EKG Safety, Compliance and Patient Care Practice Test

25 practice questions

Choose an answer, then check it under Show answer.

1. Question 1 of 25Medium

   What should an EKG technician do when the hospital's EHR is unavailable during planned maintenance and a routine EKG is due?

   1. AA. Cancel the EKG until the system is working again
   2. BB. Record the EKG and keep the results in a personal notebook
   3. CC. Record the EKG but leave it undocumented to avoid confusion
   4. DD. Use downtime procedures and enter the data when it is back
   Show answer to question 1

   Answer: D. Use downtime procedures and enter the data when it is back

   Downtime procedures, such as paper forms and printed tracings, let care continue safely, and the information is entered or uploaded once the system is restored.

   Why the other options are wrong

   • AOrdered care continues during downtime using the facility's backup process.
   • BPersonal notebooks are not part of the medical record and put patient information at risk.
   • CEvery test performed must be documented, even during downtime.

2. Question 2 of 25Easy

   A technician has placed the first AED pad on an adult's bare upper right chest, just below the collarbone. Where does the second pad go in the standard anterolateral position?

   1. AA. Directly beside the first pad on the upper right chest
   2. BB. On the upper abdomen, just above the navel
   3. CC. On the left side of the chest below the armpit
   4. DD. On top of the left shoulder, over the joint
   Show answer to question 2

   Answer: C. On the left side of the chest below the armpit

   In the anterolateral position, one pad goes on the upper right chest below the collarbone and the other on the left side of the chest a few inches below the armpit, so the shock passes through the heart.

   Why the other options are wrong

   • APads placed side by side let the current pass between them without crossing the heart.
   • BA pad on the abdomen does not place the heart between the two pads.
   • DA pad on the shoulder does not direct the shock through the heart.

3. Question 3 of 25Medium

   A technician finds a 55-year-old woman unresponsive on the floor of a clinic waiting room. Help has been called and an AED is on the way. During a 10-second check, she makes occasional gasping sounds and no pulse is felt. What should the technician do?

   1. AA. Treat the gasps as breathing and place her on her side.
   2. BB. Wait for the gasping to stop before starting CPR.
   3. CC. Give rescue breaths only, about one every 6 seconds.
   4. DD. Start CPR, beginning with chest compressions.
   Show answer to question 3

   Answer: D. Start CPR, beginning with chest compressions.

   Occasional gasps (agonal breathing) are not normal breathing. An unresponsive person with only gasping and no pulse is in cardiac arrest, so CPR begins at once, starting with compressions.

   Why the other options are wrong

   • AThe recovery position is for a person who is breathing normally and has a pulse, not for agonal gasping.
   • BWaiting for the gasps to stop delays CPR while the brain and heart receive no blood flow.
   • CRescue breathing alone is for a person who has a pulse; without a pulse, compressions are needed.

4. Question 4 of 25Medium

   Performing EKGs in order of clinical need and giving every patient the same quality of care, regardless of insurance status, reflects which ethical principle?

   1. AA. Autonomy
   2. BB. Fidelity
   3. CC. Justice
   4. DD. Veracity
   Show answer to question 4

   Answer: C. Justice

   Justice means treating patients fairly and distributing care according to need, not according to factors such as insurance or ability to pay.

   Why the other options are wrong

   • AAutonomy is respect for a patient's right to make decisions about his or her own care.
   • BFidelity is faithfulness to promises and professional duties.
   • DVeracity is truthfulness in communication with patients and colleagues.

5. Question 5 of 25Medium

   During a busy morning in an outpatient stress lab, a technician finishes a treadmill test and the next patient is already waiting. What should she do with the equipment before the next test?

