CAMC EKG TECHNICIAN CERTIFICATION
EXAM ACTUAL QUESTIONS AND ANSWERS -
LATEST AND COMPLETE UPDATE WITH
VERIFIED SOLUTIONS – ASSURED PASS WITH
ISTANT DOWNLOAD PDF.
1. The primary pacemaker of the heart under normal physiologic conditions is
the:
A. Atrioventricular (AV) node
B. Sinoatrial (SA) node
C. Bundle of His
D. Purkinje fibers
Rationale: The SA node has the highest intrinsic firing rate (60–100 bpm)
and therefore normally sets the heart rate.
2. A normal PR interval on a standard 12-lead ECG represents:
A. Ventricular depolarization time
B. Atrial depolarization through AV nodal conduction
C. Ventricular repolarization
D. Time from ventricular depolarization to repolarization
Rationale: The PR interval reflects conduction from the atria through the
AV node to the ventricles.
3. Which electrolyte imbalance is most commonly associated with peaked T
waves?
A. Hypokalemia
B. Hyperkalemia
C. Hypocalcemia
D. Hypernatremia
, Rationale: Elevated serum potassium levels accelerate repolarization,
producing tall, peaked T waves.
4. A patient presents with an ECG showing absent P waves, irregularly
irregular rhythm, and narrow QRS complexes. This rhythm is most
consistent with:
A. Atrial flutter
B. Atrial fibrillation
C. Ventricular tachycardia
D. Sinus arrhythmia
Rationale: Atrial fibrillation lacks organized atrial activity and produces
an irregular ventricular response.
5. The correct paper speed for standard ECG recording in adults is:
A. 10 mm/sec
B. 25 mm/sec
C. 50 mm/sec
D. 100 mm/sec
Rationale: Standard ECGs are recorded at 25 mm/sec unless otherwise
specified.
6. Which lead is best used to continuously monitor cardiac rhythm in most
clinical settings?
A. Lead I
B. Lead II
C. Lead V1
D. Lead aVL
Rationale: Lead II aligns with the heart’s electrical axis and best
visualizes P waves and rhythm.
,7. A QRS duration greater than 0.12 seconds suggests:
A. Normal ventricular conduction
B. Ventricular conduction delay
C. Atrial enlargement
D. Sinus tachycardia
Rationale: Wide QRS complexes indicate delayed ventricular
depolarization, such as bundle branch block.
8. When placing precordial lead V1, the electrode should be positioned:
A. Fourth intercostal space, left sternal border
B. Fourth intercostal space, right sternal border
C. Fifth intercostal space, midclavicular line
D. Fifth intercostal space, anterior axillary line
Rationale: V1 is placed at the fourth intercostal space to the right of the
sternum.
9. Which rhythm is characterized by a ventricular rate of 20–40 bpm and wide
QRS complexes?
A. Sinus bradycardia
B. Junctional rhythm
C. Idioventricular rhythm
D. Atrial flutter
Rationale: Idioventricular rhythms originate in the ventricles and have
slow rates with wide QRS.
10.ST-segment elevation in contiguous leads most strongly indicates:
A. Pericarditis
B. Acute myocardial infarction
C. Electrolyte imbalance
D. Left ventricular hypertrophy
, Rationale: Localized ST elevation reflects acute transmural myocardial
injury.
11.A first-degree AV block is defined by:
A. Dropped QRS complexes
B. Progressive PR lengthening
C. PR interval >0.20 seconds with 1:1 conduction
D. Complete AV dissociation
Rationale: First-degree AV block is a delay, not a block, in AV
conduction.
12.Which artifact is most commonly caused by patient movement or muscle
tension?
A. AC interference
B. Somatic tremor
C. Wandering baseline
D. 60-cycle interference
Rationale: Muscle activity produces irregular, rapid deflections known as
somatic tremor.
13.The electrical axis of the heart normally falls within:
A. −90° to −30°
B. −30° to +90°
C. +90° to +180°
D. −180° to −90°
Rationale: Normal adult QRS axis lies between −30° and +90°.
14.Which condition most commonly causes right bundle branch block?
