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CCMA EKG and Cardiovascular Testing Practice Test

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25 practice questions

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  1. Question 1 of 25Hard

    During a routine EKG, the display suddenly shows a chaotic, wavy tracing. The patient is talking, alert and says he feels fine. What should the medical assistant do first?

    1. A. Start chest compressions immediately
    2. B. Call 911 and get the AED
    3. C. Check the electrodes and lead wires
    4. D. Give the patient an aspirin

    Show answer to question 1

    Answer: C. Check the electrodes and lead wires

    The patient is assessed, not just the tracing. A patient in ventricular fibrillation is unresponsive and pulseless, so an alert, talking patient with this tracing most likely has artifact; the medical assistant checks connections and has the patient lie still.

    Why the other options are wrong

    • ACompressions are for a patient who is unresponsive and not breathing normally.
    • BEmergency response is not needed for an alert patient whose tracing shows artifact.
    • DGiving medication is outside the medical assistant's scope and is not indicated here.

  2. Question 2 of 25Hard

    During an EKG, a 66-year-old man suddenly develops a rapid, regular rhythm with wide QRS complexes and no visible P waves. He says he feels dizzy. What should the medical assistant do?

    1. A. Finish the tracing and give it to the provider after the visit
    2. B. Ask the patient to cough and recheck the tracing in an hour
    3. C. Stay with the patient and call the provider immediately
    4. D. Remove the electrodes and have the patient walk around

    Show answer to question 2

    Answer: C. Stay with the patient and call the provider immediately

    A rapid, regular rhythm with wide QRS complexes suggests ventricular tachycardia, which can quickly become life-threatening. The medical assistant stays with the patient, gets the provider immediately and activates emergency response if the patient becomes unresponsive.

    Why the other options are wrong

    • ADelaying notification could allow the rhythm to worsen without treatment.
    • BTreatment decisions belong to the provider, and an hour's delay is unsafe.
    • DWalking a dizzy patient with a dangerous rhythm risks a fall and collapse.

  3. Question 3 of 25Medium

    Lead II is commonly used for rhythm strips. Between which two electrodes does lead II record?

    1. A. Left arm negative and left leg positive
    2. B. Right arm positive and left arm negative
    3. C. Right leg negative and left arm positive
    4. D. Right arm negative and left leg positive

    Show answer to question 3

    Answer: D. Right arm negative and left leg positive

    Lead II measures electrical activity from the right arm (negative) to the left leg (positive). This direction follows the normal flow of the heart's impulse, so lead II usually shows clear, upright P waves.

    Why the other options are wrong

    • ALeft arm negative to left leg positive describes lead III.
    • BLead I runs from the right arm (negative) to the left arm (positive), the reverse of this option.
    • CThe right leg electrode is the ground and is not a pole of lead II.

  4. Question 4 of 25Medium

    If a patient's sinoatrial node fails to fire, what is the expected intrinsic pacing rate if the atrioventricular (AV) junction assumes control?

    1. A. 20 to 40 beats per minute
    2. B. 80 to 100 beats per minute
    3. C. 60 to 80 beats per minute
    4. D. 40 to 60 beats per minute

    Show answer to question 4

    Answer: D. 40 to 60 beats per minute

    The AV junction has an intrinsic automaticity rate of 40 to 60 beats per minute, allowing it to function as a secondary pacemaker when the SA node fails. A rate of 20 to 40 beats per minute represents the intrinsic escape rate of the ventricular Purkinje network rather than the AV junction.

  5. Question 5 of 25Medium

    When applying the chest electrodes, which electrode should be placed before V3 so that V3 can be positioned correctly?

    1. A. V1
    2. B. V4
    3. C. V5
    4. D. V6

    Show answer to question 5

    Answer: B. V4

    V3 is placed midway between V2 and V4, so V4 is usually placed before V3. A common sequence is V1, V2, V4, V3, V5 and V6.

    Why the other options are wrong

    • AV1 is placed early, but V3's position is defined by V2 and V4, not V1.
    • CV5 is placed level with V4 after V4 is located and does not define V3.
    • DV6 is placed in the midaxillary line and does not define V3's position.

  6. Question 6 of 25Medium

    A medical assistant measures the PR interval on a rhythm strip as 4 small boxes. What is the PR interval, and is it within the normal range?

