Deck 46: Electrocardiography and Pulmonary Function Testing

Question 1

Which of the following is the process by which a graphic pattern is created from the electrical impulses generated in the heart as it pumps?

A) Electroencephalography
B) Electromyography
C) Electrocardiography
D) Electroneurography
E) Electrogastrography

Answer 1

Electrocardiography

Question 2

The different views recorded on an electrocardiogram that are produced by the electrical activity of the heart are ____.

A) leads
B) stylus
C) electrodes
D) deflections
E) probes

Answer 2

leads

Question 3

Which of the following is the electrical impulse that initiates a chain reaction resulting in contraction?

A) Repolarization
B) Deflection
C) Depolarization
D) Artifact
E) Polarization

Answer 3

Depolarization

Question 4

Which precordial electrode is placed in the fifth intercostal space, where it intersects an imaginary line drawn straight down the middle of the clavicle?

A) V₆
B) V₂
C) V₄
D) V₁
E) V₃

Question 5

Which of the following delays the electrical impulse for muscle contraction, giving the atria time to contract completely and fill the ventricles with blood?

A) AV node
B) SA node
C) Purkinje fibers
D) Bundle of His
E) Bundle branches

Question 6

Which precordial electrode is placed in the fifth intercostal space, directly below the middle of the armpit?

A) V₁
B) V₂
C) V₄
D) V₆
E) V₃

Question 7

The instrument that measures and displays the electrical impulses responsible for the cardiac cycle is a(n) ____.

A) electrocardiograph
B) electroencephalograph
C) electrocardiogram
D) electroencephalogram
E) electrode

Question 8

The peaks and valleys of the electrical impulses responsible for the cardiac cycle are called ____.

A) electrodes
B) styluses
C) leads
D) deflections
E) probes

Question 9

Which of the following would you include when preparing the room and equipment for an electrocardiogram?

A) Select a room in which all electrical equipment is turned off
B) Perform the procedure in an X-ray department
C) Place the patient on a metal table
D) Set the room's temperature control to a very cool setting
E) Check the ECG paper after preparing the patient

Question 10

Which of the following is the primary pacemaker of the heart?

A) AV node
B) Bundle of His
C) SA node
D) Purkinje fibers
E) Bundle branches

Question 11

Which of the following is a record of the waves of electrical impulses responsible for the cardiac cycle?

A) Electrode
B) Electrocardiogram
C) Electrocardiograph
D) Electroencephalograph
E) Electroencephalogram

Question 12

Which precordial electrode is placed in the fourth intercostal space to the left of the sternum?

A) V₆
B) V₁
C) V₄
D) V₂
E) V₃

Question 13

Which precordial electrode is located by counting to the fourth intercostal space to the right of the sternum?

A) V₁
B) V₂
C) V₃
D) V₄
E) V₆

Question 14

Possible causes for a wandering baseline are ____.

A) the use of paper clips, wet hands, or improper mounting
B) loose wires or a short circuit in the wires
C) improper grounding or cardiac arrest
D) poor skin preparation, dangling wire, or breathing movement
E) wrong selector switch setting or crossed wires

Question 15

Transmission of electrical impulses in the heart begins in the ____.

A) AV node
B) Purkinje fibers
C) bundle of His
D) bundle branches
E) SA node

Question 16

Which of the following would you do to alleviate a patient's anxiety about having an electrocardiography?

A) Tell the patient that the procedure will last 1 hour
B) Explain to the patient that a small amount of electricity passes through the body
C) Describe to the patient what disease or abnormality the physician is looking for
D) Encourage the patient to ask questions and verbalize her concerns
E) Tell the patient that although ECGs are unpleasant, they are necessary

Question 17

Which of the following measures and evaluates a patient's lung capacity and volume?

A) Chest x-ray
B) Pulmonary function test
C) Bronchoscopy
D) Lung scan
E) Electroencephalogram

Question 18

Which of the following is an erroneous mark or defect that may appear on an ECG strip?

A) Electrolyte
B) Deflection
C) Stylus
D) Lead
E) Artifact

Question 19

If a lead does not appear on an ECG tracing, what should you do before you repeat the tracing?

A) Re-center the stylus
B) Set the sensitivity selector to 2
C) Reconnect the wire
D) Increase the paper speed to 50 mm per second
E) Move the ECG table away from the wall

Question 20

Which of the following is a pen-like instrument that records impulse movement on the ECG paper?

