CCI CRAT Exam Practice Test 3 with correct solutions 2024

Of the following, which would not be indicative of ventricular fibrillation? - answer-Waves would be seen with every other complex The following would be indicative of ventricular fibrillation: No waves will be seen The QRS will be more than 120ms The rate will be 100-250 The patient will lose consciousness If a premature ventricular contraction (PVC) comes from different foci, they are referred to as which of the following? - answer-Multifocal PVC's If the PVC's come from different foci, they would be referred to as multifocal PVC's.If the PVC's come from a common point or focus and appear the same shape, they would be considered unifocal PVC's. Report a problem with this question If they suspect the patient has premature ventricular contraction, which of the following would the nurse look for on the ECG strip? - answer-Irregular rhythm and premature QRS complexes that are wide and uncommon If they suspect the patient has premature ventricular contraction the nurse would look for an irregular rhythm and premature QRS complexes that are wide and uncommon on the ECG strip. This condition can also cause a loss of atrial kick and reduce ventricular filling time causing a problem with cardiac output. Which of the following would be considered the approximate O2 saturation of the blood in the right atrium? - answer-60-75% The approximate O2 saturation of the blood in the right atrium would be 60-75%. This is deoxygenated blood that returns to the heart from the body. It will have a high concentration of C02. Deoxygenated blood returns to the heart through the inferior and superior vena cava and empties into which of the following? - answer-Right atrium Deoxygenated blood returns to the heart through the inferior and superior vena cava and empties into the right atrium. From the right atrium, the blood goes through the tricuspid valve into the right ventricle. The stretching of muscle fibers in the ventricles is known as which of the following? - answer-Preload Preload is the stretching of muscle fibers in the ventricles and is ascertained by the pressure and amount of blood unexpended in the left ventricle at the end of diastole. Afterload is the amount of pressure the left ventricle must push against to pump blood into the circulation. When the patient has no electrical activity in the heart and is unresponsive with no cardiac output, the cardiac monitor would show which of the following? - answer-Asystole When the patient has no electrical activity in the heart and is unresponsive with no cardiac output, it is called asystole. This condition normally results from a prolonged period of cardiac arrest where there was not effective resuscitation. Patients with idioventricular rhythms require which of the following? - answer-Continuous ECG monitoring Patients with idioventricular rhythms require continuous ECG monitoring and constant assessment until their treatment restores hemodynamic stability. The patient should be on bed rest with pacemaker equipment at the bedside with atropine readily available. Patient demographic sheets include all of the following information except? - answer-Patient religious preference Patient demographic sheet, also known as a face sheet, of a claim or charge for medical services includes the following patient information: Name Sex Date of birth Address Phone number Account number Employer contact Health insurance Emergency contact Guarantor contact Doctor contact Complications from failure to capture could include all of the following except? - answer-Liver failure Complications from failure to capture could include the following:Increased stimulation threshold because of such things as medications and/or electrolyte imbalance.A fracture of the pacing lead wire.Perforation of the myocardium by a lead wireDisplacement of a pacing lead wire- (common cause) Of the following, which would not be considered a patient identifier that could be used in the healthcare setting? - answer-Speak the patient's name and wait and see if they respond. Always follow the policies and procedure of the facility when identifying a patient. Most facilities require at least 2 forms of patient identification. Some of the patient identifiers could include: Ask the patient their full name Check the patient's arm band Check/ask the patient's birth date The aortic valve permits blood to flow into which of the following? - answer-Aorta The aortic valve is located where the left ventricle meets the aorta. The aortic valve permits blood to flow into the aorta from the left ventricle. The aortic valve prevents blood regurgitation into the left ventricle. When sinus arrhythmia is related to respiration, there will be which of the following with inspiration? - answer-Increase in heart rate Sinus arrhythmia is the heart's normal response to respirations and results from an inhibition of reflex vagal activity or tone. When sinus arrhythmia is related to respiration, there will be an increase in heart rate with inspiration and a decrease in heart rate with expiration. Report a problem with