    1. A. 0.08 second; shorter than normal
    2. B. 0.40 second; longer than normal
    3. C. 0.16 second; within normal range
    4. D. 0.24 second; longer than normal

    Show answer to question 6

    Answer: C. 0.16 second; within normal range

    At standard speed, 4 small boxes equal 0.16 second. A normal PR interval is 0.12 to 0.20 second, so this value is normal.

    Why the other options are wrong

    • A0.08 second would be 2 small boxes, not 4.
    • B0.40 second would be 10 small boxes, or 2 large boxes.
    • D0.24 second would be 6 small boxes, not 4.

  7. Question 7 of 25Medium

    Why does the AV node briefly delay the electrical impulse before passing it to the ventricles?

    1. A. To allow the SA node to recharge fully
    2. B. To let the ventricles repolarize first
    3. C. To slow the heart rate below 60 per minute
    4. D. To let the ventricles fill with blood

    Show answer to question 7

    Answer: D. To let the ventricles fill with blood

    The brief delay at the AV node lets the atria finish contracting so the ventricles fill with blood before they contract. This delay is part of the PR interval on the EKG.

    Why the other options are wrong

    • AThe SA node recovers on its own; the AV delay is not for SA node recharging.
    • BVentricular repolarization happens after the ventricles contract, not before.
    • CThe AV delay does not set the heart rate; the SA node normally controls the rate.

  8. Question 8 of 25Medium

    A tracing shows sudden gaps where the baseline disappears and then returns in one lead. The patient is lying still. What is the most likely cause?

    1. A. The patient is breathing too deeply
    2. B. The room temperature is too low
    3. C. A loose electrode or damaged wire
    4. D. The paper speed is set to 50 mm per second

    Show answer to question 8

    Answer: C. A loose electrode or damaged wire

    An interrupted baseline occurs when the electrical connection is broken, such as by an electrode that has come loose or a lead wire that is cracked or disconnected. The medical assistant checks the connections and replaces faulty parts.

    Why the other options are wrong

    • ADeep breathing causes a wandering baseline, not gaps in the tracing.
    • BA cold room can cause shivering artifact, not missing segments.
    • DA faster paper speed widens the waveforms but does not create gaps.

  9. Question 9 of 25Easy

    On a normal EKG, each P wave begins with an impulse from which structure, the heart's natural pacemaker?

    1. A. Atrioventricular node
    2. B. Sinoatrial node
    3. C. Bundle of His
    4. D. Purkinje fibers

    Show answer to question 9

    Answer: B. Sinoatrial node

    The sinoatrial (SA) node in the right atrium normally fires 60 to 100 times per minute and starts each heartbeat. Its impulse spreads through the atria and produces the P wave.

    Why the other options are wrong

    • AThe AV node receives the impulse from the atria and takes over as pacemaker only if the SA node fails.
    • CThe bundle of His carries the impulse from the AV node toward the ventricles.
    • DPurkinje fibers spread the impulse through the ventricular walls.

  10. Question 10 of 25Easy

    Where is the V6 electrode placed?

    1. A. Left anterior axillary line, level with V4
    2. B. Left midaxillary line, level with V4
    3. C. Right midaxillary line, level with V4
    4. D. Left posterior axillary line, level with V2

    Show answer to question 10

    Answer: B. Left midaxillary line, level with V4

    V6 is placed on the left midaxillary line at the same horizontal level as V4 and V5. Keeping V4 through V6 level gives an accurate view of the lateral wall of the heart.

    Why the other options are wrong

    • AThe left anterior axillary line at the level of V4 is the location for V5.
    • CStandard chest electrodes are placed on the left side of the chest.
    • DThe posterior axillary line at the level of V2 is not a standard position for V6.

  11. Question 11 of 25Medium

    A 35-year-old woman who rushed up three flights of stairs has a regular rhythm at 118 beats per minute with a normal P wave before each QRS complex. Which rhythm is shown?

    1. A. Sinus bradycardia
    2. B. Atrial fibrillation
    3. C. Ventricular fibrillation
    4. D. Sinus tachycardia

    Show answer to question 11

    Answer: D. Sinus tachycardia

    A sinus rhythm faster than 100 beats per minute is sinus tachycardia. It commonly occurs with exertion, anxiety, pain or fever.