   1. AA. Reuse the first patient's electrodes on the next one if they still stick
   2. BB. Discard the used electrodes and disinfect the handrails, cuff and leads
   3. CC. Wipe only the handrails, since the lead wires touched only clean skin
   4. DD. Disinfect all equipment once at lunch, when the schedule allows it
   Show answer to question 5

   Answer: B. Discard the used electrodes and disinfect the handrails, cuff and leads

   Electrodes are single-use items and are discarded after each patient. Reusable items that touched the patient or were handled during the test, such as the treadmill handrails, blood pressure cuff and lead wires, are disinfected between patients.

   Why the other options are wrong

   • ASingle-use electrodes can carry skin organisms and lose adhesion, so reusing them risks cross-contamination and a poor tracing.
   • CLead wires touch the patient's skin and are handled often, so they need disinfection between patients like other contact surfaces.
   • DWaiting until lunch exposes the next patients to contaminated equipment; disinfection is required between every patient.

6. Question 6 of 25Easy

   Which description of a Holter monitor should an EKG technician give a patient?

   1. AA. It records only when you press a button because you feel symptoms.
   2. BB. It records your heart rhythm continuously, usually for 24 to 48 hours.
   3. CC. It is placed under your skin and records your rhythm for several years.
   4. DD. It records for about ten seconds while you lie very still in the office.
   Show answer to question 6

   Answer: B. It records your heart rhythm continuously, usually for 24 to 48 hours.

   A Holter monitor is a portable recorder connected to chest electrodes that records every heartbeat continuously, usually for 24 to 48 hours, while the patient keeps a diary.

   Why the other options are wrong

   • ARecording mainly when the patient presses a button describes a patient-activated event monitor.
   • CA device under the skin that records for years is an implantable loop recorder.
   • DA brief recording while lying still in the office describes a resting 12-lead EKG.

7. Question 7 of 25Medium

   Before using teach-back, a technician says, "I want to make sure I explained this clearly." Why is this phrasing recommended?

   1. AA. It puts the focus on the teaching, so the patient does not feel tested.
   2. BB. It is the exact wording that HIPAA requires before patient teaching.
   3. CC. It allows the technician to skip explaining the activity diary later.
   4. DD. It tells the patient that the answers will be graded for the record.
   Show answer to question 7

   Answer: A. It puts the focus on the teaching, so the patient does not feel tested.

   Teach-back checks how well the instructions were taught, not the patient's intelligence. Framing it this way lowers embarrassment and makes patients more willing to reveal confusion.

   Why the other options are wrong

   • BHIPAA protects health information; it does not set wording for patient teaching.
   • CTeach-back confirms understanding of the instructions; it never replaces teaching any of them.
   • DTeach-back is not a graded test, and implying that it is increases anxiety.

8. Question 8 of 25Medium

   At a physician office, vital signs are part of a 64-year-old woman's visit for a routine EKG, and the EHR offers to copy forward her values from last month. What should the technician do?

   1. AA. Accept the copied values, since her readings are usually stable
   2. BB. Measure her vital signs today and enter the new readings
   3. CC. Copy the values forward and add a note saying they are old
   4. DD. Leave the vital sign fields blank, since the EKG is routine
   Show answer to question 8

   Answer: B. Measure her vital signs today and enter the new readings

   The record must show what was actually measured at this visit, so the technician takes today's vital signs and enters them instead of reusing old values.

   Why the other options are wrong

   • ACopied values are not today's readings, and entering them misrepresents her current condition.
   • COld values, even when labeled, do not show the provider how she is today.
   • DA routine EKG does not remove the need to measure and document the vital signs that are part of the visit.

9. Question 9 of 25Medium

   A 38-year-old woman being fitted with a Holter monitor at an outpatient clinic says she will stay home and rest so she does not ruin the recording. What is the best response?

   1. AA. Resting is best, because any movement makes Holter recordings unusable.
   2. BB. Do your usual daily activities so the recording reflects a typical day.
   3. CC. Do hard exercise all day so that any symptoms are sure to appear.
   4. DD. Stay in bed except for bathroom trips until the monitor comes off.
   Show answer to question 9

   Answer: B. Do your usual daily activities so the recording reflects a typical day.