this question An EKG would be considered which of the following? - answer-A way to record the small amount of voltage of the heart. An EKG would be considered a way to record the small amount of voltage of the heart. These signals are transmitted through the chest to the skin where they are picked up and recorded. Which of the following types of permanent pacemakers are typically used today? - answer-Demand The fixed rate pacemaker are set to continuously discharged at a preset rate regardless of the heart rate of the patient. These are not often used today. The demand pacemakers are more commonly used today and discharge only when the heart rate of the patient drops below the rate that is set on the pacemaker. All of the following might be considered limb leads except? - answer-V6 The limb leads would include: Lead I Lead II Lead III AVF AVL AVR Which of the following would best describe a situation which could possibly cause harm to a patient? - answer-Potential risks If there is a situation or thing which has the potential to cause harm to a patient, it would be considered potential risks. Most situations/things have potential risks associated with them. According to the image of graph paper which is used for EKG tracing shown above, the amplitude of the waveforms are determined by the vertical boxes. Each large box in the above graph would equal which of the following? - answer-5 mm Each large square on this graph paper would equal 5 mm = 0.5 mv.Each small square on this graph paper would equal 1 mm = 0.1 mv. What is unique about the T wave on a rhythm strip with ventricular tachycardia? - answer-Opposite direction from QRS complex In identifying ventricular tachycardia on a rhythm strip the following characteristics should be sought: Regular rhythm Rate of 100-250 bpm Absent P wave Unmeasurable PR interval 0.16 wide and bizarre QRS complex T Wave in opposite direction of QRS complex Unmeasurable QT interval Which of the following would not be considered correct for the value of good patient teaching? - answer-The patient will be more likely to pay their medical bill. The value of good patient teaching might include:A decrease in the rate of malpractice suites when the patient has realistic expectations.Patients are more likely to respond well to the treatment plan with less complications.There is an improved understanding of the medical condition and diagnosis.Patients might be more likely to stay with the practice and may refer other patients. Leads would be best described as which of the following? - answer-A covered wire which conducts the electrical impulse from the electrodes to the EKG machine. The leads would be considered the covered wires which conduct the electrical impulse from the electrodes to the EKG machine. These leads are attached to the chest and limbs. Which of the following would not be considered a main responsibility of the ECG technician? - answer-Drawing labs The ECG technician doesn't typically draw labs.Some of their responsibilities would include:Viewing the ECG readingAlerting the healthcare professional of any problemsMaking the determination of whether an abnormal heart rhythm is occurring The R wave represents which of the following on the ECG? - answer-The electrical flow of the signal through the muscle in the ventricle The R wave represents the electrical flow of the signal through the muscle in the ventricle. This is the second part of the QRS complex. Sustained ventricular tachycardia requires which of the following? - answer-Immediate treatment Sustained ventricular tachycardia requires immediate treatment to prevent death. Treatment depends upon whether the patient has a pulse. If the patient has no pulse, treatment requires immediate defibrillation and CPR. If the patient has a pulse, the treatment will depend upon whether they are stable or not, and if they have monomorphic or polymorphic QRS complexes. Report a problem with this question The technician should communicate to the patient that the electrodes will be placed on their skin and the technician may need to perform which of the following? - answer-Shave the hair off The patient should be educated about the steps taken in an ECG procedure to properly place the electrodes. This includes explaining the necessity of cleaning the skin and possibly shaving the hair in the areas the electrodes will be placed. ECG graph paper consists of precisely spaced horizontal lines that represent time measured in millimeters, 25 mm is equal to which of the following increments of time? - answer-1 second The standard paper speed is 25 mm/sec which means that 25 mm is equal to one second of time. One second of time is represented by 5 heavy vertical lines. Each heavy vertical line represents 0.20 second. When using verbal instructions for patient education, which of the following would be considered the best way to reinforce these instructions? - answer-Provide the patient with additional written material covering the subject discussed in the education Once the technician/nurse has provided verbal instructions to a patient, the best way to reinforce would