CET Stress Testing Procedures 2 — Questions and Answers
Question 1: During a treadmill stress test, at what point should the technician immediately stop the test without waiting for physician approval?
- Patient requests to stop
- ST elevation of 2mm or more in non-infarct leads (Correct answer)
- Heart rate reaches 85% of maximum predicted
- Patient reports mild leg fatigue
Correct answer: ST elevation of 2mm or more in non-infarct leads
ST elevation of ≥2mm in non-infarct leads is an absolute indication for immediate termination due to high risk of acute MI.
Question 2: What is the standard Bruce Protocol starting speed and grade for a treadmill stress test?
- 2.5 mph at 12% grade
- 1.7 mph at 10% grade (Correct answer)
- 3.0 mph at 0% grade
- 2.0 mph at 5% grade
Correct 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.
Question 3: Which electrode position is most prone to artifact during treadmill exercise stress testing?
- V4
- aVF
- Limb leads placed on the torso (Correct answer)
- V1
Correct answer: Limb leads placed on the torso
Limb leads repositioned to the torso (Mason-Likar modification) are more susceptible to motion artifact from arm and trunk movement.
Question 4: A patient's blood pressure drops 10 mmHg from baseline during increasing exercise workload. This finding is called:
- Orthostatic hypotension
- Exercise-induced hypotension (Correct answer)
- Vasovagal response
- Chronotropic incompetence
Correct answer: Exercise-induced hypotension
A drop of ≥10 mmHg in systolic BP from baseline during increasing exercise is called exercise-induced hypotension and is an indication to stop the test.
Question 5: During pharmacologic stress testing with dobutamine, which arrhythmia finding is a reason to terminate the infusion?
- Sinus tachycardia above 100 bpm
- Sustained ventricular tachycardia (Correct answer)
- Occasional PVCs
- First-degree AV block
Correct answer: Sustained ventricular tachycardia
Sustained ventricular tachycardia during dobutamine infusion is a serious arrhythmia that requires immediate termination of the test.
Question 6: The recovery phase of a stress test is typically monitored for how long after exercise ends?
- 1 minute
- 3 minutes
- At least 6–8 minutes (Correct answer)
- Until heart rate normalizes completely
Correct answer: At least 6–8 minutes
The recovery phase is monitored for at least 6–8 minutes because ischemic ECG changes or arrhythmias can appear or worsen after exercise stops.
Question 7: Which Borg Scale rating corresponds to 'somewhat hard' effort during a stress test?
- 9
- 13 (Correct answer)
- 17
- 20
Correct answer: 13
A Borg Scale rating of 13 corresponds to 'somewhat hard,' and is commonly used to gauge patient exertion during stress testing.
CET Stress Testing Procedures 2
During a treadmill stress test, at what point should the technician immediately stop the test without waiting for physician approval?