?

A) It decreases in stages.

B) It is maintained throughout the test.

C) It increases in stages.

D) It is adjusted for patient comfort.

5) What is obtained near the end of each exercise stage?

A) Patient's temperature

B) Blood pressure reading and a 12-lead ECG

C) Assessment of patient's pain level

D) Blood for laboratory tests

6) Which of the following is not assessed during exercise electrocardiography?

A) Heart rate

B) Oxygen level

C) Physical appearance

D) Blood glucose level

7) What is your most important responsibility during an exercise electrocardiography test?

A) Provide for safety and be prepared for an emergency.

B) Attach the electrodes properly.

C) Interpret the test.

D) Inform family members of the test outcome.

8) What does exercise electrocardiography evaluate?

A) How the heart and blood vessels respond to physical activity

B) The resting and exercise stroke volume of the ventricles

C) The capacity of the patient's heart and lungs

D) Changes in cardiac output due to exercise

9) Which of the following is not a reason exercise electrocardiography is used?

A) To help diagnose causes of chest pain

B) To evaluate how the heart responds to electrical stimulation

C) To evaluate the effectiveness of cardiac medications

D) To identify the cause of abnormal heart rhythms that develop during physical exercise

10) What is the term for a narrowing of the coronary arteries that causes a reduction in the blood flow to the heart?

A) Ischemia

B) Congestive heart failure

C) Coronary vascular disease

D) Angina

11) What is the term for an oppressive pain or pressure in the chest when the heart muscle does not receive enough oxygen due to partial or complete blockage of a coronary artery?

A) Angina

B) Apnea

C) Ischemia

D) Anemia

12) The following is noted on an ECG during exercise electrocardiography. What is this feature called? 

A) PVC

B) ST segment elevation

C) ST segment depression

D) Wide QRS duration

13) Besides myocardial ischemia, what else can cause ST segment depression?

A) Certain medications

B) Hypertension

C) Bundle branch block

D) Congestive heart failure

14) Which of these patients would be a candidate for a chemical stress test?

A) A 70-year-old patient making a first visit to an ambulatory facility

B) A 68-year-old patient confined to bed after cardiac surgery

C) A 45-year-old patient during a routine physical

D) A 50-year-old patient with a history of heart disease

15) What chemical is injected intravenously during a nuclear stress test to allow the heart to be viewed on a special camera?

A) Valium

B) Radioactive tracer

C) Digitalis

D) Beta blocker

16) When a chemical stress test is performed using Persantine, adenosine, or a similar chemical, how does the chemical affect the patient?

A) It stimulates the patient so he or she can exercise longer.

B) It changes the heart's rhythm from atrial fibrillation to normal sinus rhythm.

C) It relaxes the heart.

D) It mimics the stresses placed on the heart during exercise.

17) Which of the following procedures is considered invasive?

A) Treadmill stress test

B) 12-lead ECG

C) Chemical stress test

D) Ambulatory monitoring

18) Which of the following would you include when instructing a patient about an upcoming exercise electrocardiography test?

A) Check the order and then advise the patient regarding any medications that should or should not be taken before the procedure.

B) Ensure that the history form and the permission slip, which will be completed by the licensed practitioner, are on the chart.

C) Ask the patient to come in right after lunch to complete the test.

D) Tell the patient to avoid alcohol, tobacco, and caffeine for at least 1 hour before exercise electrocardiography.

19) Which of the following medications would most likely be stopped before a treadmill stress test?

A) Cholesterol medication

B) Beta blocker

C) Aspirin

D) Coumadin

20) On the consent form for Mrs. Smith's treadmill stress test, a large X is marked on the signature line. Should you continue with the procedure? Why or why not?

A) No, do not complete the test. Mrs. Smith does not understand why the consent form is necessary.

B) Yes, complete the test. Mrs. Smith did not have her glasses available when signing.

C) No, do not complete the test. Mrs. Smith has refused to have the test.

D) Yes, complete the test. Mrs. Smith is unable to sign her name.

21) You are preparing a 72-year-old patient for exercise electrocardiography. The patient says he is frightened of all modern technology. Which of the following would not help alleviate this patient's fears during exercise electrocardiography?

