CET Final Practice Examination – Full-Length EKG
Technician Certification Exam Preparation
1. When preparing a patient for a standard 12-lead EKG, the technician notices the patient is
shivering due to the cold temperature in the room. Which of the following artifacts is most
likely to appear on the tracing?
A. Wandering baseline
B. Interrupted baseline
C. AC interference
D. Somatic tremor
Correct Answer: D
Explanation: Somatic tremor is an artifact caused by involuntary or voluntary muscle
movement, such as shivering or talking. The clinical reasoning involves identifying jagged,
uneven spikes on the EKG tracing that correspond to muscle activity. To ensure a clean
reading, the technician must provide a blanket or help the patient relax to minimize
movement. A common pitfall is confusing this with AC interference, which appears as a
consistent, fine sawtooth pattern caused by electrical equipment.
2. An EKG technician is performing a 12-lead EKG on a patient with a known case of
dextrocardia. How should the precordial leads be placed?
A. Mirror the standard positions on the right side of the chest.
,B. In the standard positions on the left side of the chest.
C. Place all leads on the patient’s back (V7-V9).
D. Space the leads evenly across both sides of the chest.
Correct Answer: A
Explanation: Dextrocardia is a condition where the heart is situated on the right side of
the chest, requiring a mirrored lead placement to capture accurate electrical activity. The
clinical reasoning for this adjustment is that standard left-sided placement would result in
low voltage and incorrect axis interpretation. The technician must document the right-
sided placement clearly to inform the interpreting physician. A common mistake is placing
only V1 and V2 on the right, which fails to provide a complete view of the right-sided heart.
3. Which of the following heart rates would be classified as Sinus Bradycardia for an adult
patient?
A. 65 beats per minute
B. 45 beats per minute
C. 85 beats per minute
D. 110 beats per minute
Correct Answer: B
Explanation: Sinus Bradycardia is defined as a normal sinus rhythm with a heart rate of
less than 60 beats per minute in an adult. The clinical significance of this finding depends
,on the patient’s symptoms; for athletes, it may be normal, while for others, it could indicate
cardiac issues. The technician must assess the patient for signs of decreased cardiac output,
such as dizziness or fainting. A pitfall is assuming any rate under 60 is pathological without
considering the patient’s clinical context.
4. A technician is applying electrodes for a Holter monitor. The patient asks if they can
continue their daily routine of swimming. How should the technician respond?
A. Yes, as long as the device is kept in a waterproof pouch.
B. Yes, swimming will not affect the recording or the device.
C. No, the device must stay dry and should not be submerged.
D. No, but the patient may remove the electrodes for the swim.
Correct Answer: C
Explanation: Holter monitors are not waterproof and must remain dry to ensure the
integrity of the recording and the safety of the device. The clinical reasoning is that
moisture can cause the electrodes to detach and short-circuit the recording hardware. The
technician must educate the patient on maintaining the device, including avoiding showers
and swimming. Failing to provide these instructions often leads to failed tests and the need
for a repeat procedure.
5. During a stress test, the patient reports a sudden onset of chest pain and shortness of
breath. What is the most appropriate action for the EKG technician to take?
A. Continue the test to see if the symptoms resolve.
, B. Slow down the treadmill and wait for the physician to arrive.
C. Stop the test immediately and notify the supervising physician.
D. Ask the patient to take deep breaths and increase the incline.
Correct Answer: C
Explanation: Patient safety is the priority during a stress test, and the onset of chest pain
(angina) is a primary indication to terminate the procedure. Clinical reasoning dictates that
these symptoms suggest myocardial ischemia, which could lead to a cardiac event if
exercise continues. The technician must act quickly to stop the stressor and provide
immediate care under physician supervision. A common pitfall is ignoring subjective
patient complaints if the EKG tracing does not yet show ST-segment changes.
6. When calculating a heart rate using the 1500 method, the technician counts 25 small boxes
between two consecutive R waves. What is the heart rate?