   A Holter recording is meant to show the heart during the patient's normal routine, including activities that usually bring on symptoms unless the provider has said otherwise, so she should keep to a typical day and log it.

   Why the other options are wrong

   • ANormal movement is expected; the recorder is designed for everyday activity.
   • CUnusually hard exercise is not the instruction and may be unsafe; she should follow her usual routine.
   • DStaying in bed would not show how her heart behaves during a typical day.

10. Question 10 of 25Medium

    A week into her event monitoring, a 27-year-old woman calls the cardiology clinic. She did not record two brief episodes of fluttering in her chest because they felt mild and she was not sure they mattered. Which instruction should the technician give?

    1. AA. Record only episodes that last at least several minutes
    2. BB. Record only strong symptoms so the device's memory is saved
    3. CC. Describe mild episodes at her next visit instead of recording
    4. DD. Record every episode as it happens, even a mild, brief one
    Show answer to question 10

    Answer: D. Record every episode as it happens, even a mild, brief one

    An event monitor is used to match symptoms with the heart rhythm at that moment, so every episode is recorded when it happens, even a mild or brief one. A recording that shows a normal rhythm during symptoms is useful to the provider too.

    Why the other options are wrong

    • ABrief episodes are often the very ones the monitor is meant to capture, so waiting for long ones can miss them.
    • BMild symptoms can still come with important rhythm changes, so they are recorded too.
    • CA later description cannot show what her heart rhythm was during the episode.

11. Question 11 of 25Easy

    At a physician office, a 52-year-old man is fitted with a small monitor that attaches directly to his upper left chest. It has no lead wires or separate recorder, and it records his heart rhythm continuously for the 14 days he wears it. Which type of monitor is this?

    1. AA. A standard Holter monitor
    2. BB. An adhesive patch monitor
    3. CC. A post-event recorder
    4. DD. A wearable defibrillator vest
    Show answer to question 11

    Answer: B. An adhesive patch monitor

    An adhesive patch monitor is a single wire-free unit worn on the chest that records the rhythm continuously for days to weeks. When the wear period ends, it is removed and returned, often by mail, and the stored recording is analyzed for the provider.

    Why the other options are wrong

    • AA standard Holter monitor uses lead wires that connect the chest electrodes to a separate recorder.
    • CA post-event recorder is applied only after symptoms begin, so it does not record continuously.
    • DA wearable defibrillator is a vest that watches the rhythm and can deliver a shock, not a small recorder on the chest.

12. Question 12 of 25Medium

    When teaching a patient to keep a Holter diary, which instruction is accurate?

    1. AA. Leave the diary blank unless you faint or develop severe chest pain.
    2. BB. Fill in the whole diary from memory after you return the recorder.
    3. CC. Write down your activities and their times, even when you feel fine.
    4. DD. Record symptoms only, because the times of activities are not needed.
    Show answer to question 12

    Answer: C. Write down your activities and their times, even when you feel fine.

    The diary links what the patient was doing, and any symptoms, to exact times on the recording. Activity entries help the provider interpret rhythm changes even when no symptoms occurred.

    Why the other options are wrong

    • AWaiting for severe symptoms leaves out the everyday activities and milder symptoms the provider needs.
    • BEntries made later from memory are often inaccurate; they should be written as events happen.
    • DActivity times are needed to interpret changes in heart rate and rhythm.

13. Question 13 of 25Medium

    A 5-month-old infant is seen in a pediatric cardiology clinic, and the provider asks for the infant's heart rate before the EKG. Which method is preferred?

    1. AA. Palpate the radial pulse for 15 seconds and multiply by 4.
    2. BB. Palpate the carotid pulse for 30 seconds and multiply by 2.
    3. CC. Auscultate the apical pulse for a full 60 seconds.
    4. DD. Read the rate from a pulse oximeter after about 5 seconds.
    Show answer to question 13

    Answer: C. Auscultate the apical pulse for a full 60 seconds.

