EKG certification Certification EKG Stress Testing & Holter Monitoring 2 — Questions and Answers
Question 1: During a cardiac stress test, what is the primary reason for monitoring the ST segment on the EKG?
- To detect exercise-induced myocardial ischemia (Correct answer)
- To measure heart rate recovery time
- To evaluate atrial flutter patterns
- To assess QT interval prolongation
Correct answer: To detect exercise-induced myocardial ischemia
ST segment depression during exercise is the hallmark EKG finding that indicates myocardial ischemia due to inadequate coronary blood flow.
Question 2: A patient wearing a Holter monitor reports feeling palpitations at 3:15 PM but the diary entry is missing. What feature of the Holter system helps correlate symptoms?
- The event marker button pressed by the patient (Correct answer)
- Automatic blood pressure readings
- Built-in pulse oximetry
- Physician remote access alerts
Correct answer: The event marker button pressed by the patient
The event marker button allows patients to flag the exact time they experience symptoms, enabling correlation with the recorded rhythm strip.
Question 3: What is the target heart rate formula most commonly used to determine adequate stress during an exercise stress test?
- 220 minus the patient's age (Correct answer)
- 200 minus the patient's age
- 180 minus the patient's resting heart rate
- 250 minus half the patient's age
Correct answer: 220 minus the patient's age
The age-predicted maximum heart rate is calculated as 220 minus age, and the target is typically 85% of this value for a diagnostic test.
Question 4: Which of the following is an absolute contraindication to performing an exercise stress test?
- Acute myocardial infarction within the past 2 days (Correct answer)
- Controlled hypertension on medication
- Stable angina with known single-vessel disease
- Left bundle branch block on resting EKG
Correct answer: Acute myocardial infarction within the past 2 days
Acute MI within 2 days is an absolute contraindication because exercise could extend the infarct zone and cause life-threatening arrhythmias.
Question 5: A Holter monitor recording reveals frequent premature ventricular complexes (PVCs) occurring in a pattern of one PVC every third beat. What is this pattern called?
- Trigeminy (Correct answer)
- Bigeminy
- Couplets
- Ventricular tachycardia
Correct answer: Trigeminy
Trigeminy is the pattern where a PVC occurs every third beat, following two normal sinus beats in a repetitive cycle.
Question 6: During a pharmacologic stress test using adenosine, which side effect should the EKG technician expect and prepare for?
- Transient chest tightness and flushing (Correct answer)
- Sustained ventricular tachycardia
- Permanent AV block
- Acute hypertensive crisis
Correct answer: Transient chest tightness and flushing
Adenosine commonly causes transient chest tightness, flushing, and brief AV conduction delays that resolve quickly due to its ultra-short half-life.
EKG certification Certification EKG Stress Testing & Holter Monitoring 2
During a cardiac stress test, what is the primary reason for monitoring the ST segment on the EKG?