A. 50 bpm
B. 60 bpm
C. 75 bpm
D. 100 bpm
Correct Answer: B
Explanation: The 1500 method is the most accurate way to calculate heart rate for regular
rhythms by dividing 1500 by the number of small boxes between R waves. In this case,
Technician Certification Exam Preparation
1. When preparing a patient for a standard 12-lead EKG, the technician notices the patient is
shivering due to the cold temperature in the room. Which of the following artifacts is most
likely to appear on the tracing?
A. Wandering baseline
B. Interrupted baseline
C. AC interference
D. Somatic tremor
Correct Answer: D
Explanation: Somatic tremor is an artifact caused by involuntary or voluntary muscle
movement, such as shivering or talking. The clinical reasoning involves identifying jagged,
uneven spikes on the EKG tracing that correspond to muscle activity. To ensure a clean
reading, the technician must provide a blanket or help the patient relax to minimize
movement. A common pitfall is confusing this with AC interference, which appears as a
consistent, fine sawtooth pattern caused by electrical equipment.
2. An EKG technician is performing a 12-lead EKG on a patient with a known case of
dextrocardia. How should the precordial leads be placed?
A. Mirror the standard positions on the right side of the chest.
,B. In the standard positions on the left side of the chest.
C. Place all leads on the patient’s back (V7-V9).
D. Space the leads evenly across both sides of the chest.
Correct Answer: A
Explanation: Dextrocardia is a condition where the heart is situated on the right side of
the chest, requiring a mirrored lead placement to capture accurate electrical activity. The
clinical reasoning for this adjustment is that standard left-sided placement would result in
low voltage and incorrect axis interpretation. The technician must document the right-
sided placement clearly to inform the interpreting physician. A common mistake is placing
only V1 and V2 on the right, which fails to provide a complete view of the right-sided heart.
3. Which of the following heart rates would be classified as Sinus Bradycardia for an adult
patient?
A. 65 beats per minute
B. 45 beats per minute
C. 85 beats per minute
D. 110 beats per minute
Correct Answer: B
Explanation: Sinus Bradycardia is defined as a normal sinus rhythm with a heart rate of
less than 60 beats per minute in an adult. The clinical significance of this finding depends
,on the patient’s symptoms; for athletes, it may be normal, while for others, it could indicate
cardiac issues. The technician must assess the patient for signs of decreased cardiac output,
such as dizziness or fainting. A pitfall is assuming any rate under 60 is pathological without
considering the patient’s clinical context.
4. A technician is applying electrodes for a Holter monitor. The patient asks if they can
continue their daily routine of swimming. How should the technician respond?
A. Yes, as long as the device is kept in a waterproof pouch.
B. Yes, swimming will not affect the recording or the device.
C. No, the device must stay dry and should not be submerged.
D. No, but the patient may remove the electrodes for the swim.
Correct Answer: C
Explanation: Holter monitors are not waterproof and must remain dry to ensure the
integrity of the recording and the safety of the device. The clinical reasoning is that
moisture can cause the electrodes to detach and short-circuit the recording hardware. The
technician must educate the patient on maintaining the device, including avoiding showers
and swimming. Failing to provide these instructions often leads to failed tests and the need
for a repeat procedure.
5. During a stress test, the patient reports a sudden onset of chest pain and shortness of
breath. What is the most appropriate action for the EKG technician to take?
A. Continue the test to see if the symptoms resolve.
, B. Slow down the treadmill and wait for the physician to arrive.
C. Stop the test immediately and notify the supervising physician.
D. Ask the patient to take deep breaths and increase the incline.
Correct Answer: C
Explanation: Patient safety is the priority during a stress test, and the onset of chest pain
(angina) is a primary indication to terminate the procedure. Clinical reasoning dictates that
these symptoms suggest myocardial ischemia, which could lead to a cardiac event if
exercise continues. The technician must act quickly to stop the stressor and provide
immediate care under physician supervision. A common pitfall is ignoring subjective
patient complaints if the EKG tracing does not yet show ST-segment changes.
6. When calculating a heart rate using the 1500 method, the technician counts 25 small boxes
between two consecutive R waves. What is the heart rate?
A. 50 bpm
B. 60 bpm
C. 75 bpm
D. 100 bpm
Correct Answer: B
Explanation: The 1500 method is the most accurate way to calculate heart rate for regular
rhythms by dividing 1500 by the number of small boxes between R waves. In this case,