A) Electrode
B) Stylus
C) Lead
D) Deflection
E) Probe

Question 21

Which of the following would you include in patient preparation for a pulmonary function test?

A) Tell the patient that eating and smoking are permitted up until the time of the test
B) Instruct the patient to sit in a chair with legs crossed
C) Instruct the patient to slightly elevate the chin and slightly extend the neck
D) Tell the patient to bite down firmly on the mouthpiece
E) Encourage the patient to perform the test even if he has a viral infection

Question 22

Which of the following is a measurement taken to determine the amount of air that can be quickly forced from the lungs?

A) Maximal voluntary ventilation
B) Tidal volume
C) Forced vital capacity
D) Peak expiratory flow rate
E) Peak flow zone

Question 23

When pressed, which of the following should cause the stylus to move up 10mm (10 small squares) and remain there for 0.08 second (2 small squares or 2 mm)?

A) Speed selector
B) Standardization control
C) Centering control
D) Sensitivity control
E) Stylus temperature control

Question 24

An instrument used to measure the air taken in by and expelled from the lungs is the ____.

A) peak flow meter
B) calibration syringe
C) spirometer
D) stylus
E) respirator

Question 25

Which of the following represents the time it takes for the ventricles to contract and recover, or repolarize?

A) P-R interval
B) S-T interval
C) Q-T interval
D) U wave
E) QRS complex

Question 26

Which of the following is a small upward curve that represents the sinoatrial node impulse, wave of depolarization through the atria, and resultant contraction?

A) P wave
B) S wave
C) S-T segment
D) Q wave
E) R wave

Question 27

The greatest volume of air that can be expelled when a person performs a rapid, forced expiration is the ____.

A) inspiratory capacity
B) forced vital capacity
C) peak expiratory flow rate
D) residual volume
E) peak flow zone

Question 28

Pulmonary function tests are useful in monitoring ____.

A) myocardial infarction
B) chronic obstructive pulmonary disease
C) angina pectoris
D) arrhythmias
E) congestive heart failure

Question 29

The time it takes for electrical impulses to travel from the SA node to the AV node is the ____.

A) S-T segment
B) Q wave
C) R wave
D) P-R interval
E) Q-T interval

Question 30

The deflections that occur on an ECG are labeled with the letters ____.

A) A, B, C, D, E, and F
B) P, Q, R, S, T, and U
C) H, I, J, K, and L
D) V, W, X, Y, and Z
E) M, N, O, P, and Q

Question 31

The impulse that travels through both ventricles is the ____.

A) R wave
B) Q wave
C) S wave
D) P wave
E) T wave

Question 32

Electrical impulse sensors used to obtain an electrocardiogram are called ____.

A) leads
B) styluses
C) electrodes
D) artifacts
E) probes

Question 33

Which of the following is used to assess the electrical activity of a patient's heart over a 24-hour period of normal activity?

A) Stress testing
B) Pulmonary function testing
C) Holter monitoring
D) Electrocardiography
E) Echocardiography

Question 34

Which of the following would you include in the patient teaching for a patient with a Holter monitor?

A) Encourage the patient to shower while the device is in place
B) Tell the patient that using an electrical blanket is permissible
C) Instruct the patient to record all activities, emotions, symptoms, and medications taken
D) Tell the patient to wear tight-fitting clothing to keep the monitor in place
E) Instruct the patient to remove any electrodes that seem loose

Question 35

Which of the following refers to the contraction of the ventricles following depolarization?

A) QRS complex
B) T wave
C) Q-T interval
D) S-T segment
E) P wave

Question 36

Which of the following may result in extraneous marks on the ECG tracing?

A) Improper electrode placement
B) Detached wire
C) Use of paper clips
D) Breathing movement
E) Electrical interference

Question 37

Which of these allow you to adjust the position of the stylus?

A) Centering control
B) Sensitivity control
C) Marker control
D) Standardization control
E) Stylus temperature control

Question 38

Which of the following results in a flat line on the ECG tracing?

A) Poor skin preparation
B) Dirty electrodes
C) Detached/loose wire
D) Muscle movement
E) Electrical interference

Question 39

Which of the following represents the time between contraction of the ventricles and recovery?

A) P wave
B) Q wave
C) S-T segment
D) P-R interval
E) QRS complex

Question 40

Which of the following assesses the heart's conduction system during exercise, when the demand for oxygen is increased?

A) Holter monitoring
B) Electrocardiography
C) Pulmonary function test
D) Stress testing
E) Encephalography

Question 41

Which of the following can prevent a wandering baseline?

