AMCA EKG TECHNICIAN CERTIFICATION EXAM– QUESTIONS
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1. A patient arrives for a standard 12-lead ECG and expresses anxiety about receiving
electrical shocks from the machine. Which of the following responses by the EKG
technician is most appropriate?
A. Advise the patient that the machine uses a high-voltage current to stimulate the heart.
B. Explain that the EKG machine only records electrical activity produced by the heart and does
not transmit electricity into the body.
C. Inform the patient that a mild electrical sensation is normal during electrode placement.
D. Discontinue the procedure immediately and notify the ordering physician of the patient's
refusal.
ANSWER: B. Explain that the EKG machine only records electrical activity produced by
the heart and does not transmit electricity into the body.
The EKG machine is a diagnostic device that functions exclusively as a recorder of the heart's
natural electrical impulses, meaning no electrical current passes from the machine into the
patient. Option A is incorrect because it introduces false and frightening information. Option
C is incorrect because electrodes are passive sensors, not stimulators. Option D is premature
since patient education typically resolves anxiety without canceling a necessary diagnostic test.
2. While preparing a patient for a resting 12-lead ECG, the technician notices heavy oily
residue on the patient's anterior chest wall. What is the correct preparatory step to ensure
adequate electrode adhesion and signal quality?
A. Apply conductive gel directly over the oily skin areas before attaching the electrodes.
B. Clean the electrode site areas gently with soap and water or an alcohol wipe, and allow the
skin to dry completely.
C. Increase the machine gain setting to compensate for high skin resistance.
D. Shave the chest hair and apply the electrodes immediately over the natural oils.
,ANSWER: B. Clean the electrode site areas gently with soap and water or an alcohol wipe,
and allow the skin to dry completely.
Skin oils increase electrical resistance and interfere with proper electrode adherence, leading
to artifact and poor tracing quality. Cleaning the skin removes oils and dead skin cells. Option
A is incorrect because gel alone does not break down oils effectively. Option C is incorrect
because gain adjustments amplify artifact rather than correcting poor skin preparation.
Option D is incorrect because oil must be removed even if hair is shaved.
3. During a routine 12-lead ECG, the technician observes a wandering baseline
characterized by up and down fluctuations of the tracing on the paper. Which of the
following is the most likely cause?
A. Broken lead wire on lead V1
B. Patient breathing heavily or movement of the cables
C. 60-cycle electrical interference from nearby medical equipment
D. Somatic tremor caused by involuntary muscle shivering
ANSWER: B. Patient breathing heavily or movement of the cables
A wandering baseline is typically caused by patient movement, deep respirations, or tension
and movement on the lead wires. Option A typically causes a flat line or stylized baseline shift
in a specific lead group rather than a general wandering baseline. Option C causes AC
interference, which appears as small, uniform, jagged spikes. Option D causes somatic tremor,
which presents as fuzzy, irregular baseline baseline oscillations.
4. An EKG technician is positioning the precordial electrodes for a standard 12-lead ECG.
Where should electrode V4 be correctly placed?
A. Fourth intercostal space at the right sternal border
B. Fourth intercostal space at the left sternal border
C. Fifth intercostal space at the left midclavicular line
D. Fifth intercostal space at the left anterior axillary line
ANSWER: C. Fifth intercostal space at the left midclavicular line
V4 is standardly placed at the fifth intercostal space intersecting the left midclavicular line.
Option A describes the landmark for V1. Option B describes the landmark for V2. Option D
describes the landmark for V5.
,5. Which of the following waves on a normal EKG tracing represents atrial depolarization?
A. P wave
B. QRS complex
C. T wave
D. U wave
ANSWER: A. P wave
The P wave reflects the electrical spread through the right and left atria, resulting in atrial
depolarization. Option B represents ventricular depolarization. Option C represents
ventricular repolarization. Option D represents repolarization of the Purkinje fibers or
hypokalemia when prominent.
6. A patient asks the EKG technician what a normal sinus rhythm means. Which of the
following is the best professional explanation?
A. It means your heart is beating abnormally fast due to excessive caffeine intake.
B. It means the electrical impulse originates in the sinoatrial node and travels normally through
the heart at a standard rate.
C. It means you are experiencing a temporary blockage in your main coronary artery.
D. It means the rhythm is irregular and requires immediate surgical intervention.
ANSWER: B. It means the electrical impulse originates in the sinoatrial node and travels
normally through the heart at a standard rate.
