Free EKG Certification Trivia Question and Answers

Question 1

Which among the following ECG features sets atrial flutter apart from other atrial dysrhythmias:

Accepted Answer

The "Saw Tooth" or "Picket Fence" appearance of waveforms before QRS

Answer

Atrial flutter is characterized by a rapid, regular atrial rhythm, typically between 250-350 bpm, caused by a re-entrant circuit in the atria. On an ECG, this manifests as distinctive 'sawtooth' or 'picket fence' shaped flutter (F) waves, particularly visible in leads II, III, and aVF, replacing normal P waves. This unique morphology is a hallmark differentiating it from other atrial dysrhythmias.

Question 2

First-degree heart block PR interval:

Accepted Answer

Constant and greater than 0.20second in duration

Answer

First-degree AV block is a condition where electrical impulses from the atria are delayed as they pass through the AV node to the ventricles. On an ECG, this is identified by a PR interval that is consistently prolonged, specifically greater than 0.20 seconds (or 200 milliseconds). Despite the delay, every P wave is followed by a QRS complex, meaning no beats are dropped.

Question 3

The following are ECG features associated with myocardial ischemia:

Accepted Answer

Changes in the ST segment and T waves

Answer

Myocardial ischemia, a lack of oxygen to the heart muscle, primarily affects the repolarization phase of the cardiac cycle. On an ECG, this is typically reflected by changes in the ST segment, such as depression or elevation, and/or T wave abnormalities like inversion or flattening. These alterations indicate altered electrical activity in the oxygen-deprived heart muscle.

Question 4

A 70-year-old patient has had intermittent chest pain in the past. His ECG at rest is typical. It is decided to subject him to a stress test while exercise. The aimed heart rate will be which of the following:

Accepted Answer

150 bpm

Answer

For a cardiac stress test, the maximum predicted heart rate (MPHR) is commonly estimated using the formula 220 minus the patient's age. For a 70-year-old patient, the MPHR would be 220 - 70 = 150 bpm. While the target heart rate for diagnostic purposes is often 85% of MPHR, 150 bpm represents the maximum physiological limit for this age and is a key benchmark in stress testing protocols.

Question 5

Which of the following describes a stress test indicator?

Accepted Answer

Evaluation of chest pain in a patient with normal baseline E.K.G.

Answer

A stress test is primarily indicated to evaluate symptoms suggestive of coronary artery disease, such as chest pain, especially when the resting ECG is normal. It helps to unmask ischemia that may only become apparent under the increased myocardial oxygen demand of exercise. Conditions like acute MI, severe hypertension, or angina at rest are generally contraindications or require immediate medical attention, not a stress test.

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Free EKG Certification Trivia Question and Answers