    In infants the peripheral pulses are small and the rate varies, so the apical pulse is auscultated with a stethoscope over the chest for a full 60 seconds.

    Why the other options are wrong

    • AAn infant's radial pulse is hard to feel, and a 15-second count is too short for an accurate rate.
    • BThe carotid pulse is hard to locate on an infant's short neck and is not used for routine counts.
    • DA brief oximeter reading is easily distorted by movement and does not replace a full-minute apical count.

14. Question 14 of 25Easy

    Which description of chest pain is most typical of a heart attack?

    1. AA. Sharp pain that worsens when pressing on one rib
    2. BB. Brief stabbing pain that lasts for only a second or two
    3. CC. Burning pain on the skin with a blistering rash
    4. DD. Pressure or squeezing that spreads to the arm or jaw
    Show answer to question 14

    Answer: D. Pressure or squeezing that spreads to the arm or jaw

    Heart attack pain is typically a pressure, squeezing or heaviness in the chest that may spread to the arm, jaw, neck or back, often with sweating, nausea or shortness of breath.

    Why the other options are wrong

    • APain reproduced by pressing on a rib is more typical of a chest wall problem than of a heart attack.
    • BPain lasting only a second or two is not typical of cardiac ischemia.
    • CBurning skin pain with a blistering rash suggests shingles rather than a heart attack.

15. Question 15 of 25Medium

    How should a technician document information that was left out of a patient's electronic record earlier in the shift?

    1. AA. Change the time stamp so the note appears at the original time
    2. BB. Leave it out once the related tracing has already been uploaded
    3. CC. Add it as a late entry, dated now, that states when it occurred
    4. DD. Write it on the paper copy only, so the record stays unchanged
    Show answer to question 15

    Answer: C. Add it as a late entry, dated now, that states when it occurred

    A late entry is clearly labeled, carries the date and time it is actually written and states when the event happened, which keeps the record accurate and honest.

    Why the other options are wrong

    • ABackdating an entry misrepresents when it was written and is improper.
    • BRelevant information must still be documented even after a tracing is uploaded.
    • DA note on a paper copy may never reach the patient's permanent record.

16. Question 16 of 25Hard

    At an urgent care center, a STAT 12-lead EKG on a 60-year-old man with chest pain will not transmit to the electronic record because of a network error. What should the technician do first?

    1. AA. Print the tracing and hand it directly to the provider
    2. BB. Keep retrying the upload until it succeeds, then notify
    3. CC. Delete the tracing and repeat it once the network works
    4. DD. Leave it in the machine and report the problem at shift end
    Show answer to question 16

    Answer: A. Print the tracing and hand it directly to the provider

    A STAT tracing must reach the provider without delay, so the technician uses the backup of a printed copy delivered in person, then reports the network problem and completes the upload as policy directs.

    Why the other options are wrong

    • BRepeated attempts can waste critical minutes while the provider waits.
    • CDeleting a valid tracing loses data and delays care for a patient with chest pain.
    • DWaiting until the end of the shift could delay emergency treatment.

17. Question 17 of 25Easy

    On an inpatient unit, which team member is usually responsible for ongoing assessment of the patient and giving the medications the provider orders?

    1. AA. The EKG technician
    2. BB. The cardiologist
    3. CC. The registered nurse
    4. DD. The unit secretary
    Show answer to question 17

    Answer: C. The registered nurse

    The registered nurse assesses the patient throughout the shift, gives ordered medications and coordinates daily care, so the technician reports patient concerns to the nurse.

    Why the other options are wrong

    • AThe technician performs cardiac tests and reports findings but does not give medications or perform ongoing assessment.
    • BThe cardiologist diagnoses and orders treatment but does not usually give routine medications at the bedside.
    • DThe unit secretary handles phones, records and clerical tasks, not hands-on patient care.

