NHA EKG TECHNICIAN
CERTIFICATION EXAM 2026
QUESTIONS AND ANSWERS
1. When performing a 12-lead EKG, where should the V4 electrode be placed?
A. Fourth intercostal space, right sternal border
B. Fifth intercostal space, midclavicular line
C. Fourth intercostal space, left sternal border
D. Fifth intercostal space, anterior axillary line
Answer: B
Conceptual Explanation: V4 is placed at the fifth intercostal space at the midclavicular
line. V1 and V2 are at the fourth intercostal space, and V5 is at the anterior axillary line.
2. A technician calculates the heart rate using the 1500 method. There are 20 small boxes
between two R waves. What is the heart rate?
A. 60 bpm
B. 100 bpm
C. 75 bpm
D. 150 bpm
,Answer: C
Conceptual Explanation: The 1500 method divides 1500 by the number of small boxes
between R waves ( = 75 bpm).
3. Which of the following is the standard paper speed for an EKG recording?
A. 10 mm/sec
B. 50 mm/sec
C. 25 mm/sec
D. 5 mm/sec
Answer: C
Conceptual Explanation: The standard paper speed for EKG machines is 25 mm/second.
50 mm/sec is used for faster heart rates to spread out the waves.
4. Which interval represents the time it takes for an electrical impulse to travel from the SA
node to the AV node?
A. QRS interval
B. PR interval
C. QT interval
D. ST segment
Answer: B
, Conceptual Explanation: The PR interval represents the time from the beginning of atrial
depolarization to the beginning of ventricular depolarization, covering the delay at the AV
node.
5. An EKG technician notices a wandering baseline on the rhythm strip. Which of the
following is the most likely cause?
A. Patient shivering
B. Electrical interference from a nearby cell phone
C. Improper skin preparation or dry electrodes
D. Lead reversal
Answer: C
Conceptual Explanation: A wandering baseline is typically caused by poor electrode
contact, often due to lotion, sweat, or dry gel. Shivering causes somatic tremors.
6. Which of the following heart rhythms is characterized by ‘sawtooth’ waves between QRS
complexes?
A. Atrial Fibrillation
B. Sinus Arrhythmia
C. Ventricular Tachycardia
D. Atrial Flutter
Answer: D
CERTIFICATION EXAM 2026
QUESTIONS AND ANSWERS
1. When performing a 12-lead EKG, where should the V4 electrode be placed?
A. Fourth intercostal space, right sternal border
B. Fifth intercostal space, midclavicular line
C. Fourth intercostal space, left sternal border
D. Fifth intercostal space, anterior axillary line
Answer: B
Conceptual Explanation: V4 is placed at the fifth intercostal space at the midclavicular
line. V1 and V2 are at the fourth intercostal space, and V5 is at the anterior axillary line.
2. A technician calculates the heart rate using the 1500 method. There are 20 small boxes
between two R waves. What is the heart rate?
A. 60 bpm
B. 100 bpm
C. 75 bpm
D. 150 bpm
,Answer: C
Conceptual Explanation: The 1500 method divides 1500 by the number of small boxes
between R waves ( = 75 bpm).
3. Which of the following is the standard paper speed for an EKG recording?
A. 10 mm/sec
B. 50 mm/sec
C. 25 mm/sec
D. 5 mm/sec
Answer: C
Conceptual Explanation: The standard paper speed for EKG machines is 25 mm/second.
50 mm/sec is used for faster heart rates to spread out the waves.
4. Which interval represents the time it takes for an electrical impulse to travel from the SA
node to the AV node?
A. QRS interval
B. PR interval
C. QT interval
D. ST segment
Answer: B
, Conceptual Explanation: The PR interval represents the time from the beginning of atrial
depolarization to the beginning of ventricular depolarization, covering the delay at the AV
node.
5. An EKG technician notices a wandering baseline on the rhythm strip. Which of the
following is the most likely cause?
A. Patient shivering
B. Electrical interference from a nearby cell phone
C. Improper skin preparation or dry electrodes
D. Lead reversal
Answer: C
Conceptual Explanation: A wandering baseline is typically caused by poor electrode
contact, often due to lotion, sweat, or dry gel. Shivering causes somatic tremors.
6. Which of the following heart rhythms is characterized by ‘sawtooth’ waves between QRS
complexes?
A. Atrial Fibrillation
B. Sinus Arrhythmia
C. Ventricular Tachycardia
D. Atrial Flutter
Answer: D
