CCT Exam Practice - Performing
Resting ECG Complete Solutions
lead reversal with left arm/right arm results in - ANSWER-lead I is completely
inverted (P wave, QRS wave, and T wave)
dextrocardia definition - ANSWER-rare condition in which the heart points towards
the right side of the chest instead of the left
a posterior ECG is performed when? - ANSWER-performed when a posterior MI is
suspected (involves RCA and circumflex artery occlusions)
posterior ECG lead placement & info - ANSWER-leads V1-V3 remain unchanged
V4-V6 are relabeled as V7-V9 on ECG
V4 connects to V7 and is placed on the left posterior axillary line
V5 connects to V8 and is placed on the left posterior mid scapular line
V6 connects to V9 and is places on the patient's back at the left spinal border
A right-sided ECG is indicated for patients who present with - ANSWER-ECG
evidence of an inferior infarction specifically right ventricular MI's, which involve RCA
occlusions
right sided ECG lead placement - ANSWER-leads should be relabeled V1R-V6R
complete mirror image of a standard 12-lead ECG
arms and legs remain the same
V1R placed at 4th intercostal space at left sternal border
V2R placed at 4th intercostal space at right sternal border
V3R between V2R and V4R
V4R placed at 5th intercostal space at right midclavicular line
V5R placed on right anterior axillary line in same line as V4R and V6R
V6R placed on right mid axillary line
signal averaged ECG - ANSWER-- diagnostic test that averages multiple QRS
complexes over a 10-20 minute time period, or at least 250 QRS's in order to see
changes in electrical activity
- identifies LATE POTENTIALS suggesting that the patient may be at risk for
developing serious ventricular arrhythmias
15-lead pediatric ECG - ANSWER-uses the same anatomic positions as the adult
ECG, but with right sided leads V2R-V4R added because the right ventricle is more
prominent
V2R placed on 4th intercostal space right sternal border
V3R diagonally between V2R and V4R
V4R placed on 5th intercostal space on right midclavicular line
pediatric ECG normal findings - ANSWER-resting heart rate of >100 BPM
, right axis deviation greater than 90° (due to right ventricle being more prominent in a
child)
T wave inversions in lead V1-V3 (juvenile T-wave pattern)
sinus arrhythmia is common
dominant R wave in lead V1 may be seen
RSR' pattern in lead V1
short PR interval and QRS duration
slightly prolonged QTc
why might an ECG be performed? - ANSWER-- diagnose changes in heart rhythm
- check for problems with the flow of electricity through the heart
lead placement for 4VR is located where on the patient?
a. 4th intercostal space, right sternal border
b. 5th intercostal space, right mid-axillary line
c. 5th intercostal space, right mid-clavicular line
d. 5th intercostal space, right anterior axillary line - ANSWER-c. 5th intercostal
space, right mid clavicular line
what is the proper lead placement for a right side 12 lead ECG?
a. limb leads only placed in a mirror image of a standard 12 lead ECG
b. chest leads only placed in a mirror image of a standard 12 lead ECG
c. leads V1, V2, V3 only placed in a mirror image of a standard 12 lead ECG
d. leads V4, V5, V6 only placed in a mirror image of a standard 12 lead ECG -
ANSWER-b. chest leads only placed in a mirror image of a standard 12 lead ECG
when performing a 12-lead ECG you notice that leads I and II have a lot of artifact.
which electrode most likely needs to be replaced?
a. left leg
b. left arm
c. right leg
d. right arm - ANSWER-d. right arm
after completing a standard 12-lead ECG on an adult patient, the physician requests
that you include a tracing with a V4R electrode, as well. what is the physician most
likely looking for by adding this electrode?