be to also provide written instructions. These will back up the verbal instructions if the patient forgets something. Alternating current interference can be caused by all of the following except? - answer-Too little electrode gel Alternating current interference can be caused by the following: Crossed lead wires Improper grounding of the ECG machine Other equipment in the area radiating electrical energy The method of calculating ventricular rate that involves beginning with the first R wave that peaks on a heavy black line is known as which of the following? - answer-Sequence method The sequence method entails locating the first R wave that peaks on a heavy black line. Then the technician assigns the following numbers to the next six heavy black lines; 300,150,100,75,60,and 50. The next R wave peak is measured by the nearest heavy black line, the number assigned to that line is the ventricular rate. Of the following, which might be considered a potential result of a patient having PVC's? - answer-Ventricular tachycardia PVC's are considered the most common arrhythmia.If a patient has PVC's that continue to worsen, they could experience: Ventricular tachycardia Ventricular fibrillation Asystole All but which of the following symptoms might accompany chest pain? - answer-Abdominal pain The symptoms that typically accompany chest pain might include: Nausea/vomiting Dizziness Sweating Heart palpitations The alligator clips on the ECG machine must be checked for all of the following after each procedure except? - answer-teeth remain sharp Alligator clips and cables on the ECG machine must be checked for the following after each procedure: The pins fit snugly on the electrode Electrolyte paste or gel clinging to the clips Cracks or fraying Damage to the equipment Which of the following is the weight of the average human heart? - answer-8-12 oz The approximate delay in seconds between the atria and the ventricle would be considered __________? - answer-0.13 seconds Junctional arrhythmias originate in which of the following? - answer-Atrioventricular junction Junctional arrhythmias originate in the atrioventricular junction. Junctional arrhythmias occur when the SA node is suppressed and fails to conduct impulses or when a block occurs in conduction. Report a problem with this question One of the five basic changes that are evident on the ECG tracing from complications that represents failure to depolarize is known as which of the following? - answer-Loss of capture Loss of capture represents failure to depolarize. The pacing activity continues to occur without evidence that the electrical activity has depolarized or captured the myocardium. If complications are observed the proper personnel must be alerted for appropriate treatment and interventions. Report a problem with this question A junctional escape rhythm shows a regular rhythm of which of the following? - answer-40-60 bpm A junctional escape rhythm shows a regular rhythm of 40-60 bpm on a rhythm strip. There will be inverted P waves in leads that would normally have normal P waves. The P waves may occur before, after, or during the QRS complex. The PR interval is less than 0.12 second and is measurable only if the P wave is prior to the QRS complex. The rest of the waveform should appear normal. Report a problem with this question If an elevation in the ST segment is seen on a rhythm strip, it could be indicative of which of the following conditions? - answer-Myocardial infarction If an elevation in the ST segment occurs on a rhythm strip it is often referred to as "tombstoning." This is typically seen if the patient is experiencing a myocardial infarction. The AV node normally generates how many impulses in a minute? - answer-40-60 The SA node of the heart generates 60-100 impulses per minute. The AV node of the heart generates 40-60 impulses per minute. Which of the following is a disorder of impulse formation that is caused by a lack of electrical activity in the atrium? - answer-Sinus arrest Sinus arrest, also known as atrial standstill, is a disorder of impulse formation caused by a lack of electrical activity in the atrium. During sinus arrest the atria are stimulated and a whole PQRST complex will be missing from the rhythm strip. Which of the following would be see on an EKG strip if a ventricular arrhythmia is suspected? - answer-Widening of the QRS complex They would see a widening of the QRS complex if they were looking for a ventricular arrhythmia. This occurs when the impulses are generated by the ventricles instead of atria. Which of the following would not be considered a limitation of a Holter monitor? - answer-If the patient keeps a diary Some of the limitations of a Holter monitor could include: Depending on the monitor computer to help find the problem. If the patient doesn't keep a diaryThere can be interfering factors If the patient is uncooperative Only a 4 to 10% likelihood of capturing the arrhythmia An interruption in electrode contact with skin The aVR, aVL, and aVF would be considered augmented limb leads. They use the same three electrodes as which of