    Why the other options are wrong

    • AThe rate of 118 is fast, not slow.
    • BThe rhythm is regular with normal P waves, which rules out atrial fibrillation.
    • CVentricular fibrillation is a chaotic rhythm with no identifiable P waves or QRS complexes.

  12. Question 12 of 25Hard

    A new EKG shows inverted P waves, QRS complexes and T waves in lead I, while aVR looks upright. The patient's previous EKG was normal. What is the most likely cause?

    1. A. The chest electrodes were placed too low
    2. B. The arm electrodes were reversed
    3. C. The paper speed was set incorrectly
    4. D. The patient was shivering during the test

    Show answer to question 12

    Answer: B. The arm electrodes were reversed

    Reversing the right and left arm electrodes flips lead I, making its waves negative, and makes aVR look upright. The medical assistant checks the limb electrode placement and repeats the tracing before giving it to the provider.

    Why the other options are wrong

    • ALow chest electrodes affect the chest leads, not lead I and aVR.
    • CPaper speed changes the width of waves, not their direction.
    • DShivering causes irregular artifact rather than inverted waves.

  13. Question 13 of 25Medium

    An EKG tracing displays continuous, small, uniform spikes at 60 cycles per second that obscure the baseline. Which of the following actions should the medical assistant take to eliminate this artifact?

    1. A. Move the patient bed away from wall electrical cords and outlets
    2. B. Instruct the patient to hold their breath for ten seconds
    3. C. Provide a warm blanket to keep the patient from shivering
    4. D. Re-prep the skin with alcohol and apply fresh electrodes

    Show answer to question 13

    Answer: A. Move the patient bed away from wall electrical cords and outlets

    Uniform spikes at 60 cycles per second represent alternating current (AC) interference caused by nearby electrical equipment or wiring. Moving the examination bed away from power cords and unplugging unneeded devices resolves this issue, whereas providing a warm blanket treats somatic tremor caused by shivering.

  14. Question 14 of 25Easy

    On an EKG, what does the P wave represent?

    1. A. Ventricular depolarization
    2. B. Ventricular repolarization
    3. C. Atrial repolarization
    4. D. Atrial depolarization

    Show answer to question 14

    Answer: D. Atrial depolarization

    The P wave represents depolarization of the atria as the impulse spreads from the SA node. It is normally a small, rounded, upright wave before each QRS complex.

    Why the other options are wrong

    • AVentricular depolarization produces the QRS complex.
    • BVentricular repolarization produces the T wave.
    • CAtrial repolarization is usually hidden within the QRS complex.

  15. Question 15 of 25Hard

    A patient with Parkinson's disease has a constant hand tremor that causes artifact in the limb leads. Which adjustment is most likely to reduce the artifact?

    1. A. Place the arm electrodes on the patient's wrists
    2. B. Move the arm electrodes up to the upper arms
    3. C. Ask the patient to grip the table edges tightly
    4. D. Place both arm electrodes on the same arm

    Show answer to question 15

    Answer: B. Move the arm electrodes up to the upper arms

    Moving the arm electrodes closer to the trunk, such as onto the upper arms, places them farther from the source of the tremor and reduces artifact. Both sides are placed at the same level, and the modified placement is noted on the tracing.

    Why the other options are wrong

    • AThe wrists are close to the tremor, which increases artifact.
    • CGripping creates muscle tension that adds artifact.
    • DBoth arm electrodes on one arm produce an inaccurate tracing.

  16. Question 16 of 25Easy

    A 12-lead EKG shows a baseline obscured by regular, uniform, rapid spikes with a frequency of 60 cycles per second. Which of the following is the most likely cause?

    1. A. Electrical interference from nearby equipment
    2. B. Inadequate skin preparation causing dried gel contact
    3. C. Deep respirations causing chest wall excursion
    4. D. Muscle tension from voluntary patient movement

    Show answer to question 16

    Answer: A. Electrical interference from nearby equipment

    Alternating current (AC) interference, also known as 60-cycle interference, is caused by electrical leakage from nearby equipment, improper grounding, or crossing electrical cables, which produces consistent, tight, uniform oscillations. Muscle tension produces irregular, jagged spikes known as somatic tremor rather than uniform 60 Hz waves.

  17. Question 17 of 25Medium

    After the electrical impulse passes through the AV node, where does it travel next?

