ACSM-EP Electrocardiography 2

Question 1

During exercise stress testing, which ECG change is considered the most significant indicator of myocardial ischemia?

Accepted Answer

Horizontal or downsloping ST-segment depression ≥1 mm

Answer

Horizontal or downsloping ST-segment depression ≥1 mm at 80 ms past the J-point is the classic ECG criterion for exercise-induced myocardial ischemia.

Question 2

What does the QT interval on an ECG represent?

Accepted Answer

Total ventricular electrical activity from depolarization through repolarization

Answer

The QT interval encompasses both ventricular depolarization (QRS) and repolarization (T wave), representing total ventricular electrical activity.

Question 3

A patient's ECG shows a ventricular rate of 150 bpm with narrow QRS complexes and no visible P waves. Which arrhythmia is most likely?

Accepted Answer

Atrial flutter with 2:1 block

Answer

Atrial flutter typically presents at 150 bpm ventricular rate due to 2:1 AV conduction of the 300 bpm atrial flutter rate, often with sawtooth flutter waves hidden in QRS complexes.

Question 4

On a standard ECG at normal paper speed, how many small squares represent 1 second?

Accepted Answer

25

Answer

At the standard paper speed of 25 mm/sec, each small square (1 mm) = 0.04 seconds, so 25 small squares = 1 second.

Question 5

Which lead configuration is best for monitoring ST-segment changes in the inferior wall of the left ventricle?

Accepted Answer

II, III, and aVF

Answer

Leads II, III, and aVF are inferior leads that face the inferior wall of the left ventricle, making them optimal for detecting inferior wall ischemia.

ACSM Practice Test

ACSM Practice Test

ACSM-EP Electrocardiography 2