the following? - answer-Leads I, II, and III The aVR, aVL, and aVF would be considered augmented limb leads. The signal is small so the electrical signal is augmented to allow for proper interpretation. Together they provide a broad overview of the electrical activity of the heart. A waveform that is in an upward direction would be considered which of the following? - answer-Positive A waveform that is in an upward direction would be considered positive. A waveform is the movement that is away from the isoelectric line. This waveform can deflect up or down. If the waveform deflects upward, it would be considered positive Of the following, which would regulate the blood flow in the heart itself? - answer-ValvesThe blood flow in the heart is regulated by the following 4 valves: Triscupid Mitral Aortic Pulmonary From the beginning of the QRS complex to the highest point in the T wave would be considered which of the following? - answer-The absolute refractory period From the beginning of the QRS complex to the highest point in the T wave would be considered the absolute refractory period. This is considered to be the period that is from phase 0 to approximately -60 mV during phase 3. Cardiac valves which have half-mooned shaped cusps would be considered which of the following? - answer-Pulmonic valves Semilunar valves would include the aortic and pulmonic. The semilunar valves would be considered the valves that have cusps which have half-mooned shapes. When providing patient education, which of the following would not be considered correct? - answer-Hand out the papers for the patient to read, doesn't require review with the patient. When providing patient education, the following would be considered correct: Use customized/printed out resources for education. Hand out the papers for the patient to read, then review them with the patient to ensure they understand the directions. Address any individualized needs of the patient.Answer questions which the patient might have. A beat that occurs prior to a normal beat, causes an irregular rhythm, and is caused by an irritable location within the AV junction acting as a pacemaker, is known as which of the following? - answer-Premature junctional contraction A premature junctional contraction is caused by an irritable location within the AV junction acting as a pacemaker and firing either prematurely or out of sequence. The premature junctional contraction is an ectopic beat that occurs before a normal beat and causes an irregular rhythm. The atria are depolarized in retrograde fashion, and the ventricles are depolarized normally. Leads V1 and V2 offer which of the following views of the heart? - answer-Septal The leads V1 and V2 offers views of the septal portion of the heart.Inferior leads would be II, III, and aVF.Lateral leads would be I, aVL, V5, and V6.Anterior leads would be V3 and V4. If an ECG strip on a patient has an unrecognizable pattern of fibrillatory waves, which of the following would this be an indication of? - answer-Ventricular fibrillation If an ECG strip on a patient has an unrecognizable pattern of fibrillatory waves, it would be an indication of ventricular fibrillation. In this condition, the ventricles do not contract but instead quiver so cardiac output falls to zero. If a patient is in ventricular fibrillation, which of the following interventions would be the preferred treatment? - answer-Defibrillation If a patient is in ventricular fibrillation, the preferred treatment would be defibrillation.If successful, the shock will put the heart back in sinus rhythm. Which of the following carries the cell to cell conduction of depolarization through the myocardium? - answer-Sodium ions Fast-moving sodium ions (Na+) carry the cell to cell conduction of depolarization through the myocardium. The progressing wave of depolarization causes contraction of the myocardium as this wave of positive charges passes through the interiors of the myocytes. Junctional escape rhythms happen on which of the following leads when the "P" wave occurs? - answer-Leads 2, 3, and aVF Junctional escape rhythms happen on Leads 2, 3, and aVF when the "P" wave occurs. They tend to happen before, during, and after the QRS complex. The right ventricle pumps blood through which of the following valves into the pulmonary arteries? - answer-Pulmonic valve The right ventricle pumps blood through the pulmonic valve into the pulmonary arteries and on into the lungs. The pulmonic valve is a semilunar valve. The pulmonic valve is located where the pulmonary artery meets the right ventricle, and permits blood to flow from the right ventricle to the pulmonary artery and prevents blood regurgitation into that ventricle. During diastole, when the ventricles relax, it allows for which of the following to occur? - answer-Allows the atria to create space for receiving more blood During diastole, when the ventricles relax, it allows the atria to create space for receiving more blood.When the pressure in the ventricles decrease, the diastolic pressure is created. If a patient has had a MI (myocardial infarction) and