NHA EKG EXAM 2026 QUESTIONS WITH
VERIFIED ANSWERS
1. Where is the primary pacemaker of the heart located?
A. At the base of the interatrial septum
B. In the right atrium at the junction with the superior vena cava
C. In the floor of the right atrium
D. Within the interventricular septum
Answer: B
Conceptual Explanation: The Sinoatrial (SA) node is the heart’s primary pacemaker,
located in the wall of the right atrium near the opening of the superior vena cava.
2. When placing the electrodes for a 12-lead EKG, where should V4 be positioned?
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: Lead V4 is placed at the fifth intercostal space in the
midclavicular line.
3. Using the 1500 method, what is the heart rate if there are 20 small boxes between two R
waves?
A. 60 bpm
B. 150 bpm
C. 100 bpm
D. 75 bpm
Answer: D
Conceptual Explanation: The 1500 method involves dividing 1500 by the number of small
boxes between R waves. 1500 divided by 20 equals 75 bpm.
4. Which of the following EKG findings is characteristic of a First-Degree AV Block?
A. A progressively lengthening PR interval followed by a dropped QRS
B. A constant PR interval with intermittent dropped QRS complexes
C. More P waves than QRS complexes with no relationship between them
D. A constant PR interval greater than 0.20 seconds
Answer: D
, Conceptual Explanation: First-degree AV block is defined by a consistent delay in
conduction through the AV node, resulting in a PR interval longer than 0.20 seconds (one
large box).
5. What instructions should a technician provide to a patient wearing a Holter monitor?
A. Avoid showering or getting the monitor wet
B. Remove the monitor during sleep
C. Only record activities that cause chest pain
D. Change the electrodes every 4 hours
Answer: A
Conceptual Explanation: Holter monitors must stay dry to ensure data integrity and lead
adhesion; therefore, patients should not shower or swim.
6. A wandering baseline artifact on an EKG tracing is most likely caused by:
A. Electronic interference from nearby devices
B. Patient shivering or muscle tension
C. Lead wires crossing each other
D. Poor electrode contact or patient respiration
Answer: D
Conceptual Explanation: Wandering baseline is often caused by respiration or poor skin
contact/dry gel on electrodes.
VERIFIED ANSWERS
1. Where is the primary pacemaker of the heart located?
A. At the base of the interatrial septum
B. In the right atrium at the junction with the superior vena cava
C. In the floor of the right atrium
D. Within the interventricular septum
Answer: B
Conceptual Explanation: The Sinoatrial (SA) node is the heart’s primary pacemaker,
located in the wall of the right atrium near the opening of the superior vena cava.
2. When placing the electrodes for a 12-lead EKG, where should V4 be positioned?
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: Lead V4 is placed at the fifth intercostal space in the
midclavicular line.
3. Using the 1500 method, what is the heart rate if there are 20 small boxes between two R
waves?
A. 60 bpm
B. 150 bpm
C. 100 bpm
D. 75 bpm
Answer: D
Conceptual Explanation: The 1500 method involves dividing 1500 by the number of small
boxes between R waves. 1500 divided by 20 equals 75 bpm.
4. Which of the following EKG findings is characteristic of a First-Degree AV Block?
A. A progressively lengthening PR interval followed by a dropped QRS
B. A constant PR interval with intermittent dropped QRS complexes
C. More P waves than QRS complexes with no relationship between them
D. A constant PR interval greater than 0.20 seconds
Answer: D
, Conceptual Explanation: First-degree AV block is defined by a consistent delay in
conduction through the AV node, resulting in a PR interval longer than 0.20 seconds (one
large box).
5. What instructions should a technician provide to a patient wearing a Holter monitor?
A. Avoid showering or getting the monitor wet
B. Remove the monitor during sleep
C. Only record activities that cause chest pain
D. Change the electrodes every 4 hours
Answer: A
Conceptual Explanation: Holter monitors must stay dry to ensure data integrity and lead
adhesion; therefore, patients should not shower or swim.
6. A wandering baseline artifact on an EKG tracing is most likely caused by:
A. Electronic interference from nearby devices
B. Patient shivering or muscle tension
C. Lead wires crossing each other
D. Poor electrode contact or patient respiration
Answer: D
Conceptual Explanation: Wandering baseline is often caused by respiration or poor skin
contact/dry gel on electrodes.