18. Question 18 of 25Easy

    Which behavior by a certified EKG technician reflects the honesty expected under professional codes of ethics, such as the NHA Code of Ethics?

    1. AA. Representing credentials and training accurately to patients and staff
    2. BB. Telling an anxious patient that the technician is a nurse to calm him
    3. CC. Listing a certification on a resume before actually passing the exam
    4. DD. Signing a coworker's initials on a log that the coworker forgot to sign
    Show answer to question 18

    Answer: A. Representing credentials and training accurately to patients and staff

    Ethical practice requires honesty in all professional interactions, including representing one's title, credentials and training accurately. Patients and coworkers rely on that information to know who is caring for them.

    Why the other options are wrong

    • BClaiming to be a nurse misrepresents the technician's credentials, even when the intent is to comfort the patient.
    • CListing a credential before earning it is misrepresentation and can lead to disciplinary action.
    • DSigning another person's initials falsifies a record, no matter how minor the task seems.

19. Question 19 of 25Easy

    What is the main purpose of using SBAR when an EKG technician reports a concern to a nurse or provider?

    1. AA. To give key information in a clear and predictable order
    2. BB. To document the patient's consent before the test begins
    3. CC. To replace written documentation in the health record
    4. DD. To record the billing codes for the test that was done
    Show answer to question 19

    Answer: A. To give key information in a clear and predictable order

    SBAR (Situation, Background, Assessment, Recommendation) organizes a report so the listener gets the essential facts quickly and in an expected order, which reduces miscommunication.

    Why the other options are wrong

    • BConsent is a separate process and is not what SBAR is designed for.
    • CA verbal SBAR report supplements documentation; it does not replace it.
    • DBilling codes are handled in the record and billing system, not in a verbal report.

20. Question 20 of 25Hard

    A technician is giving chest compressions to an unresponsive woman on a hospital outpatient unit when a coworker arrives with the AED. What should happen next?

    1. AA. Both rescuers stop CPR and wait for the code team to apply the AED.
    2. BB. The coworker turns on the AED and applies the pads while compressions continue.
    3. CC. The technician stops compressions so the coworker can check a pulse for a minute.
    4. DD. The coworker waits until 5 cycles are complete before opening the AED.
    Show answer to question 20

    Answer: B. The coworker turns on the AED and applies the pads while compressions continue.

    The AED is used as soon as it is available. The second rescuer turns it on and attaches the pads while the first keeps doing compressions, pausing only when the AED analyzes the rhythm.

    Why the other options are wrong

    • AStopping CPR to wait for the team leaves the patient without blood flow or defibrillation.
    • CA pulse check takes no more than 10 seconds, and stopping compressions for a minute is harmful.
    • DDelaying the AED until 5 cycles are done postpones a shock that may save her life.

21. Question 21 of 25Hard

    A 52-year-old man with chest pain in the emergency department is trembling and asks the technician, 'Am I having a heart attack?' as she attaches the leads. Which response is best?

    1. AA. Try to relax. Your rhythm looks normal on the screen, so it's probably fine.
    2. BB. You look too young and healthy for a heart attack, so please don't worry.
    3. CC. I'm not allowed to talk about that, so please stay quiet while I work.
    4. DD. I can see you're worried. A provider will review this tracing right away.
    Show answer to question 21

    Answer: D. I can see you're worried. A provider will review this tracing right away.

    Acknowledging his fear and saying what happens next gives honest support without interpreting the tracing, which is the provider's role.

    Why the other options are wrong

    • ACommenting on the rhythm is interpretation outside the technician's role and may give false reassurance.
    • BAge and appearance do not rule out a heart attack, so this is false reassurance.
    • CShutting down the question ignores his fear, and anxious muscle tension can also cause artifact.

22. Question 22 of 25Hard

    A technician records an unusual EKG on a patient in the emergency department. She wants to post it in an online study group for EKG students after covering the patient's name. What is the most appropriate action?

