CET CET ECG Reporting & Documentation 2 — Questions and Answers
Question 1: Which ECG interval measures the combined duration of ventricular depolarization and repolarization?
- PR interval from P wave onset to QRS onset
- QT interval from QRS onset to the end of the T wave (Correct answer)
- P wave duration from onset to offset
- RR interval between two consecutive R waves
Correct answer: QT interval from QRS onset to the end of the T wave
The QT interval spans from the start of the QRS to the end of the T wave, encompassing total ventricular electrical activity.
Question 2: Why is documenting a patient's current medications on the ECG requisition clinically important?
- It determines the correct billing code for the procedure
- Medications such as antiarrhythmics and digoxin can alter rate, intervals, and waveform morphology (Correct answer)
- It is required only for male patients over 50 years of age
- Medication lists are irrelevant to ECG interpretation
Correct answer: Medications such as antiarrhythmics and digoxin can alter rate, intervals, and waveform morphology
Many cardiac and non-cardiac drugs alter heart rate, conduction intervals, and waveform morphology in ways that affect interpretation.
Question 3: What does a delta wave on an ECG indicate?
- Normal ventricular repolarization in an otherwise healthy patient
- Left bundle branch block with aberrant conduction
- Pre-excitation pattern associated with Wolff-Parkinson-White syndrome (Correct answer)
- Right atrial enlargement with increased P wave voltage
Correct answer: Pre-excitation pattern associated with Wolff-Parkinson-White syndrome
A delta wave is a slurred initial upstroke on the QRS caused by accessory pathway conduction in WPW syndrome.
Question 4: Which ECG finding requires the technician to immediately notify clinical staff?
- Normal sinus rhythm with a ventricular rate of 72 bpm
- PR interval measuring 0.16 seconds within normal range
- Ventricular fibrillation on the monitor (Correct answer)
- Sinus arrhythmia with mild rate variation on inspiration
Correct answer: Ventricular fibrillation on the monitor
Ventricular fibrillation is a life-threatening arrhythmia requiring immediate emergency response from clinical staff.
Question 5: What does the term 'axis deviation' refer to in ECG documentation?
- The physical position of electrodes placed on the patient's body
- The mean direction of ventricular depolarization in the frontal plane (Correct answer)
- The speed at which the ECG paper feeds through the recording machine
- Deviation of the P wave amplitude above the normal baseline
Correct answer: The mean direction of ventricular depolarization in the frontal plane
Axis deviation reflects an abnormal direction of the heart's electrical activation, often indicating hypertrophy or conduction abnormalities.
Question 6: How should an ECG technician handle a tracing with persistent artifact that cannot be eliminated?
- Discard the tracing entirely and document that no recording was obtained
- Submit the tracing with a written note explaining the artifact and its likely cause (Correct answer)
- Repeat the test indefinitely until a completely artifact-free tracing is obtained
- Alter the tracing digitally to remove the artifact before submitting
Correct answer: Submit the tracing with a written note explaining the artifact and its likely cause
Submitting an artifact-affected tracing with documentation provides the physician context needed for the best possible interpretation.
CET CET ECG Reporting & Documentation 2
Which ECG interval measures the combined duration of ventricular depolarization and repolarization?