Question 1

If artifact is present in leads I,II,and aVR,the most likely source of the artifact is on the
A)right arm.
B)left arm.
C)right leg.
D)left leg.

Accepted Answer

Leads I, II, and aVR all have an electrical viewpoint that includes the right arm as a reference point. Therefore, the most likely source of the artifact is on the right arm, which could be caused by movements, loose or improperly applied lead wires, or poor skin preparation. Artifacts from the left arm or leg would not necessarily affect leads I, II, and aVR in the same way.

Question 2

Your patient is smiling and visiting with family,but the cardiac monitor shows that the patient's heart has completely stopped.The rhythm on the monitor is thus
A)artifact.
B)a life-threatening emergency.
C)dangerous,but it can wait awhile.
D)"toothbrush tachycardia."

Accepted Answer

The patient's behavior suggests they are not in distress, indicating that the monitor reading is likely an artifact, a false reading due to interference or technical issues.

Question 3

A digital converter on the EKG machine
A)controls the amount of artifact.
B)controls the calibration of the machine.
C)is the pen that prints out the EKG tracing.
D)converts the analog signal to a digital one.

Accepted Answer

A digital converter on the EKG machine converts the analog signal from the patient's heart into a digital signal that can be displayed on a screen or printed out. This allows for easier analysis and interpretation of the EKG tracing.

Question 4

Muscle artifact is seen most often in
A)the precordial leads.
B)the limb leads.
C)leads whose positive electrode is on the right leg.
D)leads whose negative electrode is on the right arm.

Accepted Answer

Muscle artifact is most commonly seen in the limb leads because these leads are more susceptible to interference from muscle movements, given their placement on the limbs where muscular activity is frequent.

Question 5

Your patient is having chills.What kind of artifact can this produce?
A)60-cycle interference
B)Baseline sway
C)Broken recording
D)Somatic tremors

Accepted Answer

Somatic tremors can produce artifact due to muscle contractions, which can be caused by chills or shivering.

Question 6

Sixty-cycle interference is commonly caused by
A)patient movement.
B)respirations.
C)lotion on the skin interfering with the signal.
D)electrical interference.

Accepted Answer

Sixty-cycle interference, also known as "mains hum," is typically caused by electrical interference from the power source or other electrical equipment.

Question 7

On your sleeping patient's 12-lead EKG,Lead I's waves and complexes are extremely jittery-completely unreadable-as are aVR's.The most likely cause of this is
A)heart is on the right side of the body instead of the left.
B)gain is set too low.
C)patient has an arrhythmia.
D)right arm electrode or patch is loose or off.

Accepted Answer

The most likely cause of jittery and unreadable waves in Lead I and aVR is a loose or off electrode or patch on the right arm. This would result in poor conduction of electrical signals from the right arm and affect the recordings of those leads on the EKG. Checking and fixing the electrode or patch would likely resolve the issue. A heart being on the right side of the body instead of the left, gain being set too low, or the patient having an arrhythmia are less likely explanations for this particular EKG finding.

Question 8

The artifact caused by the jiggling of wires during toothbrushing is called
A)CPR artifact.
B)"toothbrush asystole."
C)PVCs.
D)"toothbrush tachycardia."

Accepted Answer

The answer of The artifact caused by the jiggling of...

Question 9

The most common cause for the P wave,QRS complex,and T wave to be inverted in Lead I is
A)dextrocardia.
B)incorrect lead placement.
C)myocardial infarction.
D)left bundle branch block.

Accepted Answer

Incorrect lead placement is the most common cause for inversion of the P wave, QRS complex, and T wave in Lead I, as it can lead to a reversal of the electrical axis.

Question 10

You're doing a 12-lead EKG on a patient who has tremors that make the EKG hard to read.You should
A)leave,telling the nurse to call you when the tremors stop,so you can return and try again.
B)make several attempts at a good tracing,then document on the EKG how many attempts were made.
C)call the physician and ask for medication to stop the tremors.
D)do the EKG as usual with no documentation about tremors.

Accepted Answer

Making several attempts at a good tracing and documenting the number of attempts made on the EKG will provide a clear picture to the physician and prevent any misinterpretation of the results. It is important to have an accurate EKG reading for proper diagnosis and treatment.

Question 11

Somatic tremor artifact is commonly caused by
A)patient movement.
B)respirations.
C)lotion on the skin interfering with the signal.
D)electrical interference.

Accepted Answer

Somatic tremor artifact is caused by patient movement, such as shaking or shivering, which can distort the EEG signal.

Question 12

Normal paper speed for printing out the EKG is
A)25 mm/sec.
B)50 mm/sec.
C)10 mm/sec.
D)20 mm/sec.

Accepted Answer

The normal paper speed for printing out the EKG is 25 mm/sec. This speed allows for accurate measurement of the various components of the EKG waveforms, such as the P wave, QRS complex, and T wave. A faster paper speed (e.g. 50 mm/sec) may make it difficult to accurately measure the duration and amplitude of various waveforms, while a slower speed (e.g. 10 or 20 mm/sec) may make it difficult to identify subtle changes in waveforms that could indicate underlying heart conditions. Therefore, a paper speed of 25 mm/sec is considered the standard for most EKG recordings.