    1. AA. Do not post it; teaching use must follow facility policy
    2. BB. Post it, since covering the name removes every privacy concern
    3. CC. Post it only in a private group limited to health care students
    4. DD. Post it after the patient gives verbal permission in the hallway
    Show answer to question 22

    Answer: A. Do not post it; teaching use must follow facility policy

    A tracing can carry other identifiers, such as dates, times, age and facility details, and the patient has not given written authorization. Teaching use of real tracings goes through facility policy, which ensures proper de-identification or authorization.

    Why the other options are wrong

    • BOther details on a tracing, such as the date, time, age or location, can still identify the patient.
    • CA private group is still a disclosure outside the facility, and limiting membership does not make it authorized.
    • DVerbal permission in a hallway is not a valid HIPAA authorization, which must be written and signed.

23. Question 23 of 25Hard

    A 52-year-old man choking on food in a hospital cafeteria cannot speak or cough, then becomes unresponsive. The technician lowers him to the floor and calls for help. What should the technician do next?

    1. AA. Begin CPR, looking in the mouth before giving breaths.
    2. BB. Do repeated blind finger sweeps until the food is found.
    3. CC. Keep giving abdominal thrusts with him lying on the floor.
    4. DD. Wait for the response team before doing anything else.
    Show answer to question 23

    Answer: A. Begin CPR, looking in the mouth before giving breaths.

    When a choking person becomes unresponsive, the rescuer starts CPR, beginning with compressions. Each time the airway is opened for breaths, the rescuer looks in the mouth and removes an object only if it can be seen.

    Why the other options are wrong

    • BBlind finger sweeps can push the object deeper and are not recommended.
    • CFor an unresponsive person, chest compressions replace abdominal thrusts and can also help move the object.
    • DWaiting without starting CPR wastes time while the brain is without oxygen.

24. Question 24 of 25Hard

    At an outpatient testing center, the order for a 57-year-old woman is for a 12-lead EKG, but she says her doctor told her she would wear a heart monitor for two days. What should the technician do?

    1. AA. Perform both tests so nothing the doctor wanted is missed
    2. BB. Apply a Holter monitor, since her account is more recent
    3. CC. Do the 12-lead and tell her the doctor must have changed plans
    4. DD. Contact the ordering provider's office to clarify before testing
    Show answer to question 24

    Answer: D. Contact the ordering provider's office to clarify before testing

    The technician performs only the test that is ordered. When the order and the patient's understanding differ, the ordering provider's office is contacted to confirm the correct test before proceeding.

    Why the other options are wrong

    • ATests may not be performed without a valid order.
    • BA patient's report cannot replace a provider's order for a different test.
    • CGuessing about the provider's intent could mean she misses the test she actually needs.

25. Question 25 of 25Hard

    On a telemetry unit, a technician is replacing the monitoring electrodes of a 70-year-old man when he asks her to take the monitor off so he can shower. What should the technician do?

    1. AA. Remove the monitor, since showering is part of his normal daily care
    2. BB. Check with his nurse, who decides whether monitoring can pause
    3. CC. Silence the central station alarms for his room until he returns
    4. DD. Tell him the monitor can never be removed for any reason at all
    Show answer to question 25

    Answer: B. Check with his nurse, who decides whether monitoring can pause

    Telemetry is ordered monitoring, so the decision to interrupt it belongs to the nurse or provider, following the order and unit protocol. The technician passes the request to the nurse rather than deciding on her own.

    Why the other options are wrong

    • ARemoving ordered monitoring is a clinical decision; doing it on her own could leave a dangerous rhythm undetected.
    • CSilencing alarms for a patient who is off the monitor creates a serious safety risk and is not the technician's decision.
    • DMonitoring can sometimes be paused when the nurse or provider allows it, so an absolute refusal is inaccurate.

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