A) Avoid the use of paper clips on the tracing
B) Make sure all the leads are connected properly
C) Eliminate other sources of electricity in the room
D) Be sure the skin is prepared adequately
E) Make sure the temperature of the room is comfortable

Question 42

How do you determine the heart rate from a regular ECG tracing?

A) Count the number of ST segments in a 60-second strip
B) Multiply the number of QRS complexes in a 6-second strip by 10
C) Multiply the number of QRS complexes in a 10-second strip by 10
D) Count the P waves in a 20-second strip
E) Count the number of QRS complexes in a 30-second strip

Question 43

After preparing the ECG machine, you explained the procedure to Mrs. Thomas, connected the electrodes, and began the tracing, as shown in the picture. You rechecked the electrodes and they are all placed correctly. None of the wires are loose. However, you notice that Mrs. Thomas's skin smells fragrant, as though she has used a body lotion recently. Which of the following describes the problem, its possible cause, and the correct solution?

A) Extraneous marks caused by paper clips; remove the paper clips
B) Somatic interference caused by patient shivering; offer a warm blanket
C) Wandering baseline caused by lotion on the skin; re-prep the skin with isopropyl alcohol
D) AC interference caused by nearby equipment; turn equipment off
E) Flat line caused by crossed wires; reconnect the wires correctly

Question 44

Which of the following measures the patient's response to a constant or increasing workload?

A) Holter monitor test
B) Exercise ECG
C) resting ECG
D) Ultrasound
E) Peak expiratory flow rate

Question 45

AC interference can be prevented by ____.

A) keeping the patient warm to prevent shivering
B) making sure lead wires are not crossed and following the contour of the body
C) making certain that a lead has not been disconnected from the electrode
D) preparing the patient's skin adequately
E) avoiding the use of paper clips

Question 46

Which of the following delays the electrical impulse to give time for the atria to complete contraction and the ventricles to fill?

A) Bundle of His
B) SA node
C) Bundle branches
D) AV node
E) Purkinje fibers

Question 47

Gillian is a cheerful, active teenager who is having an ECG as part of a physical required by her school to participate in cheerleading activities. You explain that she needs to remain very still while you record the ECG. You begin the tracing, as shown in the picture. Although Gillian remains still, when she sees the look on your face, she asks, "What's wrong?" What abnormality is visible in lead V₆, and what is your best choice of action?

A) Somatic interference; ask Gillian again to remain still
B) Wandering baseline; check for loose electrodes
C) AC interference; turn off nearby electrical equipment
D) Flat line; check pulse and respirations and begin CPR
E) Flat line; look for loose or disconnected wires

Question 48

If a patient is uncomfortable lying flat on the examining table for an ECG test, he can be placed in the ____.

A) prone position
B) supine position
C) Fowler's position
D) Sims' position
E) proctologic position

Question 49

The urgent care center where you work is being remodeled, and the room usually used for obtaining ECGs is currently unavailable. The ECG equipment has been moved around the corner to the room next to the X-ray room. When you begin your first patient ECG of the day, the tracing looks as shown in the figure. What problem is present and how can you fix it?

A) Extraneous marks; avoid using paper clips on the graph paper
B) Somatic interference; ask the patient to be very still while you record the ECG
C) Wandering baseline; check and reconnect loose leads
D) Flat line; check for crossed wires or loose leads
E) AC interference; move the ECG equipment to a room farther from other electric equipment

Question 50

You are attempting to record an ECG for Mr. Potter, a 72-year-old patient who has Parkinson's disease. Knowing this, you automatically place the limb electrodes close to the trunk. However, the tracing looks as shown in the picture. What artifact is present and what can you do to fix it?

A) Extraneous marks; avoid using paper clips on the graph paper
B) Somatic interference; wait until Mr. Potter's tremors subside
C) wandering baseline; check for loose electrodes
D) AC interference; turn off nearby electrical equipment
E) Flat line; check pulse and respiration, then begin CPR

Question 51

The arrhythmia in which P waves cannot be identified because of rapid multiple electrical signals that fire from areas of the atria other than the SA node is ____.

A) atrial fibrillation
B) PVCs
C) ventricular fibrillation
D) bundle branch block
E) ventricular tachycardia

Question 52

The ____ send(s) out electrical impulses to initiate depolarization.

A) bundle branches
B) AV node
C) Purkinje fibers
D) SA node
E) bundle of His

Question 53

What is the arrhythmia pictured here?