    1. A. Bundle of His
    2. B. Sinoatrial node
    3. C. Purkinje fibers
    4. D. Right atrium

    Show answer to question 17

    Answer: A. Bundle of His

    The normal conduction pathway is SA node, atria, AV node, bundle of His, right and left bundle branches, then Purkinje fibers. The bundle of His is the next structure after the AV node.

    Why the other options are wrong

    • BThe SA node starts the impulse before it reaches the AV node.
    • CPurkinje fibers are the last part of the pathway, after the bundle branches.
    • DThe impulse spreads through the atria before reaching the AV node.

  18. Question 18 of 25Hard

    A patient on the EKG table suddenly becomes unresponsive and is not breathing normally. The tracing shows chaotic, irregular waves with no identifiable QRS complexes. What should the medical assistant do?

    1. A. Check the lead wires before doing anything else
    2. B. Call for help, start CPR and get the AED
    3. C. Print the tracing and send it to the provider
    4. D. Wait 5 minutes to see if the rhythm corrects itself

    Show answer to question 18

    Answer: B. Call for help, start CPR and get the AED

    An unresponsive patient who is not breathing normally with a chaotic tracing is likely in ventricular fibrillation, a cardiac arrest rhythm. The medical assistant calls for help, activates emergency response, starts high-quality CPR and uses the AED as soon as it arrives.

    Why the other options are wrong

    • AChecking wires fits an alert patient, but an unresponsive patient needs CPR without delay.
    • CPrinting a tracing delays lifesaving care.
    • DVentricular fibrillation does not correct itself; every minute without CPR and defibrillation lowers survival.

  19. Question 19 of 25Hard

    A patient's tracing shows a sharp, narrow vertical line immediately before each QRS complex. The patient mentions having an implanted cardiac device. What do these lines most likely represent?

    1. A. AC interference from the EKG machine
    2. B. Premature ventricular contractions
    3. C. Muscle tremor from patient movement
    4. D. Pacemaker spikes from the device

    Show answer to question 19

    Answer: D. Pacemaker spikes from the device

    A pacemaker delivers a small electrical stimulus that appears as a sharp, narrow spike before the paced P wave or QRS complex. The medical assistant notes the pacemaker on the tracing so the provider can interpret it correctly.

    Why the other options are wrong

    • AAC interference produces many regular spikes throughout the baseline, not one before each QRS.
    • BPVCs are early, wide QRS complexes without a preceding spike.
    • CMuscle tremor produces irregular, jagged artifact, not a consistent single spike.

  20. Question 20 of 25Medium

    A medical assistant is placing chest electrodes on a woman with large breasts. How should electrodes that fall in the breast area, such as V4, be placed?

    1. A. Under the breast, at their usual landmarks
    2. B. On top of the breast tissue, over the nipple
    3. C. Higher on the chest, above all of the breast tissue
    4. D. Lower, on the abdomen below the ribs

    Show answer to question 20

    Answer: A. Under the breast, at their usual landmarks

    Chest electrodes are placed at their standard anatomical landmarks. When breast tissue covers a landmark, the breast is gently lifted, by the medical assistant or the patient, and the electrode is placed beneath it on the chest wall.

    Why the other options are wrong

    • BBreast tissue between the electrode and the chest wall weakens the signal and shifts the position.
    • CMoving electrodes higher than their landmarks changes the tracing.
    • DThe abdomen is below the correct positions and would distort the tracing.

  21. Question 21 of 25Medium

    On a regular rhythm strip, there are 4 large boxes between consecutive R waves. Using the 300 method, what is the heart rate?

    1. A. 75 beats per minute
    2. B. 60 beats per minute
    3. C. 100 beats per minute
    4. D. 40 beats per minute

    Show answer to question 21

    Answer: A. 75 beats per minute

    For regular rhythms, divide 300 by the number of large boxes between R waves. 300 divided by 4 equals 75 beats per minute.

    Why the other options are wrong

    • B60 beats per minute corresponds to 5 large boxes between R waves.
    • C100 beats per minute corresponds to 3 large boxes between R waves.
    • D40 beats per minute would require about 7.5 large boxes between R waves.

  22. Question 22 of 25Easy

    Which of the following rhythms is characterized on an EKG tracing by distinct, saw-toothed baseline waves known as flutter waves?