a. dextrocardia
b. right bundle branch block
c. right ventricular infarction
d. right ventricular hypertrophy - ANSWER-c. right ventricular infarction
the fifth intercostal space, left midclavicular line is a landmark for what precordial
electrode placement
a. V3
b. V4
c. V5
d. V6 - ANSWER-b. V4
lead V6 should be placed
a. left mid-axillary line, 5th intercostal space
Resting ECG Complete Solutions
lead reversal with left arm/right arm results in - ANSWER-lead I is completely
inverted (P wave, QRS wave, and T wave)
dextrocardia definition - ANSWER-rare condition in which the heart points towards
the right side of the chest instead of the left
a posterior ECG is performed when? - ANSWER-performed when a posterior MI is
suspected (involves RCA and circumflex artery occlusions)
posterior ECG lead placement & info - ANSWER-leads V1-V3 remain unchanged
V4-V6 are relabeled as V7-V9 on ECG
V4 connects to V7 and is placed on the left posterior axillary line
V5 connects to V8 and is placed on the left posterior mid scapular line
V6 connects to V9 and is places on the patient's back at the left spinal border
A right-sided ECG is indicated for patients who present with - ANSWER-ECG
evidence of an inferior infarction specifically right ventricular MI's, which involve RCA
occlusions
right sided ECG lead placement - ANSWER-leads should be relabeled V1R-V6R
complete mirror image of a standard 12-lead ECG
arms and legs remain the same
V1R placed at 4th intercostal space at left sternal border
V2R placed at 4th intercostal space at right sternal border
V3R between V2R and V4R
V4R placed at 5th intercostal space at right midclavicular line
V5R placed on right anterior axillary line in same line as V4R and V6R
V6R placed on right mid axillary line
signal averaged ECG - ANSWER-- diagnostic test that averages multiple QRS
complexes over a 10-20 minute time period, or at least 250 QRS's in order to see
changes in electrical activity
- identifies LATE POTENTIALS suggesting that the patient may be at risk for
developing serious ventricular arrhythmias
15-lead pediatric ECG - ANSWER-uses the same anatomic positions as the adult
ECG, but with right sided leads V2R-V4R added because the right ventricle is more
prominent
V2R placed on 4th intercostal space right sternal border
V3R diagonally between V2R and V4R
V4R placed on 5th intercostal space on right midclavicular line
pediatric ECG normal findings - ANSWER-resting heart rate of >100 BPM
, right axis deviation greater than 90° (due to right ventricle being more prominent in a
child)
T wave inversions in lead V1-V3 (juvenile T-wave pattern)
sinus arrhythmia is common
dominant R wave in lead V1 may be seen
RSR' pattern in lead V1
short PR interval and QRS duration
slightly prolonged QTc
why might an ECG be performed? - ANSWER-- diagnose changes in heart rhythm
- check for problems with the flow of electricity through the heart
lead placement for 4VR is located where on the patient?
a. 4th intercostal space, right sternal border
b. 5th intercostal space, right mid-axillary line
c. 5th intercostal space, right mid-clavicular line
d. 5th intercostal space, right anterior axillary line - ANSWER-c. 5th intercostal
space, right mid clavicular line
what is the proper lead placement for a right side 12 lead ECG?
a. limb leads only placed in a mirror image of a standard 12 lead ECG
b. chest leads only placed in a mirror image of a standard 12 lead ECG
c. leads V1, V2, V3 only placed in a mirror image of a standard 12 lead ECG
d. leads V4, V5, V6 only placed in a mirror image of a standard 12 lead ECG -
ANSWER-b. chest leads only placed in a mirror image of a standard 12 lead ECG
when performing a 12-lead ECG you notice that leads I and II have a lot of artifact.
which electrode most likely needs to be replaced?
a. left leg
b. left arm
c. right leg
d. right arm - ANSWER-d. right arm
after completing a standard 12-lead ECG on an adult patient, the physician requests
that you include a tracing with a V4R electrode, as well. what is the physician most
likely looking for by adding this electrode?
a. dextrocardia
b. right bundle branch block
c. right ventricular infarction
d. right ventricular hypertrophy - ANSWER-c. right ventricular infarction
the fifth intercostal space, left midclavicular line is a landmark for what precordial
electrode placement
a. V3
b. V4
c. V5
d. V6 - ANSWER-b. V4
lead V6 should be placed
a. left mid-axillary line, 5th intercostal space
