Deck 4: Technical Aspects of the EKG

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.

Answer 1

A

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."

Answer 2

A

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.

Answer 3

D

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.

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

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.

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.

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."

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.

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.

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.

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.

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.

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.

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.

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.

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

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.

Question 19

Muscle artifact can be minimized by monitoring the patient in Lead

A)I.
B)II.
C)aVR.
D)V₁ or MCL₁.

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

Question 21

Which of the following correctly describes the function of the gain setting on the EKG machine?

A)It filters out extraneous noise and artifact.
B)It controls the speed of the recording.
C)It sends a message to the physician about any abnormality on the EKG.
D)It regulates the height of the complexes.

Question 22

Chills can cause somatic tremor artifact.

Question 23

CPR artifact is seen only during CPR.

Question 24

Small adhesive patches with conductive gel on the skin side are

A)cables.
B)electrodes.
C)conduits.
D)oscilloscopes.

Question 25

"Toothbrush tachycardia" can be lethal.

Question 26

Which of the following is NOT true about how the heart's electrical impulses result in the printed EKG?

A)Heart's impulses are picked up by electrodes on the skin.
B)The heart impulses are sent through a microphone.
C)Electrodes send the signal through a cable to an amplifier in the EKG machine.
D)A digital converter changes the analog signal to a digital one.

Question 27

Microshock is different from macroshock in that microshock is

A)a higher-voltage electrical shock.
B)a lower-voltage electrical shock.
C)caused by inadequate grounding of electrical equipment.
D)incapable of causing death.

Question 28

Artifact is a sign that the patient is in distress.

Question 29

Electrically speaking,the heart is a

A)transmitter.
B)receiver.
C)cable.
D)galvanometer.

Question 30

A rhythm that looks lethal cannot be artifact.

Question 31

Macroshock and microshock are two kinds of electrical shock the patient can sustain from faulty equipment.

Question 32

Sometimes,the presence of artifact can be verified by changing the lead.

Question 33

The part of the EKG machine that converts an analog signal to a digital signal is the

A)lead wire.
B)electrode.
C)amplifier.
D)digital converter.

Question 34

Life-threatening arrhythmias will cause symptoms of decreased cardiac output.

Question 35

Artifact in Leads I,III,and aVL is caused by a loose or detached electrode patch or wire on the left arm.

Question 36

Artifact can mimic arrhythmias.

Question 37

If artifact is seen in leads I,III,and aVL,the problem is on which limb?

A)Right arm
B)Right leg
C)Left arm
D)Left leg

Question 38

Artifact does not cause symptoms of decreased cardiac output.

Question 39

Artifact is an unwanted interference or jitter on the EKG tracing.

Question 40

To minimize artifact,what must be done?

A)Attach electrode patches securely
B)Tell the patient not to breathe during the EKG
C)Tell the patient not to move during the EKG
D)All but B

Question 41

Baseline sway is caused by lotion or sweat on the skin interfering with the ________ reaching the EKG machine.

Question 42

If you think the rhythm is artifact,check your patient for any symptoms of decreased cardiac output first,then check his monitor wires and patches and observe the rhythm in another lead.

Question 43

Electrically speaking,the EKG machine is a ________ and the heart is a transmitter.

Question 44

Troubleshooting involves determining and alleviating the cause of ________.

Question 45

A thick-looking pattern on the EKG paper that looks like someone used a thick Magic Marker to write the baseline is typical of what kind of artifact?

Question 46

The EKG machine's control feature that might reduce artifact is the ________.

Question 47

Broken recording is caused by ________.

Question 48

It is possible to have artifact in the midst of a dangerous rhythm.

Question 49

CPR artifact is caused by chest compressions obscuring the real ________.

Question 50

If artifact is seen in leads I,III,and aVL,you should direct your corrective efforts to which limb or limbs?

Question 51

Using an EKG machine with frayed wires is not dangerous if the wires are taped together.

Question 52

________ is unwanted jitter or interference on the EKG tracing.

Question 53

The word "somatic" means ________.

Question 54

The EKG machine control feature that controls the size of the waves and complexes is the ________.