CCT Resting ECG Procedures 2

Question 1

What is the correct intercostal space and anatomical location for electrode V4?

Accepted Answer

5th intercostal space at the midclavicular line

Answer

V4 is placed at the 5th intercostal space in the midclavicular line (the line descending vertically from the midpoint of the clavicle). This landmark must be correctly identified before placing V5 and V6.

Question 2

During a resting ECG, a patient continues to shiver despite being asked to relax. What is the most likely artifact that will result, and how can it be minimized?

Accepted Answer

Muscle tremor artifact (rapid, irregular oscillations obscuring the baseline); warm the patient with a blanket and re-attempt

Answer

Shivering produces rapid, irregular, high-frequency muscle potentials that overlay the ECG baseline (somatic tremor artifact). Warming the patient with a blanket to stop shivering is the most effective solution.

Question 3

A technician is performing an ECG on a morbidly obese patient and finds it difficult to identify the sternal angle. What is the best approach to locating the correct intercostal spaces?

Accepted Answer

Palpate the sternum from the top to find the manubriosternal junction (sternal angle/angle of Louis) and count ribs methodically from that landmark

Answer

The sternal angle (angle of Louis) is a palpable bony landmark at the junction of the manubrium and sternal body that marks the 2nd rib. Counting down from this point provides accurate intercostal space identification regardless of body habitus.

Question 4

Which of the following ECG findings is an artifact rather than a true cardiac finding?

Accepted Answer

A perfectly regular, high-frequency oscillation at 60 Hz (AC interference) superimposed on all leads

Answer

60 Hz AC interference is an artifact caused by electromagnetic interference from electrical power lines and devices, not a cardiac electrical event. It appears as a regular, fine oscillation superimposed uniformly on all leads.

Question 5

When is it appropriate to use the 'half-standardization' (5 mm/mV) setting on an ECG machine?

Accepted Answer

When QRS complexes are so tall that they overlap adjacent leads, making interpretation impossible at standard gain

Answer

Half-standardization (reducing gain to 5 mm/mV instead of 10 mm/mV) is used when QRS or T wave amplitudes are so large at standard gain that complexes overflow into adjacent channels, overlapping and making the tracing uninterpretable.

CCT - Certified Cardiographic Technician Exam Practice Test

CCT - Certified Cardiographic Technician Exam Practice Test

CCT Resting ECG Procedures 2