Normal sinus rhythm indicates that the sinoatrial node is functioning as the primary
pacemaker, producing normal waveforms, intervals, and a rate between 60 and 100 beats per
minute. Options A, C, and D describe abnormal pathological states or inaccurate clinical
definitions.
7. Which of the following standard leads are considered bipolar leads?
A. Leads I, II, and III
B. Leads AVR, AVL, and AVF
C. Leads V1, V2, and V3
D. Leads V4, V5, and V6
, ANSWER: A. Leads I, II, and III
Leads I, II, and III are bipolar limb leads because they measure the electrical potential
difference between two specific extremities. Option B represents augmented unipolar limb
leads. Options C and D represent unipolar chest precordial leads.
8. When calculating the heart rate from an EKG strip using the 1500 method, a technician
counts 20 small boxes between two consecutive R waves. What is the patient's ventricular
heart rate?
A. 60 beats per minute
B. 75 beats per minute
C. 100 beats per minute
D. 150 beats per minute
ANSWER: B. 75 beats per minute
The 1500 method divides 1500 by the number of small boxes between consecutive R waves.
Dividing 1500 by 20 yields 75 beats per minute. Options A, C, and D are incorrect
mathematical calculations based on this formula.
9. An elderly patient with severe Parkinson disease is scheduled for a 12-lead EKG. The
resulting tracing shows erratic, jagged spikes along the baseline. What type of artifact is
most likely present, and how can it be minimized?
A. AC interference; unplug nearby electrical equipment
B. Somatic tremor; have the patient place their hands underneath their buttocks to reduce muscle
movement
C. Wandering baseline; clean the skin with alcohol to remove oils
D. Interrupted baseline; check for loose cable connections
ANSWER: B. Somatic tremor; have the patient place their hands underneath their buttocks
to reduce muscle movement
Somatic tremor is caused by muscle movement, such as tremors or shivering, and can be
minimized by having the patient rest their hands under their hips or legs to relax limb muscles.
Option A describes 60-cycle interference. Option C describes baseline drift. Option D describes
a disconnected lead wire.
10. What is the standard paper speed for a conventional 12-lead EKG machine?
AND ANSWERS | VERIFIED AND WELL DETAILED ANSWERS
PLUS RATIONALES | GUARANTEED PASS | LATEST EXAM
UPDATE | EXAM PREP | STUDY GUIDE | PRACTICE TEST|
DOWNLOAD INSTANT PDF
1. A patient arrives for a standard 12-lead ECG and expresses anxiety about receiving
electrical shocks from the machine. Which of the following responses by the EKG
technician is most appropriate?
A. Advise the patient that the machine uses a high-voltage current to stimulate the heart.
B. Explain that the EKG machine only records electrical activity produced by the heart and does
not transmit electricity into the body.
C. Inform the patient that a mild electrical sensation is normal during electrode placement.
D. Discontinue the procedure immediately and notify the ordering physician of the patient's
refusal.
ANSWER: B. Explain that the EKG machine only records electrical activity produced by
the heart and does not transmit electricity into the body.
The EKG machine is a diagnostic device that functions exclusively as a recorder of the heart's
natural electrical impulses, meaning no electrical current passes from the machine into the
patient. Option A is incorrect because it introduces false and frightening information. Option
C is incorrect because electrodes are passive sensors, not stimulators. Option D is premature
since patient education typically resolves anxiety without canceling a necessary diagnostic test.
2. While preparing a patient for a resting 12-lead ECG, the technician notices heavy oily
residue on the patient's anterior chest wall. What is the correct preparatory step to ensure
adequate electrode adhesion and signal quality?
A. Apply conductive gel directly over the oily skin areas before attaching the electrodes.
B. Clean the electrode site areas gently with soap and water or an alcohol wipe, and allow the
skin to dry completely.
C. Increase the machine gain setting to compensate for high skin resistance.
D. Shave the chest hair and apply the electrodes immediately over the natural oils.
,ANSWER: B. Clean the electrode site areas gently with soap and water or an alcohol wipe,
and allow the skin to dry completely.
Skin oils increase electrical resistance and interfere with proper electrode adherence, leading
to artifact and poor tracing quality. Cleaning the skin removes oils and dead skin cells. Option
A is incorrect because gel alone does not break down oils effectively. Option C is incorrect
because gain adjustments amplify artifact rather than correcting poor skin preparation.
Option D is incorrect because oil must be removed even if hair is shaved.