they are presenting with persistent sinus tachycardia, it can be a sign of which of the following? - answer-Massive heart damage If a patient has had a MI and they are presenting with persistent sinus tachycardia, it can be a sign of massive heart damage and pending failure. This will occur in about 30% of people that have had a massive MI. Early ventricular repolarization would be indicated by which of the cardiac complex segments? - answer-ST Early ventricular repolarization would be indicated by the ST segment.The ST segments are measured between the end of the S wave and the beginning of the T wave. The ectopic impulses fire at which of the following rate ranges in atrial fibrillation? - answer-400-600 times/min In atrial fibrillation the ectopic impulses may fire at a rate of 400-600 times/min, making the atria quiver instead of contracting. The ventricles will only respond to the impulses that make it through the AV node. Of the following, which might be considered a sign of hyperkalemia on a patient's ECG? - answer-A peaked T-wave When performing an ECG, it would be important for the technician to know that if there is a peaked T-wave with the duration of the base of 0.20 mm or less, it can be indicative of hyperkalemia. If the QRS complex widens, it could be caused by an increasing potassium level. In order for the EKG technician to perform an accurate test, which of the following sources could they use to obtain the best specific information about the EKG machine? - answer-The manufacturers directions In order for the EKG technician to perform an accurate test, the best source of specific information about the said machine would be the EKG manufactures directions. The manufacturer of the machine prints out directions typically in a booklet related all the information and directions as to the use of the piece of equipment. Report a problem with this question Which of the following would best describe a cardiac lead? - answer-The flexible wire that is between two electrodes The flexible wire that is between two electrodes would be considered a cardiac lead.These can be either leg or arm. In the QRS complex, which of the following is represented by the S wave? - answer-Conduction of the electrical impulse through both ventricles In the QRS complex, the waves represent the following:Q wave-conduction of the electrical impulse down the interventricular septumR wave-conduction of the electrical impulse to the left ventricleS wave-conduction of the electrical impulse through both ventricles When performing an EKG, the technician would control the output (height) of the wave forms by which of the following controls? - answer-Gain When performing an EKG, the technician would control the output (height) of the wave forms by controlling the gain. The gain also helps to regulate height of the wave forms. Which of the following pacemaker complications leads to competition between the intrinsic and electronic pacemakers? - answer-Undersensing Undersensing is a pacemaker complication where the pacemaker is unable to detect any electrical activity. The pacemaker never turns off which results in competition between the intrinsic and electronic pacemakers. This can lead to life-threatening complications including cardiac arrest as a result of R-on-T pacing. In atrial fibrillation, which of the following is how many times the atria will fire a minute? - answer-400-600 bpm In atrial fibrillation, the atria will fire 400-600 bpm. The pulses happen so fast that it causes the atria to quiver instead of contract. If the ECG technician is performing an ECG procedure and the patient all of a sudden becomes unresponsive, isn't breathing, and doesn't have a pulse, which of the following should be their first step? - answer-Start CPR (compressions) If a patient becomes unresponsive, has no pulse, and stops breathing, then the technician should (start ACLS protocol) compressions and call a code blue.Remember: circulation, airway, and breathing (CAB) If the ECG system does not allow the entry of patient information or if there is no time due to an emergency which of the following would be the proper procedure to record the information? - answer-Write it on the completed ECG All patient information must be entered or written accurately no matter the circumstances. If the technician is unable to enter the information into the machine for any reason they should be sure to write the information on the completed ECG for future reference. Which of the following should the technician do prior to starting an ECG exam? - answer-All of the above The technician should perform the following prior to an ECG exam: Review the physician's orders and the patient's medical history Make the patient as comfortable as possible Explain the exam and what to expect to the patient Once these steps are complete the technician can place the electrodes and continue with the ECG exam. Which of the following would be considered the receiving chambers of the heart? - answer-Left atrium There are 2 chambers of the heart that would be considered receiving chambers: Left atrium Right atrium