CCMA EKG Administration 5 — Questions and Answers
Question 1: Which lead is considered the 'Gold Standard' for detecting ST-segment changes associated with myocardial infarction of the inferior wall?
- Leads II, III, and aVF (Correct answer)
- Leads V1 and V2
- Leads I and aVL
- Leads V4, V5, and V6
Correct answer: Leads II, III, and aVF
Inferior wall MI changes are best seen in the inferior leads: II, III, and aVF, which look at the bottom of the heart.
Question 2: A patient's EKG shows no P waves and an irregularly irregular rhythm. This pattern is MOST consistent with:
- Atrial fibrillation (Correct answer)
- Sinus bradycardia
- First-degree AV block
- Premature ventricular contractions
Correct answer: Atrial fibrillation
The absence of distinct P waves combined with an irregularly irregular ventricular rhythm is the hallmark of atrial fibrillation.
Question 3: Before applying EKG electrodes, the medical assistant should prepare the patient's skin by:
- Cleaning with alcohol and allowing it to dry completely (Correct answer)
- Applying a thick layer of lotion to improve conductivity
- Shaving only if the patient requests it
- Using warm water and soap, then immediately applying electrodes
Correct answer: Cleaning with alcohol and allowing it to dry completely
Cleaning the skin with alcohol removes oils and debris, and allowing it to dry prevents interference with electrode adhesion and conductivity.
Question 4: The PR interval on an EKG normally measures:
- 0.12 to 0.20 seconds (Correct answer)
- 0.06 to 0.10 seconds
- 0.40 to 0.44 seconds
- 0.20 to 0.28 seconds
Correct answer: 0.12 to 0.20 seconds
A normal PR interval ranges from 0.12 to 0.20 seconds (3–5 small squares), representing atrial depolarization and AV node conduction delay.
Question 5: Which of the following is the CORRECT placement for lead aVR?
- Right arm electrode is the positive pole (Correct answer)
- Left arm electrode is the positive pole
- Left leg electrode is the positive pole
- All limb electrodes combined form the positive pole
Correct answer: Right arm electrode is the positive pole
In augmented lead aVR, the right arm electrode serves as the positive pole, and it views the heart from the right shoulder perspective.
Question 6: A medical assistant records an EKG and notices that every other beat has a wide, bizarre QRS complex not preceded by a P wave. This MOST likely represents:
- Premature ventricular contractions (PVCs) in a bigeminy pattern (Correct answer)
- Bundle branch block
- Second-degree AV block type I
- Atrial flutter with 2:1 block
Correct answer: Premature ventricular contractions (PVCs) in a bigeminy pattern
A PVC bigeminy pattern consists of one normal beat alternating with one wide, abnormal QRS complex that arises from the ventricle without a preceding P wave.
Question 7: When documenting an EKG procedure, which information is MOST critical to record in the patient's chart?
- Date, time, patient's name, lead placement verification, and any symptoms reported (Correct answer)
- The name of the physician who ordered the test only
- The brand and serial number of the EKG machine
- Room temperature and humidity at the time of recording
Correct answer: Date, time, patient's name, lead placement verification, and any symptoms reported
Accurate documentation must include the date, time, patient identifier, confirmation of correct lead placement, and any symptoms the patient experienced during the recording.
CCMA EKG Administration 5
Which lead is considered the 'Gold Standard' for detecting ST-segment changes associated with myocardial infarction of the inferior wall?