A) Maintaining a sense of confidence

B) Following safety precautions

C) Explaining the location of the crash cart

D) Answering his questions

22) Of the following, which concept is least important for the patient to understand before signing the consent form for an exercise electrocardiography procedure?

A) The procedure itself

B) The risks involved

C) The reason the test was ordered

D) When the test results will be available

23) A complete history of the patient is needed before an exercise electrocardiography. Which of the following information is not needed for the history?

A) Cardiovascular risk factors

B) The amount of sleep the patient had the night before

C) Medications being taken

D) Medical history

24) You are explaining the exercise electrocardiography procedure to a 36-year-old female patient. She tells you she has a very low pain tolerance and is afraid the procedure will hurt. Which of the following symptoms would you tell her to expect during exercise electrocardiography?

A) Mild fatigue, increased heart rate, and increased respiratory rate

B) Chest pain and weakness

C) Dizziness

D) Blurred vision and headache

25) Which of the following conditions would not prevent a patient from participating in exercise electrocardiography?

A) Unstable angina

B) Diabetes

C) Pericarditis

D) Third-degree AV block

26) Which statement is correct regarding your responsibilities during an exercise electrocardiography test?

A) You will prepare the patient, connect the leads, and print a tracing.

B) You are responsible only for connecting the ECG leads to the patient.

C) You will instruct the patient about the procedure, attach the electrodes, and monitor the patient during the procedure.

D) You will provide patient instructions and monitor the patient for 2 hours after completion of the test.

27) Before initiating an exercise stress test, you may be asked to take and record a series of blood pressure readings and 12-lead ECG results. What are the most common patient positions, in order, in which these are obtained?

A) Sitting, supine, standing, and after hyperventilation

B) Standing, sitting, after hyperventilation, and supine

C) Supine, sitting, standing, and after hyperventilation

D) Supine, sitting, after hyperventilation, and standing

28) How do you determine how many pretest recordings of blood pressure and 12-lead ECGs you obtain?

A) Ask your coworker.

B) Check the physician's order.

C) Check the facility policy.

D) Ask the patient.

29) What is the purpose of the hyperventilation ECG during pretesting?

A) To determine the patient's lung capacity

B) To identify ECG changes caused by breathing

C) To determine if the patient will become short of breath while on the treadmill

D) To rule out lung disease before testing

30) Which of the following equipment is not needed to prepare a patient for a treadmill exercise test?

A) Blood pressure equipment

B) Skin preparation solution and shaving equipment

C) Eye protection and face shield

D) Adhesive tape belt

31) Which is the most commonly used stress test protocol?

A) Bruce protocol

B) Modified Bruce protocol

C) Naughton protocol

D) Persantine protocol

32) What calculation is performed to find a patient's target heart rate for exercise electrocardiography?

A) 200 minus the patient's age multiplied by 20% to 30%

B) 220 minus the patient's age

C) Pulse rate multiplied by 2

D) 220 minus the patient's age multiplied by 60% to 85%

33) Which statement is correct regarding the patient who achieves the target heart rate (THR) during the test?

A) The test results are more reliable when the patient nears or achieves the THR.

B) The patient definitely does not have cardiac disease.

C) The patient definitely has cardiac disease if he or she achieves the THR.

D) The results are questionable and may need to be repeated if the patient nears or achieves the THR.

34) What is the rate pressure product?

A) Diastolic blood pressure times heart rate

B) Systolic blood pressure times diastolic blood pressure

C) Systolic blood pressure times heart rate

D) Heart rate times respiration rate

35) After an exercise stress test, the patient will have a cooling-off period. How long does this last and what should you do during this time?

A) It lasts 30 minutes and you do not have any responsibilities during this time.

B) The cooling-off period lasts about 45 minutes and you should monitor the patient for any changes.

C) No cooling-off time is needed for this test.

D) It will last 6 to 15 minutes and you should monitor the patient for any changes.

36) Which of the following statements about exercise electrocardiography results is true?

A) Exercise electrocardiography results provide conclusive evidence of heart disease.

