NHA EKG TECHNICIAN
CERTIFICATION EXAM PREP 2026/2027
1. When performing a 12-lead EKG, where is the V4 electrode placed?
A. Fourth intercostal space at the right sternal border
B. Fifth intercostal space at the left midclavicular line
C. Fourth intercostal space at the left sternal border
D. Horizontal level of V4 at the left anterior axillary line
Answer: B
Conceptual Explanation: V4 is correctly placed at the fifth intercostal space at the
midclavicular line. V1 is the right sternal border, V2 is the left sternal border, and V5 is the
anterior axillary line.
2. An EKG technician observes a heart rate of 150 bpm with a ‘sawtooth’ pattern between
QRS complexes. Which rhythm is most likely?
A. Atrial Fibrillation
B. Ventricular Tachycardia
C. Atrial Flutter
,D. Sinus Tachycardia
Answer: C
Conceptual Explanation: Atrial Flutter is characterized by rapid, regular atrial waves that
resemble a sawtooth (F-waves), usually at a rate of 250-350 bpm.
3. Using the 1500 method, calculate the heart rate if there are 25 small boxes between two R
waves.
A. 100 bpm
B. 75 bpm
C. 60 bpm
D. 50 bpm
Answer: C
Conceptual Explanation: The 1500 method involves dividing 1500 by the number of small
boxes between R waves. 1500 divided by 25 equals 60 bpm.
4. Which interval represents the time it takes for an electrical impulse to travel from the SA
node to the AV node?
A. PR Interval
B. QT Interval
C. QRS Complex
D. ST Segment
, Answer: A
Conceptual Explanation: The PR interval represents the time from the beginning of atrial
depolarization to the beginning of ventricular depolarization, covering the conduction
through the AV node.
5. While performing a stress test, a patient complains of dizziness and the EKG shows ST-
segment elevation. What is the priority action?
A. Ask the patient to slow down their pace
B. Stop the test immediately and notify the physician
C. Complete the test to reach the target heart rate
D. Recalibrate the EKG machine
Answer: B
Conceptual Explanation: ST-segment elevation during a stress test is a sign of myocardial
ischemia or injury; the test must be stopped immediately for patient safety.
6. A technician notices a wandering baseline on an EKG tracing. Which of the following is a
common cause?
A. Shivering or patient movement
B. Corroded lead wires
C. Electrical interference from a nearby cell phone
D. Improper skin preparation or loose electrodes
CERTIFICATION EXAM PREP 2026/2027
1. When performing a 12-lead EKG, where is the V4 electrode placed?
A. Fourth intercostal space at the right sternal border
B. Fifth intercostal space at the left midclavicular line
C. Fourth intercostal space at the left sternal border
D. Horizontal level of V4 at the left anterior axillary line
Answer: B
Conceptual Explanation: V4 is correctly placed at the fifth intercostal space at the
midclavicular line. V1 is the right sternal border, V2 is the left sternal border, and V5 is the
anterior axillary line.
2. An EKG technician observes a heart rate of 150 bpm with a ‘sawtooth’ pattern between
QRS complexes. Which rhythm is most likely?
A. Atrial Fibrillation
B. Ventricular Tachycardia
C. Atrial Flutter
,D. Sinus Tachycardia
Answer: C
Conceptual Explanation: Atrial Flutter is characterized by rapid, regular atrial waves that
resemble a sawtooth (F-waves), usually at a rate of 250-350 bpm.
3. Using the 1500 method, calculate the heart rate if there are 25 small boxes between two R
waves.
A. 100 bpm
B. 75 bpm
C. 60 bpm
D. 50 bpm
Answer: C
Conceptual Explanation: The 1500 method involves dividing 1500 by the number of small
boxes between R waves. 1500 divided by 25 equals 60 bpm.
4. Which interval represents the time it takes for an electrical impulse to travel from the SA
node to the AV node?
A. PR Interval
B. QT Interval
C. QRS Complex
D. ST Segment
, Answer: A
Conceptual Explanation: The PR interval represents the time from the beginning of atrial
depolarization to the beginning of ventricular depolarization, covering the conduction
through the AV node.
5. While performing a stress test, a patient complains of dizziness and the EKG shows ST-
segment elevation. What is the priority action?
A. Ask the patient to slow down their pace
B. Stop the test immediately and notify the physician
C. Complete the test to reach the target heart rate
D. Recalibrate the EKG machine
Answer: B
Conceptual Explanation: ST-segment elevation during a stress test is a sign of myocardial
ischemia or injury; the test must be stopped immediately for patient safety.
6. A technician notices a wandering baseline on an EKG tracing. Which of the following is a
common cause?
A. Shivering or patient movement
B. Corroded lead wires
C. Electrical interference from a nearby cell phone
D. Improper skin preparation or loose electrodes
