CCT Domain 2: Performing ECG Welcome to your CCT Domain 2: Performing ECG 1. CCT: Performing ECG What is the appropriate action if a patient experiences a vasovagal reaction during an ECG procedure? Continue the ECG as planned Elevate the patient's legs and monitor vital signs Immediately stop the ECG and sit the patient up Administer anti-arrhythmic medication as a precaution None 2. CCT: Performing ECG In ECG interpretation, what does a significantly elevated ST segment suggest? Myocardial infarction Atrial fibrillation Ventricular tachycardia Sinus bradycardia None 3. CCT: Performing ECG How should the skin be prepared before attaching ECG electrodes to ensure optimal signal quality? Apply a thick layer of gel on the skin Shave the area if it is hairy, then clean with alcohol Attach the electrodes over clothing for patient comfort Use adhesive tape to secure the electrodes if the patient sweats None 4. CCT: Performing ECG During a 12-lead ECG, where should the V4 electrode be placed? In the fifth intercostal space, midclavicular line In the second intercostal space, right sternal border At the fourth intercostal space, right sternal border On the left anterior axillary line, fifth intercostal space None 5. CCT: Performing ECG What is the significance of ensuring that the ground electrode is properly attached during an ECG recording? It helps in amplifying the heart's electrical signals It reduces the risk of electric shock to the patient It minimizes interference and enhances signal clarity It increases the speed of the ECG recording process None 6. CCT: Performing ECG When performing a 12-lead ECG, what is the impact of incorrectly placing the limb leads? It will invert the PQRST complexes throughout the ECG It may simulate pathological conditions, leading to misdiagnosis It will cancel out the heart's electrical activity, resulting in a flat line It will double the amplitude of the electrical signals recorded None 7. CCT: Performing ECG What is the most appropriate course of action if the ECG machine starts to display a flat line during a test? Immediately perform CPR on the patient Check the patient's pulse and respiration Assume there is an error with the ECG machine or electrodes Increase the gain on the ECG machine None 8. CCT: Performing ECG When analyzing an ECG, what does a prolonged QT interval indicate? Hyperkalemia Risk of ventricular arrhythmias Digitalis effect Atrial enlargement None 9. CCT: Performing ECG What adjustment should be made when the ECG trace shows small and low voltage QRS complexes throughout the leads? Decrease the paper speed Increase the gain or amplitude setting Switch the lead cables Re-calibrate the ECG machine None 10. CCT: Performing ECG In the context of ECG, what does the term 'electrical axis' refer to? The total duration of the ventricular depolarization process The primary direction of the heart's electrical activity The voltage difference between the limb leads The speed of the heart's electrical impulses None 11. CCT: Performing ECG Why is it crucial to inform the patient to remain still and avoid talking during an ECG recording? It prevents the machine from overheating It reduces the risk of electrode detachment It ensures the patient's comfort and relaxation It minimizes motion artifacts on the ECG trace None 12. CCT: Performing ECG What is the primary concern when an ECG shows a 'tombstone' appearance in the ST segment? Hypercalcemia Acute myocardial infarction Pericarditis Ventricular hypertrophy None 13. CCT: Performing ECG Which lead placement is recommended to best capture the electrical activity of the lateral wall of the left ventricle? Leads V5 and V6 Leads II, III, and aVF Leads V1 and V2 Leads I and aVL None 14. CCT: Performing ECG In ECG, what does a sawtooth pattern in the inferior leads typically indicate? Atrial flutter Ventricular fibrillation Atrial fibrillation Right bundle branch block None 15. CCT: Performing ECG What should be the initial step if an ECG lead consistently shows no electrical activity? Administer anti-arrhythmic medication Replace the ECG machine Check and re-secure the electrode connection Increase the paper speed None 16. CCT: Performing ECG When performing a pediatric ECG, why is it important to adjust the electrode size and placement? To enhance the electrical conductivity To prevent skin irritation To accommodate the smaller body size To increase the ECG recording speed None 17. CCT: Performing ECG How can you differentiate between ventricular tachycardia and supraventricular tachycardia with aberrant conduction on an ECG? Ventricular tachycardia will have a narrower QRS complex Supraventricular tachycardia will show a 'sawtooth' pattern Ventricular tachycardia typically presents with a wide QRS complex Supraventricular tachycardia always presents with a P wave before each QRS None 18. CCT: Performing ECG What is the implication of an inverted U wave on an ECG? Hypokalemia Hyperkalemia Hypocalcemia Myocardial ischemia None 19. CCT: Performing ECG During an ECG, why is it crucial to avoid electrode placement over bony prominences? To prevent discomfort or pain to the patient To reduce impedance and improve signal quality To avoid misinterpretation of the heart's electrical axis To prevent movement of the electrodes during the recording None 20. CCT: Performing ECG What does a consistent PR interval prolongation indicate on an ECG? First-degree atrioventricular block Second-degree atrioventricular block Third-degree atrioventricular block Atrial fibrillation None 21. CCT: Performing ECG Why is it essential to ensure the patient's limbs are not crossed during an ECG recording? It can lead to an inaccurate heart rate calculation It may introduce additional electrical interference It can alter the limb lead measurements and axis interpretation It increases the risk of electrode detachment None 22. CCT: Performing ECG What is the best course of action if an ECG recording exhibits intermittent interruptions in the tracing? Adjust the machine's filter settings Check for loose or faulty electrode connections Increase the gain setting Decrease the paper speed None 23. CCT: Performing ECG In which scenario would you use a right-sided ECG lead placement? Suspected left ventricular hypertrophy Evaluation of a right ventricular infarction Monitoring for atrial fibrillation Assessment of the QT interval None 24. CCT: Performing ECG What is the implication of a delta wave observed on an ECG? Ventricular fibrillation Wolff-Parkinson-White syndrome Atrial flutter First-degree heart block None 25. CCT: Performing ECG When observing a prolonged PR interval that suddenly drops a QRS complex, what condition should be suspected? First-degree AV block Second-degree AV block, Mobitz type I Second-degree AV block, Mobitz type II Third-degree AV block None 26. CCT: Performing ECG What does a bifid P wave on an ECG typically indicate? Left atrial enlargement Right atrial enlargement Ventricular hypertrophy Myocardial ischemia None 27. CCT: Performing ECG In the context of ECG, what does electrical alternans primarily suggest? Pericardial effusion Myocardial infarction Hyperkalemia Ventricular hypertrophy None 28. CCT: Performing ECG How should the electrode be placed to monitor the posterior wall of the heart? On the left scapular area In the standard V1 and V2 positions In the V7 to V9 positions along the left posterior axillary line On the right chest area None 29. CCT: Performing ECG What does the presence of Q waves in leads V1 to V3 suggest on an ECG? Left ventricular hypertrophy Anteroseptal myocardial infarction Lateral myocardial infarction Right ventricular overload None 30. CCT: Performing ECG What is the clinical significance of observing tall R waves in lead V1 on an ECG? Right ventricular hypertrophy Left ventricular hypertrophy Posterior myocardial infarction Anterior myocardial infarction None 31. CCT: Performing ECG How is the heart's axis determined on an ECG? By the amplitude of the P wave By the direction of the QRS complex in the limb leads By the duration of the QT interval By the polarity of the T wave None 32. CCT: Performing ECG What does a notched R wave in leads V5 and V6 suggest on an ECG? Right bundle branch block Left bundle branch block Atrial fibrillation Ventricular tachycardia None 33. CCT: Performing ECG In which condition is an ECG most likely to show ST-segment elevation in all leads? Acute pericarditis Pulmonary embolism Acute myocardial infarction Hyperkalemia None 34. CCT: Performing ECG When assessing an ECG, what does a monophasic R wave progression in the precordial leads suggest? Normal variant Anterior myocardial infarction Ventricular aneurysm Electrode misplacement None 35. CCT: Performing ECG What is the clinical significance of an ECG showing Osborn waves (J waves)? Hypothermia or hypercalcemia Myocardial ischemia Ventricular fibrillation Hyperkalemia None 36. CCT: Performing ECG In the context of an ECG, what does the presence of peaked T waves indicate? Hypocalcemia Hyperkalemia Hypokalemia Hypercalcemia None 37. CCT: Performing ECG What is indicated by a PR interval shorter than 120 ms on an ECG? Accelerated AV nodal conduction AV block Myocardial ischemia Atrial enlargement None 38. CCT: Performing ECG How should you interpret a regular rhythm with a rate of 250 beats per minute and wide QRS complexes on an ECG? Atrial flutter with rapid ventricular response Ventricular tachycardia Supraventricular tachycardia with aberrancy Sinus tachycardia None 39. CCT: Performing ECG When interpreting an ECG, what does a biphasic P wave in lead V1 suggest? Left atrial enlargement Right atrial enlargement Atrial septal defect Mitral valve prolapse None 40. CCT: Performing ECG In the setting of an ECG, what does a QR pattern in the precordial leads typically indicate? Normal ventricular depolarization Prior anteroseptal myocardial infarction Left ventricular hypertrophy Right ventricular overload None 1 out of 40 Time is Up! Time's up