B) Because a high percentage of results are false-positives, the test is repeated twice for verification.

C) False-positive results occur more frequently in women than in men.

D) The test results are more reliable in people who exercise regularly.

37) The purpose of calculating the rate pressure product is to estimate the patient's ________.

A) Heart rate

B) Oxygen utilization

C) Resting blood pressure

D) Stress endurance

38) For which of the following patients would the Naughton protocol for exercise electrocardiography most likely be used?

A) A 56-year-old man who has congestive heart failure

B) A 63-year-old woman who exercises regularly and is in good physical condition

C) A 42-year-old woman who has diabetes

D) A 36-year-old man who is undergoing routine screening

39) What procedure combines an echocardiogram with an exercise stress test?

A) Nuclear stress test

B) Stress echocardiogram

C) Gamma stress test

D) Chemical stress test

40) Which of the following is not a phase that takes place in a stress echocardiogram test?

A) Recovery phase

B) Immediate postexercise scan

C) Nuclear phase

D) Resting echocardiogram phase

41) In the context of a nuclear stress test, what does gating mean?

A) Performing a series of scans over 24 hours for comparison studies

B) Injecting the radioactive tracer at specific intervals

C) Rotating the scanning camera around the patient's body

D) Triggering the camera to record at specific points during the cardiac cycle

42) What is the condition in which a person's heart fails to pump an adequate volume of blood to provide oxygen and nutrients to the body tissues?

A) Myocardial infarction

B) Hypertension

C) Congestive heart failure

D) Angina

43) What is the medical term for high blood pressure?

A) Hypotension

B) Hypertension

C) Angina

D) CHF

44) What is the term for breathing at an increased rate and depth of inspiration and expiration?

A) Hypoventilation

B) Apnea

C) Hypopnea

D) Hyperventilation

45) You have assisted during Mr. Rafferty's exercise electrocardiography test and are monitoring him during his cooling-off period. He tells you he feels fine and asks, "So what do the test results say? Am I healthy?" What should you do?

A) Show Mr. Rafferty the ECGs performed during the test.

B) Tell Mr. Rafferty that the results look normal.

C) Refer Mr. Rafferty to the physician for the results.

D) Tell Mr. Rafferty that you do not know how to read an ECG.

46) What does an inconclusive exercise electrocardiography test mean?

A) The patient is one of the 5% of patients who have false-positive results.

B) The patient probably has heart disease, although it did not show up on the test.

C) Additional testing must be done to determine whether the patient has heart disease.

D) The patient has no detectable coronary vascular disease.

47) Which of the following should you include in patient instructions after exercise electrocardiography?

A) You may resume caffeine intake immediately.

B) You should not take a hot shower or bath for at least 2 hours.

C) You may resume ordinary activities; there is no need to rest after this test.

D) You can call me tomorrow, and I will explain the results to you.

48) You should prepare the electrode sites on a patient's skin using a skin rasp, which is ________.

A) A piece of gauze

B) An alcohol-saturated pad

C) An electrolyte solution that magnifies electrical signals

D) A rough piece of material for abrading the skin

49) Which of the following is the term for the practice of placing the limb leads on the upper chest and torso instead of the arms and legs for exercise electrocardiography?

A) Mason-Likar attachment

B) 15-lead protocol

C) V4R protocol

D) Posterior lead placement

50) Which of the following signs or symptoms should the patient be instructed to report during an exercise electrocardiography test?

A) Mild fatigue

B) Dizziness

C) Increased heart rate

D) Increased respiratory rate

51) An echocardiogram studies which of the following structures? 

A) Valves 

B) Atrial conduction system 

C) His/Purkinje conduction system

D) Action Potential 

52) How many different left ventricular wall images are obtained during a stress echocardiography procedure?

A) 2

B) 3

C) 4

D) 5

53) A patient's exercise electrocardiography results are inconclusive. What does this mean? 

A) Exercise electrocardiography results are always 100% accurate

B) No additional testing will be required 

C) The diagnosis is normal 

D) Additional testing may be required to either identify or eliminate any abnormalities