CCT Patient Care & Clinical Safety Standards 3 — Questions and Answers
Question 1: Which blood pressure reading obtained during an exercise stress test would be considered an absolute indication to stop the test?
- Systolic BP rising to 180 mmHg
- Systolic BP dropping more than 10 mmHg from baseline despite increasing workload (Correct answer)
- Diastolic BP rising to 95 mmHg
- Systolic BP reaching 200 mmHg at peak exercise
Correct answer: Systolic BP dropping more than 10 mmHg from baseline despite increasing workload
A drop in systolic BP of more than 10 mmHg from baseline during exercise indicates hemodynamic instability and is an absolute stopping criterion.
Question 2: When performing a 12-lead ECG on a patient in respiratory distress, electrode placement should be:
- Postponed until the patient's breathing normalizes
- Completed quickly, documenting patient position if not supine (Correct answer)
- Performed with the patient sitting upright without notation
- Skipped in favor of a rhythm strip only
Correct answer: Completed quickly, documenting patient position if not supine
The ECG should be obtained promptly and any deviation from standard supine positioning must be documented for accurate interpretation.
Question 3: A CCT notices that an ECG recording shows 60 Hz electrical interference. The MOST likely cause is:
- Patient movement artifact
- Electrode contact with AC power interference from nearby equipment (Correct answer)
- Low battery in the ECG machine
- Improper lead placement order
Correct answer: Electrode contact with AC power interference from nearby equipment
60 Hz AC interference typically results from poor skin preparation or proximity to electrical equipment creating a ground loop.
Question 4: Before performing a transthoracic echocardiogram, informed consent considerations require the CCT to:
- Obtain written signed consent since it is an invasive procedure
- Explain the procedure and ensure the ordering physician has obtained consent (Correct answer)
- Skip consent since echocardiography is entirely non-invasive and risk-free
- Have the patient sign a general hospital consent only
Correct answer: Explain the procedure and ensure the ordering physician has obtained consent
The CCT explains the procedure to the patient; formal consent responsibility lies with the ordering physician, though patient understanding must be confirmed.
Question 5: Proper hand hygiene before and after patient contact should take at minimum:
- 5 seconds of vigorous rubbing
- 15-20 seconds with soap and water or the equivalent with alcohol-based gel (Correct answer)
- 30 seconds only if the patient has a known infection
- 60 seconds regardless of the hand hygiene product used
Correct answer: 15-20 seconds with soap and water or the equivalent with alcohol-based gel
CDC guidelines specify at least 15-20 seconds of hand washing or thorough alcohol-based sanitizer application to effectively reduce pathogen transmission.
Question 6: A patient refuses to have ECG electrodes placed on their chest. The CCT's appropriate response is to:
- Proceed anyway since the physician ordered the test
- Respect the refusal, document it, and notify the ordering physician (Correct answer)
- Ask a family member to convince the patient to comply
- Perform a rhythm strip instead without the patient's knowledge
Correct answer: Respect the refusal, document it, and notify the ordering physician
Competent patients have the right to refuse procedures; the CCT must document the refusal and communicate it to the care team.
Question 7: During a stress test, the patient develops sustained ventricular tachycardia on the monitor. The CCT should immediately:
- Continue the test to determine if the rhythm self-terminates
- Stop the test, keep the patient calm, and activate the emergency response (Correct answer)
- Increase workload to drive the heart rate above the VT rate
- Administer oxygen and wait for the physician to arrive before stopping
Correct answer: Stop the test, keep the patient calm, and activate the emergency response
Sustained VT is a life-threatening arrhythmia requiring immediate test termination and emergency response activation.
CCT Patient Care & Clinical Safety Standards 3
Which blood pressure reading obtained during an exercise stress test would be considered an absolute indication to stop the test?