A) Atrial fibrillation
B) PVCs
C) Ventricular fibrillation
D) Bundle branch block
E) Cardiac arrest

Question 54

Which of these arrhythmias is due to a heartbeat originating in the ventricles that occurs early in the cycle and is followed by a pause before the next cycle?

A) Atrial fibrillation
B) PVCs
C) Ventricular fibrillation
D) Bundle branch block
E) Ventricular tachycardia

Question 55

Which of the following is a correct statement about the stylus temperature control?

A) A lower temperature produces a heavier line.
B) It has no effect on the ECG tracing.
C) A higher temperature produces a heavier line.
D) Lower temperatures cause smearing.
E) A higher temperature produces a thinner line.

Question 56

What is the arrhythmia pictured here?

A) Atrial fibrillation
B) PVCs
C) Ventricular fibrillation
D) Bundle branch block
E) Cardiac arrest

Question 57

How do you prevent somatic interference on an ECG tracing?

A) Make sure lead wires follow the contour of the body
B) Ground the machine
C) Prepare the skin properly
D) Remind the patient to lie still and to refrain from talking
E) Unplug other electrical devices in the room

Question 58

Electrodes for limb leads should be attached to ____.

A) a bony area on each limb
B) a highly vascular area
C) fleshy portions of the limbs
D) the wrists and ankles
E) the knees and elbows

Question 59

The arrhythmia pictured here is ____.

A) atrial fibrillation
B) PVCs
C) ventricular fibrillation
D) bundle branch block
E) cardiac arrest

Question 60

Which of these is a life-threatening arrhythmia that results in no cardiac output?

A) Atrial fibrillation
B) PVCs
C) Ventricular fibrillation
D) Bundle branch block
E) Ventricular tachycardia

Question 61

The impulses received through various combinations of electrodes constitute different ________, or views of the electrical activity of the heart, that are recorded on the ECG.

Question 62

When using pulse oximetry long-term, you should move the sensor to a new site every ____.

A) 4 hours
B) 2 hours
C) 6 hours
D) 12 hours
E) 24 hours

Question 63

If the patient has good control of her asthma, her peak flow rate is in the ____,

A) green zone
B) yellow zone
C) red zone
D) blue zone
E) orange zone

Question 64

A(n) ________ is an instrument that measures and displays the impulses responsible for the cardiac cycle.

Question 65

The electrical impulse that initiates a chain reaction resulting in contraction is ________.

Question 66

A test used to measure breathing capacity is called ________.

Question 67

A physician will order a(n) ________ function test to evaluate a patient's lung volume and capacity.

Question 68

A patient is not hypoxemic if his pulse oximetry reading is ____ percent.

A) 94
B) 90
C) 97
D) 92
E) 89

Question 69

Which of these is a component of an acceptable maneuver for spirometry?

A) Slow and easy start
B) Variable flow
C) Coughing
D) Quick, light breath
E) Minimum of 6 seconds

Question 70

The cardiac ________ is regulated by specialized tissues in the heart wall that transmit electrical impulses and cause the heart muscle to contract and relax.

Question 71

A(n) ________ is the tracing made by an electrocardiograph.

Question 72

The process by which a graphic pattern is created from the electrical impulses generated in the heart as it pumps is ________.

Question 73

An electrocardiography device that includes a small cassette or microchip recorder and records the heart rhythm over a 24-hour period is a(n) ________ monitor.

Question 74

Calibration of a spirometer requires the use of a standardized measuring instrument called a(n) calibration ________ and should provide a reading on the spirometer within 3% of the stated volume.

Question 75

The condition of having two separate poles, one positive and the other negative, is called ________.

Question 76

Which peak flow zone indicates that large airways are beginning to narrow?

A) Green zone
B) Yellow zone
C) Red zone
D) Blue zone
E) Orange zone

Question 77

How do you prepare patients for spirometry?

A) Tell them to wear tight clothing
B) Have them stand for the test
C) Have them wear a nose clip
D) Have them bite down on the mouthpiece
E) Have them eat a light meal immediately before the test

Question 78

Electrical impulse sensors placed on the body that detect and record the electrical activity of the heart are ________.

Question 79

The peak flow zone that requires immediate medical treatment is the ____.

A) green zone
B) yellow zone
C) red zone
D) blue zone
E) orange zone

Question 80

Electrical impulses of the cardiac cycle produce a series of waves with peaks and valleys on an electrocardiogram that are called ________.