NHA EKG TECHNICIAN
CERTIFICATION EXAM PREP 2026/2027
1. Which of the following describes the electrical conduction path through the heart starting
from the primary pacemaker?
A. AV node, SA node, Bundle of His, Purkinje fibers
B. SA node, Bundle of His, AV node, Purkinje fibers
C. SA node, AV node, Bundle of His, Purkinje fibers
D. AV node, Purkinje fibers, SA node, Bundle of His
Answer: C
Conceptual Explanation: The standard electrical conduction starts at the SA node, moves
to the AV node, travels down the Bundle of His, and finally spreads through the Purkinje
fibers.
2. Where is the electrode for lead V4 placed?
A. Fourth intercostal space, right sternal border
B. Fourth intercostal space, left sternal border
C. Fifth intercostal space, midclavicular line
D. Fifth intercostal space, midaxillary line
,Answer: C
Conceptual Explanation: V4 is positioned in the fifth intercostal space at the midclavicular
line.
3. An EKG technician notices a wandering baseline on the EKG tracing. Which of the following
is a likely cause?
A. Loose or dry electrodes
B. Electrical interference from a nearby device
C. Patient shivering
D. Patient talking during the procedure
Answer: A
Conceptual Explanation: A wandering baseline is typically caused by poor electrode
contact, such as loose electrodes, dried-out gel, or skin oils/lotions.
4. If a patient is experiencing somatic tremor during an EKG, the technician should:
A. Ask the patient to hold their breath
B. Cover the patient with a blanket if they are cold
C. Move the patient’s cell phone away
D. Plug the machine into a grounded outlet
Answer: B
, Conceptual Explanation: Somatic tremor is caused by muscle movement. If a patient is
shivering because they are cold, providing a blanket can help resolve the artifact.
5. What is the standard paper speed for a 12-lead EKG?
A. 25 mm/sec
B. 10 mm/sec
C. 50 mm/sec
D. 5 mm/sec
Answer: A
Conceptual Explanation: The standard paper speed for a diagnostic EKG is 25 mm per
second.
6. Calculate the heart rate if there are 15 small boxes between two R waves.
A. 60 bpm
B. 75 bpm
C. 150 bpm
D. 100 bpm
Answer: D
Conceptual Explanation: Using the 1500 method: 1500 divided by 15 equals 100 beats
per minute.
CERTIFICATION EXAM PREP 2026/2027
1. Which of the following describes the electrical conduction path through the heart starting
from the primary pacemaker?
A. AV node, SA node, Bundle of His, Purkinje fibers
B. SA node, Bundle of His, AV node, Purkinje fibers
C. SA node, AV node, Bundle of His, Purkinje fibers
D. AV node, Purkinje fibers, SA node, Bundle of His
Answer: C
Conceptual Explanation: The standard electrical conduction starts at the SA node, moves
to the AV node, travels down the Bundle of His, and finally spreads through the Purkinje
fibers.
2. Where is the electrode for lead V4 placed?
A. Fourth intercostal space, right sternal border
B. Fourth intercostal space, left sternal border
C. Fifth intercostal space, midclavicular line
D. Fifth intercostal space, midaxillary line
,Answer: C
Conceptual Explanation: V4 is positioned in the fifth intercostal space at the midclavicular
line.
3. An EKG technician notices a wandering baseline on the EKG tracing. Which of the following
is a likely cause?
A. Loose or dry electrodes
B. Electrical interference from a nearby device
C. Patient shivering
D. Patient talking during the procedure
Answer: A
Conceptual Explanation: A wandering baseline is typically caused by poor electrode
contact, such as loose electrodes, dried-out gel, or skin oils/lotions.
4. If a patient is experiencing somatic tremor during an EKG, the technician should:
A. Ask the patient to hold their breath
B. Cover the patient with a blanket if they are cold
C. Move the patient’s cell phone away
D. Plug the machine into a grounded outlet
Answer: B
, Conceptual Explanation: Somatic tremor is caused by muscle movement. If a patient is
shivering because they are cold, providing a blanket can help resolve the artifact.
5. What is the standard paper speed for a 12-lead EKG?
A. 25 mm/sec
B. 10 mm/sec
C. 50 mm/sec
D. 5 mm/sec
Answer: A
Conceptual Explanation: The standard paper speed for a diagnostic EKG is 25 mm per
second.
6. Calculate the heart rate if there are 15 small boxes between two R waves.
A. 60 bpm
B. 75 bpm
C. 150 bpm
D. 100 bpm
Answer: D
Conceptual Explanation: Using the 1500 method: 1500 divided by 15 equals 100 beats
per minute.
