AMCA EKG EXAM 2026/2027
American Medical Certification Association | Electrocardiograph Technician Certification
✓ 100 QUESTIONS & CORRECT ANSWERS | GRADED A+ | 100% VERIFIED
100 70% 2 hrs A+
Questions Passing Score Time Limit Grade
Exam Overview
This preparation resource reflects the American Medical Certification Association (AMCA) standards for Electrocardiograph (EKG)
Technician certification for the 2026/2027 cycle. The AMCA EKG certification validates knowledge and skills required to perform
electrocardiograms, recognize cardiac rhythms, identify abnormalities, and provide quality patient care across healthcare settings.
Exam Structure
100 total multiple-choice questions Single-best-answer format
EKG strip interpretation items Integrated case-based scenarios
Computer-based at AMCA centers 2-hour time limit
Passing score: 70% or higher AMCA-aligned content outline
DOMAIN 1 Cardiovascular Anatomy & Physiology (Q1–Q10)
QUESTION 1
Which chamber of the heart is responsible for pumping oxygenated blood into systemic circulation?
A. Right atrium
B. Right ventricle
C. Left atrium
D. Left ventricle
✓ CORRECT ANSWER
D. Left ventricle
The left ventricle is the most muscular chamber of the heart and is responsible for pumping oxygenated blood through the aortic valve
into the aorta and systemic circulation. Its thick myocardial wall generates the high pressure needed to perfuse the entire body.
QUESTION 2
Which valve separates the left atrium from the left ventricle?
,A. Tricuspid valve
B. Pulmonic valve
C. Mitral valve
D. Aortic valve
✓ CORRECT ANSWER
C. Mitral valve
The mitral (bicuspid) valve is located between the left atrium and left ventricle. It has two leaflets and prevents backflow of blood into
the left atrium during ventricular contraction. Mitral valve disease can significantly affect cardiac output and may produce
characteristic EKG changes.
QUESTION 3
The primary pacemaker of the heart is the:
A. AV node
B. Bundle of His
C. SA node
D. Purkinje fibers
✓ CORRECT ANSWER
C. SA node
The sinoatrial (SA) node, located in the upper right atrium near the superior vena cava, is the heart's natural pacemaker. It generates
impulses at 60–100 beats per minute, initiating each normal cardiac cycle. Its automatic depolarization sets the heart rate under
normal conditions.
QUESTION 4
Which vessel carries deoxygenated blood from the right ventricle to the lungs?
A. Pulmonary veins
B. Pulmonary artery
C. Aorta
D. Superior vena cava
✓ CORRECT ANSWER
B. Pulmonary artery
The pulmonary artery is unique in that it carries deoxygenated blood from the right ventricle to the lungs for oxygenation — the only
artery in the body to carry deoxygenated blood. This is a fundamental distinction in understanding pulmonary versus systemic
circulation.
QUESTION 5
The AV node's intrinsic firing rate, if it were to become the pacemaker, would be:
A. 60–100 bpm
B. 40–60 bpm
C. 20–40 bpm
D. 100–150 bpm
✓ CORRECT ANSWER
B. 40–60 bpm
, The AV node has an intrinsic escape rate of 40–60 bpm. If the SA node fails, the AV node can assume pacemaker function at this
slower rate, producing a junctional rhythm. This is an important safety mechanism in the cardiac conduction hierarchy.
QUESTION 6
Which layer of the heart is responsible for the actual contractile force?
A. Epicardium
B. Pericardium
C. Myocardium
D. Endocardium
✓ CORRECT ANSWER
C. Myocardium
The myocardium is the muscular middle layer of the heart wall composed of cardiac muscle cells (cardiomyocytes). It is responsible
for generating the mechanical force of contraction. Ischemia or infarction of the myocardium is reflected in EKG changes such as ST
elevation, depression, and T-wave inversions.
QUESTION 7
The right coronary artery (RCA) most commonly supplies which structure?
A. Left ventricle anterior wall
B. SA node and AV node
C. Left bundle branch
D. Lateral wall of the left ventricle
✓ CORRECT ANSWER
B. SA node and AV node
In approximately 60% of individuals, the RCA supplies both the SA node and AV node. This is clinically significant because RCA
occlusion (inferior MI) can produce bradycardia and various degrees of heart block. EKG findings in inferior MI include ST elevation
in leads II, III, and aVF.
QUESTION 8
Purkinje fibers are responsible for:
A. Initiating the cardiac impulse
B. Delaying conduction between atria and ventricles
C. Rapidly distributing electrical impulses throughout ventricular myocardium
D. Repolarizing the SA node
✓ CORRECT ANSWER
C. Rapidly distributing electrical impulses throughout ventricular myocardium
Purkinje fibers are specialized conduction cells that form an extensive network in the ventricular myocardium. They rapidly conduct
impulses from the bundle branches to the ventricular muscle cells, enabling simultaneous contraction of the ventricles and producing
the narrow, normal QRS complex seen on EKG.
