Mixed Deck — All CET Topics Flashcards

What is the standard Bruce Protocol starting speed and grade for a treadmill stress test?

Answer: 1.7 mph at 10% grade

Stage 1 of the standard Bruce Protocol begins at 1.7 mph and 10% grade, progressing in 3-minute stages.

An ECG showing a P-wave axis of +150° (inverted in leads I and aVF, upright in aVR) with a short PR interval most likely indicates:

Answer: Ectopic atrial rhythm originating from the low right atrium or coronary sinus

A P-wave axis of approximately +150° suggests atrial activation spreading superiorly and rightward, consistent with a low atrial or coronary sinus pacemaker rather than the sinus node.

Which of the following heart rate variability (HRV) parameters derived from Holter monitoring is a time-domain measure?

Answer: SDNN (standard deviation of all NN intervals)

SDNN is a time-domain HRV measure representing the standard deviation of normal-to-normal R-R intervals over the recording period.

What does a prolonged QTc interval on an ECG suggest clinically?

Answer: Increased risk of torsades de pointes and sudden cardiac death

A prolonged QTc indicates delayed ventricular repolarization, which increases susceptibility to dangerous ventricular arrhythmias.

During a pediatric ECG, the technician notices 60-Hz electrical interference on the tracing. The BEST intervention is:

Answer: Check electrode connections and remove sources of electrical interference

60-Hz artifact is caused by poor electrode contact or nearby electrical devices; checking and resecuring all electrode connections and removing electrical sources eliminates this interference.

Which antiarrhythmic drug class is most associated with causing a lupus-like syndrome AND QRS widening on ECG?

Answer: Class IA (procainamide)

Class IA drug procainamide can cause drug-induced lupus syndrome and, due to sodium channel blockade, prolongs the QRS complex.

A patient's ECG shows a QRS axis of +120°. This is classified as:

Answer: Right axis deviation

A QRS axis beyond +90° (up to +180°) is classified as right axis deviation.

A 5-year-old's ECG shows a PR interval of 240 ms. This finding represents:

Answer: First-degree AV block

A PR interval exceeding 200 ms in a child represents first-degree AV block, indicating delayed conduction through the AV node; in a 5-year-old, 240 ms is clearly prolonged.

Which Borg Scale rating corresponds to 'somewhat hard' effort during a stress test?

Answer: 13

A Borg Scale rating of 13 corresponds to 'somewhat hard,' and is commonly used to gauge patient exertion during stress testing.

What is the recommended minimum duration a patient should rest before a resting 12-lead ECG is recorded?

Answer: 5 minutes

A minimum 5-minute supine rest is recommended so that heart rate and autonomic tone stabilize, reducing exercise-induced or postural rate changes that could confound interpretation.

The maximum predicted heart rate (MPHR) for stress testing is calculated as:

Answer: 220 minus age

The standard formula for MPHR is 220 minus the patient's age in years, and 85% of this value defines an adequate submaximal effort.

Which drug given for rate control in atrial flutter is most likely to show a sudden conversion to sinus rhythm on the ECG monitor?

Answer: Ibutilide

Ibutilide is a Class III antiarrhythmic used for chemical cardioversion of atrial flutter and fibrillation, and may produce sudden conversion to sinus rhythm.

What does a horizontal or downsloping ST depression of ≥1mm at 80ms after the J-point during stress testing indicate?

Answer: Myocardial ischemia

Horizontal or downsloping ST depression ≥1mm measured 80ms after the J-point is the classic ECG sign of exercise-induced myocardial ischemia.

What is a key principle of pediatric ecg considerations in Certified Electrocardiogram Technician practice?

Answer: Applying structured methodologies based on evidence and best practices

Pediatric ECG Considerations in Certified Electrocardiogram Technician practice requires applying structured, evidence-based methodologies while adapting to specific professional contexts.

Which safety precaution is essential when performing an ECG on a patient with an implanted pacemaker?

Answer: Document the presence of the pacemaker and note it on the ECG requisition

Documenting the device ensures the interpreting physician accounts for pacemaker spikes and altered waveform morphology.

A QTc interval of 520 ms on a patient's ECG is significant because it indicates:

Answer: Prolonged ventricular repolarization that increases risk of Torsades de Pointes

A QTc above 500 ms significantly increases the risk of the potentially fatal polymorphic VT known as Torsades de Pointes.

A Holter report shows frequent couplets (pairs of PVCs). What is the minimum number of consecutive PVCs that defines ventricular tachycardia?

Answer: 3

By definition, three or more consecutive PVCs at a rate ≥100 bpm constitutes ventricular tachycardia.

A technician notices the ECG paper is loading incorrectly and the tracing appears on the back (blank side) of the paper. What should they do?

Answer: Reload the paper so the thermal-sensitive side faces the stylus

Thermal ECG paper only marks on the heat-sensitive coated side; loading it reversed means the stylus contacts the non-reactive backing, producing a blank or very faint tracing.

Which of the following best describes the role of the ECG technician when a patient develops a life-threatening arrhythmia during a procedure?

Answer: Activate the emergency response system and continue monitoring while assisting the team

The ECG technician's role is to activate emergency response, maintain monitoring to provide real-time data, and support the clinical team — not to independently administer medications.

When recording an ECG on a patient with a pacemaker, what specific concern should the technician note?

Answer: Artifact from the pacemaker may mimic bundle branch block morphology

Pacemaker spikes followed by wide QRS complexes can resemble bundle branch blocks, so the technician must document the presence of a pacemaker on the ECG requisition.