3. During a routine 12-lead ECG, the technician observes a wandering baseline
characterized by up and down fluctuations of the tracing on the paper. Which of the
following is the most likely cause?
A. Broken lead wire on lead V1
B. Patient breathing heavily or movement of the cables
C. 60-cycle electrical interference from nearby medical equipment
D. Somatic tremor caused by involuntary muscle shivering
ANSWER: B. Patient breathing heavily or movement of the cables
A wandering baseline is typically caused by patient movement, deep respirations, or tension
and movement on the lead wires. Option A typically causes a flat line or stylized baseline shift
in a specific lead group rather than a general wandering baseline. Option C causes AC
interference, which appears as small, uniform, jagged spikes. Option D causes somatic tremor,
which presents as fuzzy, irregular baseline baseline oscillations.
4. An EKG technician is positioning the precordial electrodes for a standard 12-lead ECG.
Where should electrode V4 be correctly placed?
A. Fourth intercostal space at the right sternal border
B. Fourth intercostal space at the left sternal border
C. Fifth intercostal space at the left midclavicular line
D. Fifth intercostal space at the left anterior axillary line
ANSWER: C. Fifth intercostal space at the left midclavicular line
V4 is standardly placed at the fifth intercostal space intersecting the left midclavicular line.
Option A describes the landmark for V1. Option B describes the landmark for V2. Option D
describes the landmark for V5.
,5. Which of the following waves on a normal EKG tracing represents atrial depolarization?
A. P wave
B. QRS complex
C. T wave
D. U wave
ANSWER: A. P wave
The P wave reflects the electrical spread through the right and left atria, resulting in atrial
depolarization. Option B represents ventricular depolarization. Option C represents
ventricular repolarization. Option D represents repolarization of the Purkinje fibers or
hypokalemia when prominent.
6. A patient asks the EKG technician what a normal sinus rhythm means. Which of the
following is the best professional explanation?
A. It means your heart is beating abnormally fast due to excessive caffeine intake.
B. It means the electrical impulse originates in the sinoatrial node and travels normally through
the heart at a standard rate.
C. It means you are experiencing a temporary blockage in your main coronary artery.
D. It means the rhythm is irregular and requires immediate surgical intervention.
ANSWER: B. It means the electrical impulse originates in the sinoatrial node and travels
normally through the heart at a standard rate.
Normal sinus rhythm indicates that the sinoatrial node is functioning as the primary
pacemaker, producing normal waveforms, intervals, and a rate between 60 and 100 beats per
minute. Options A, C, and D describe abnormal pathological states or inaccurate clinical
definitions.
7. Which of the following standard leads are considered bipolar leads?
A. Leads I, II, and III
B. Leads AVR, AVL, and AVF
C. Leads V1, V2, and V3
D. Leads V4, V5, and V6
, ANSWER: A. Leads I, II, and III
Leads I, II, and III are bipolar limb leads because they measure the electrical potential
difference between two specific extremities. Option B represents augmented unipolar limb
leads. Options C and D represent unipolar chest precordial leads.
8. When calculating the heart rate from an EKG strip using the 1500 method, a technician
counts 20 small boxes between two consecutive R waves. What is the patient's ventricular
heart rate?
A. 60 beats per minute
B. 75 beats per minute
C. 100 beats per minute
D. 150 beats per minute
ANSWER: B. 75 beats per minute
The 1500 method divides 1500 by the number of small boxes between consecutive R waves.
Dividing 1500 by 20 yields 75 beats per minute. Options A, C, and D are incorrect
mathematical calculations based on this formula.
9. An elderly patient with severe Parkinson disease is scheduled for a 12-lead EKG. The
resulting tracing shows erratic, jagged spikes along the baseline. What type of artifact is
most likely present, and how can it be minimized?
A. AC interference; unplug nearby electrical equipment
B. Somatic tremor; have the patient place their hands underneath their buttocks to reduce muscle
movement
C. Wandering baseline; clean the skin with alcohol to remove oils
D. Interrupted baseline; check for loose cable connections
ANSWER: B. Somatic tremor; have the patient place their hands underneath their buttocks
to reduce muscle movement
Somatic tremor is caused by muscle movement, such as tremors or shivering, and can be
minimized by having the patient rest their hands under their hips or legs to relax limb muscles.
Option A describes 60-cycle interference. Option C describes baseline drift. Option D describes
a disconnected lead wire.
10. What is the standard paper speed for a conventional 12-lead EKG machine?