QUESTION 9
During diastole, which event is occurring?
, A. Ventricles are contracting and ejecting blood
B. The mitral and tricuspid valves are closed
C. Ventricles are relaxing and filling with blood
D. The aortic and pulmonic valves are open
✓ CORRECT ANSWER
C. Ventricles are relaxing and filling with blood
Diastole is the relaxation phase of the cardiac cycle during which the ventricles fill with blood from the atria. The AV valves (mitral
and tricuspid) are open, and the semilunar valves are closed. On the EKG, diastole corresponds roughly to the period from the end of
the T wave to the next QRS complex.
QUESTION 10
Which of the following best describes the function of the AV node in cardiac conduction?
A. It generates the fastest intrinsic rate in the heart
B. It delays the impulse to allow ventricular filling before contraction
C. It directly depolarizes the ventricular myocardium
D. It acts as a backup pacemaker at 20–40 bpm
✓ CORRECT ANSWER
B. It delays the impulse to allow ventricular filling before contraction
The AV node introduces a critical delay (approximately 0.1 seconds) in conduction between the atria and ventricles. This allows the
atria to complete their contraction and fully empty blood into the ventricles before ventricular systole begins. On the EKG, this delay is
represented by the PR interval (normal: 0.12–0.20 seconds).
DOMAIN 2 Electrophysiology (Q11–Q20)
QUESTION 11
Depolarization of the cardiac cell occurs when:
A. Potassium rapidly enters the cell
B. Sodium rapidly enters the cell, making it more positive
C. Calcium exits the cell
D. The cell membrane becomes impermeable to all ions
✓ CORRECT ANSWER
B. Sodium rapidly enters the cell, making it more positive
During Phase 0 of the cardiac action potential, fast sodium channels open, allowing a rapid influx of sodium (Na⁺) ions into the cell.
This causes the intracellular environment to shift from negative to positive — a process called depolarization. This electrical event
triggers mechanical contraction of the myocardium.
QUESTION 12
The absolute refractory period in the cardiac cycle is the time during which:
A. The heart can be stimulated with a stronger-than-normal impulse
B. The heart cannot be stimulated regardless of stimulus strength
C. Only the SA node can fire
D. The T wave is produced
American Medical Certification Association | Electrocardiograph Technician Certification
✓ 100 QUESTIONS & CORRECT ANSWERS | GRADED A+ | 100% VERIFIED
100 70% 2 hrs A+
Questions Passing Score Time Limit Grade
Exam Overview
This preparation resource reflects the American Medical Certification Association (AMCA) standards for Electrocardiograph (EKG)
Technician certification for the 2026/2027 cycle. The AMCA EKG certification validates knowledge and skills required to perform
electrocardiograms, recognize cardiac rhythms, identify abnormalities, and provide quality patient care across healthcare settings.
Exam Structure
100 total multiple-choice questions Single-best-answer format
EKG strip interpretation items Integrated case-based scenarios
Computer-based at AMCA centers 2-hour time limit
Passing score: 70% or higher AMCA-aligned content outline
DOMAIN 1 Cardiovascular Anatomy & Physiology (Q1–Q10)
QUESTION 1
Which chamber of the heart is responsible for pumping oxygenated blood into systemic circulation?
A. Right atrium
B. Right ventricle
C. Left atrium
D. Left ventricle
✓ CORRECT ANSWER
D. Left ventricle
The left ventricle is the most muscular chamber of the heart and is responsible for pumping oxygenated blood through the aortic valve
into the aorta and systemic circulation. Its thick myocardial wall generates the high pressure needed to perfuse the entire body.
QUESTION 2
Which valve separates the left atrium from the left ventricle?
,A. Tricuspid valve
B. Pulmonic valve
C. Mitral valve
D. Aortic valve
✓ CORRECT ANSWER
C. Mitral valve
The mitral (bicuspid) valve is located between the left atrium and left ventricle. It has two leaflets and prevents backflow of blood into
the left atrium during ventricular contraction. Mitral valve disease can significantly affect cardiac output and may produce
characteristic EKG changes.
QUESTION 3
The primary pacemaker of the heart is the:
A. AV node
B. Bundle of His
C. SA node
D. Purkinje fibers
✓ CORRECT ANSWER
C. SA node
The sinoatrial (SA) node, located in the upper right atrium near the superior vena cava, is the heart's natural pacemaker. It generates
impulses at 60–100 beats per minute, initiating each normal cardiac cycle. Its automatic depolarization sets the heart rate under
normal conditions.
QUESTION 4
Which vessel carries deoxygenated blood from the right ventricle to the lungs?