    1. A. Atrial flutter
    2. B. Ventricular tachycardia
    3. C. Atrial fibrillation
    4. D. Sinus arrhythmia

    Show answer to question 22

    Answer: A. Atrial flutter

    Atrial flutter produces characteristic saw-toothed flutter waves, designated as F waves, resulting from a rapid, organized reentry circuit in the atria. Atrial fibrillation generates chaotic, irregular fibrillatory waves rather than uniform saw-toothed waveforms.

  23. Question 23 of 25Easy

    To prevent internal wire breakage and extend the lifespan of EKG patient cables, how should the medical assistant handle and store them between uses?

    1. A. Pull firmly on the wire strands rather than the plug when disconnecting
    2. B. Fold the wires into sharp right angles and bind them with rubber bands
    3. C. Loop the cables loosely and hang them on the designated cart hook
    4. D. Coil the wires tightly around the handle of the EKG machine

    Show answer to question 23

    Answer: C. Loop the cables loosely and hang them on the designated cart hook

    Loosely looping patient cables and hanging them on a designated support arm or hook prevents kinks, bending stress, and fractures in the internal copper filaments. Tightly wrapping cords around equipment or creating sharp bends strains the wires and results in broken conductors and tracing artifact.

  24. Question 24 of 25Hard

    Which blood pressure reading represents an excessive hypertensive response that serves as a relative indication to terminate an exercise stress test?

    1. A. Systolic blood pressure of 190 mm Hg
    2. B. Diastolic blood pressure of 118 mm Hg
    3. C. Diastolic blood pressure of 90 mm Hg
    4. D. Systolic blood pressure of 170 mm Hg

    Show answer to question 24

    Answer: B. Diastolic blood pressure of 118 mm Hg

    According to standard clinical stress testing guidelines, an exaggerated hypertensive response consisting of a diastolic blood pressure greater than 115 mm Hg or a systolic blood pressure greater than 250 mm Hg is a relative indication to terminate the test. Systolic pressures between 160 and 200 mm Hg are typical physiological elevations during heavy exertion.

  25. Question 25 of 25Easy

    Where is the V1 electrode placed for a standard 12-lead EKG?

    1. A. Fourth intercostal space at the left sternal border
    2. B. Fifth intercostal space at the left midclavicular line
    3. C. Fourth intercostal space at the right sternal border
    4. D. Second intercostal space at the right sternal border

    Show answer to question 25

    Answer: C. Fourth intercostal space at the right sternal border

    V1 is placed in the fourth intercostal space just to the right of the sternum. V2 is placed in the same intercostal space just to the left of the sternum.

    Why the other options are wrong

    • AThe fourth intercostal space at the left sternal border is the location for V2.
    • BThe fifth intercostal space at the left midclavicular line is the location for V4.
    • DThe second intercostal space is too high and would distort the V1 tracing.

The full CCMA bank has 260 EKG and Cardiovascular Testing questions. See plans

EKG and Cardiovascular Testing is part of clinical patient care, one of the content areas NHA lists for the CCMA exam. Below are 25 original EKG and Cardiovascular Testing practice questions, each with the answer and an explanation.

Source: NHA CCMA test plan.

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Questions, answered

Are these actual CCMA questions?

No. They are original practice questions written from the public exam outline, not questions taken from the exam. Exam owners keep live questions confidential.

What does the CCMA exam cover?

Foundational knowledge and basic science, anatomy and physiology, clinical patient care, patient care coordination and education, administrative assistance, communication and customer service, and medical law and ethics. The NHA test plan has 180 questions, 150 of them scored, in 3 hours. Source: NHA CCMA test plan.

Is this CCMA EKG and Cardiovascular Testing practice test free?

Yes. The 25 questions on this page, with answers and explanations, are free to use, and there is no sign up. The full CCMA bank of 3,678 questions, with timed section tests and an AI tutor, comes with a plan.

How should I use this practice test?

Answer each question before you open Show answer, then read why the correct option is right and the others are not. Note the topics you miss and review them first. The CCMA study guide has 7 lessons for EKG and Cardiovascular Testing, listed on this page.

These are original practice questions written from the public exam outline. They are not actual exam questions. CCMA and NHA are trademarks of their owner. tests.global is not affiliated with or endorsed by NHA.

Updated November 1, 2026.