Question 13

Your patient for a 12-lead EKG has artifact in II,III,and aVF.To reduce artifact,you check the patches
A)at the 5th ICS,MCL.
B)at the 4th ICS,LSB.
C)on the left leg.
D)on the right arm.

Accepted Answer

Artifact in leads II, III, and aVF suggests an issue with the lower limb electrodes, as these leads are influenced by the electrical activity recorded from the leg electrodes.

Question 14

The "gain" setting on the EKG machine is concerned with
A)the amplitude of the waves and complexes.
B)the size of the patient.
C)Einthoven's law.
D)electrical conduction through the bundle branches.

Accepted Answer

The "gain" setting on the EKG machine determines the amplitude of the waves and complexes, i.e., the size of the electrical signal being recorded. It is used to adjust the degree of amplification of the signal to get clear and accurate readings.

Question 15

If your patient's cardiac rhythm is life-threatening,your FIRST action should be to
A)check the monitor wires and patches.
B)exchange the cardiac monitor for a new one.
C)check the patient-assess vital signs and see how he/she feels.
D)notify the family of the patient's deteriorating condition.

Accepted Answer

When a cardiac rhythm is life-threatening, the first action should be to assess the patient's condition and vital signs. It is important to determine if the patient is conscious and alert or needs immediate assistance. Only after assessing the patient can appropriate interventions be taken. Checking the monitor wires and patches, exchanging the monitor, or notifying the family should not be the first actions taken in this emergency situation.

Question 16

Some modern EKG machines are Bluetooth-capable,allowing EMS workers to
A)listen to their favorite music station while on the job.
B)control the artifact on the EKG.
C)hear the EKG's interpretation via special headphones.
D)transmit the EKG to the nearest hospital so workers can prepare for the patient's arrival.

Accepted Answer

Bluetooth-capable EKG machines allow EMS workers to transmit the EKG to the nearest hospital so workers can prepare for the patient's arrival. This can greatly benefit the patient by reducing the time it takes for the hospital to start treatment. Listening to music or controlling artifact on the EKG are not the primary functions of Bluetooth capability on an EKG machine. Headphones may be used, but only for transmitting the EKG data.

Question 17

If there is artifact in leads II,III,and aVF,on which limb(s)would you expect to find the cause of the artifact?
A)Right arm
B)Right arm and left leg
C)Left leg
D)Left arm

Accepted Answer

Leads II, III, and aVF are part of the inferior leads in an electrocardiogram (ECG), which are primarily formed by the electrical view from the left leg electrode. Therefore, artifacts in these leads would most likely originate from issues with the left leg electrode.

Question 18

Which of the following NOT a method for determining artifact versus a real rhythm?
A)Check your patient for signs of decreased cardiac output
B)Check the wires and patches.
C)Follow any visible QRS complexes.
D)Immediately defibrillate the patient.

Accepted Answer

Immediately defibrillating the patient is not a method for determining artifact versus a real rhythm. It is a last resort for treating a lethal rhythm. A, B, and C are valid methods for determining artifact versus a real rhythm.

Question 19

Muscle artifact can be minimized by monitoring the patient in Lead
A)I.
B)II.
C)aVR.
D)V₁ or MCL₁.

Accepted Answer

Lead V₁ or MCL₁ is less affected by muscle artifacts because it is placed on the chest, closer to the heart, and away from large muscle groups that can cause interference.

Question 20

Macroshock and microshock are LEAST likely to be caused by which of the following?
A)Frayed electrical cord on the EKG machine
B)Broken grounding prong on the electrical cord
C)Properly maintained EKG machine
D)Ungrounded hospital bed on which the patient is lying

Accepted Answer

A properly maintained EKG machine would have all safety features in place and would not cause macroshock or microshock.

Quiz 4: Technical Aspects of the EKG

If artifact is present in leads I,II,and aVR,the most likely source of the artifact is on the

Your patient is smiling and visiting with family,but the cardiac monitor shows that the patient's heart has completely stopped.The rhythm on the monitor is thus

A digital converter on the EKG machine

Muscle artifact is seen most often in

Your patient is having chills.What kind of artifact can this produce?

Sixty-cycle interference is commonly caused by

On your sleeping patient's 12-lead EKG,Lead I's waves and complexes are extremely jittery-completely unreadable-as are aVR's.The most likely cause of this is

The artifact caused by the jiggling of wires during toothbrushing is called

The most common cause for the P wave,QRS complex,and T wave to be inverted in Lead I is

You're doing a 12-lead EKG on a patient who has tremors that make the EKG hard to read.You should

Somatic tremor artifact is commonly caused by

Normal paper speed for printing out the EKG is

Your patient for a 12-lead EKG has artifact in II,III,and aVF.To reduce artifact,you check the patches

The "gain" setting on the EKG machine is concerned with

If your patient's cardiac rhythm is life-threatening,your FIRST action should be to

Some modern EKG machines are Bluetooth-capable,allowing EMS workers to

If there is artifact in leads II,III,and aVF,on which limb(s) would you expect to find the cause of the artifact?

Which of the following NOT a method for determining artifact versus a real rhythm?

Muscle artifact can be minimized by monitoring the patient in Lead

Macroshock and microshock are LEAST likely to be caused by which of the following?