A. Pulmonary veins
B. Pulmonary artery
C. Aorta
D. Superior vena cava
✓ CORRECT ANSWER
B. Pulmonary artery
The pulmonary artery is unique in that it carries deoxygenated blood from the right ventricle to the lungs for oxygenation — the only
artery in the body to carry deoxygenated blood. This is a fundamental distinction in understanding pulmonary versus systemic
circulation.
QUESTION 5
The AV node's intrinsic firing rate, if it were to become the pacemaker, would be:
A. 60–100 bpm
B. 40–60 bpm
C. 20–40 bpm
D. 100–150 bpm
✓ CORRECT ANSWER
B. 40–60 bpm
, The AV node has an intrinsic escape rate of 40–60 bpm. If the SA node fails, the AV node can assume pacemaker function at this
slower rate, producing a junctional rhythm. This is an important safety mechanism in the cardiac conduction hierarchy.
QUESTION 6
Which layer of the heart is responsible for the actual contractile force?
A. Epicardium
B. Pericardium
C. Myocardium
D. Endocardium
✓ CORRECT ANSWER
C. Myocardium
The myocardium is the muscular middle layer of the heart wall composed of cardiac muscle cells (cardiomyocytes). It is responsible
for generating the mechanical force of contraction. Ischemia or infarction of the myocardium is reflected in EKG changes such as ST
elevation, depression, and T-wave inversions.
QUESTION 7
The right coronary artery (RCA) most commonly supplies which structure?
A. Left ventricle anterior wall
B. SA node and AV node
C. Left bundle branch
D. Lateral wall of the left ventricle
✓ CORRECT ANSWER
B. SA node and AV node
In approximately 60% of individuals, the RCA supplies both the SA node and AV node. This is clinically significant because RCA
occlusion (inferior MI) can produce bradycardia and various degrees of heart block. EKG findings in inferior MI include ST elevation
in leads II, III, and aVF.
QUESTION 8
Purkinje fibers are responsible for:
A. Initiating the cardiac impulse
B. Delaying conduction between atria and ventricles
C. Rapidly distributing electrical impulses throughout ventricular myocardium
D. Repolarizing the SA node
✓ CORRECT ANSWER
C. Rapidly distributing electrical impulses throughout ventricular myocardium
Purkinje fibers are specialized conduction cells that form an extensive network in the ventricular myocardium. They rapidly conduct
impulses from the bundle branches to the ventricular muscle cells, enabling simultaneous contraction of the ventricles and producing
the narrow, normal QRS complex seen on EKG.
QUESTION 9
During diastole, which event is occurring?
, A. Ventricles are contracting and ejecting blood
B. The mitral and tricuspid valves are closed
C. Ventricles are relaxing and filling with blood
D. The aortic and pulmonic valves are open
✓ CORRECT ANSWER
C. Ventricles are relaxing and filling with blood
Diastole is the relaxation phase of the cardiac cycle during which the ventricles fill with blood from the atria. The AV valves (mitral
and tricuspid) are open, and the semilunar valves are closed. On the EKG, diastole corresponds roughly to the period from the end of
the T wave to the next QRS complex.
QUESTION 10
Which of the following best describes the function of the AV node in cardiac conduction?
A. It generates the fastest intrinsic rate in the heart
B. It delays the impulse to allow ventricular filling before contraction
C. It directly depolarizes the ventricular myocardium
D. It acts as a backup pacemaker at 20–40 bpm
✓ CORRECT ANSWER
B. It delays the impulse to allow ventricular filling before contraction
The AV node introduces a critical delay (approximately 0.1 seconds) in conduction between the atria and ventricles. This allows the
atria to complete their contraction and fully empty blood into the ventricles before ventricular systole begins. On the EKG, this delay is
represented by the PR interval (normal: 0.12–0.20 seconds).
DOMAIN 2 Electrophysiology (Q11–Q20)
QUESTION 11
Depolarization of the cardiac cell occurs when:
A. Potassium rapidly enters the cell
B. Sodium rapidly enters the cell, making it more positive
C. Calcium exits the cell
D. The cell membrane becomes impermeable to all ions
✓ CORRECT ANSWER
B. Sodium rapidly enters the cell, making it more positive
During Phase 0 of the cardiac action potential, fast sodium channels open, allowing a rapid influx of sodium (Na⁺) ions into the cell.
This causes the intracellular environment to shift from negative to positive — a process called depolarization. This electrical event
triggers mechanical contraction of the myocardium.
QUESTION 12
The absolute refractory period in the cardiac cycle is the time during which:
A. The heart can be stimulated with a stronger-than-normal impulse
B. The heart cannot be stimulated regardless of stimulus strength
C. Only the SA node can fire
D. The T wave is produced