A. Inferior MI
B. Hyperkalemia
C. Pulmonary embolism
EXAM ACTUAL QUESTIONS AND ANSWERS -
LATEST AND COMPLETE UPDATE WITH
VERIFIED SOLUTIONS – ASSURED PASS WITH
ISTANT DOWNLOAD PDF.
1. The primary pacemaker of the heart under normal physiologic conditions is
the:
A. Atrioventricular (AV) node
B. Sinoatrial (SA) node
C. Bundle of His
D. Purkinje fibers
Rationale: The SA node has the highest intrinsic firing rate (60–100 bpm)
and therefore normally sets the heart rate.
2. A normal PR interval on a standard 12-lead ECG represents:
A. Ventricular depolarization time
B. Atrial depolarization through AV nodal conduction
C. Ventricular repolarization
D. Time from ventricular depolarization to repolarization
Rationale: The PR interval reflects conduction from the atria through the
AV node to the ventricles.
3. Which electrolyte imbalance is most commonly associated with peaked T
waves?
A. Hypokalemia
B. Hyperkalemia
C. Hypocalcemia
D. Hypernatremia
, Rationale: Elevated serum potassium levels accelerate repolarization,
producing tall, peaked T waves.
4. A patient presents with an ECG showing absent P waves, irregularly
irregular rhythm, and narrow QRS complexes. This rhythm is most
consistent with:
A. Atrial flutter
B. Atrial fibrillation
C. Ventricular tachycardia
D. Sinus arrhythmia
Rationale: Atrial fibrillation lacks organized atrial activity and produces
an irregular ventricular response.
5. The correct paper speed for standard ECG recording in adults is:
A. 10 mm/sec
B. 25 mm/sec
C. 50 mm/sec
D. 100 mm/sec
Rationale: Standard ECGs are recorded at 25 mm/sec unless otherwise
specified.
6. Which lead is best used to continuously monitor cardiac rhythm in most
clinical settings?
A. Lead I
B. Lead II
C. Lead V1
D. Lead aVL
Rationale: Lead II aligns with the heart’s electrical axis and best
visualizes P waves and rhythm.
,7. A QRS duration greater than 0.12 seconds suggests:
A. Normal ventricular conduction
B. Ventricular conduction delay
C. Atrial enlargement
D. Sinus tachycardia
Rationale: Wide QRS complexes indicate delayed ventricular
depolarization, such as bundle branch block.
8. When placing precordial lead V1, the electrode should be positioned:
A. Fourth intercostal space, left sternal border
B. Fourth intercostal space, right sternal border
C. Fifth intercostal space, midclavicular line
D. Fifth intercostal space, anterior axillary line
Rationale: V1 is placed at the fourth intercostal space to the right of the
sternum.
9. Which rhythm is characterized by a ventricular rate of 20–40 bpm and wide
QRS complexes?
A. Sinus bradycardia
B. Junctional rhythm
C. Idioventricular rhythm
D. Atrial flutter
Rationale: Idioventricular rhythms originate in the ventricles and have
slow rates with wide QRS.
10.ST-segment elevation in contiguous leads most strongly indicates:
A. Pericarditis
B. Acute myocardial infarction
C. Electrolyte imbalance
D. Left ventricular hypertrophy
, Rationale: Localized ST elevation reflects acute transmural myocardial
injury.
11.A first-degree AV block is defined by:
A. Dropped QRS complexes
B. Progressive PR lengthening
C. PR interval >0.20 seconds with 1:1 conduction
D. Complete AV dissociation
Rationale: First-degree AV block is a delay, not a block, in AV
conduction.
12.Which artifact is most commonly caused by patient movement or muscle
tension?
A. AC interference
B. Somatic tremor
C. Wandering baseline
D. 60-cycle interference
Rationale: Muscle activity produces irregular, rapid deflections known as
somatic tremor.
13.The electrical axis of the heart normally falls within:
A. −90° to −30°
B. −30° to +90°
C. +90° to +180°
D. −180° to −90°
Rationale: Normal adult QRS axis lies between −30° and +90°.
14.Which condition most commonly causes right bundle branch block?
A. Inferior MI
B. Hyperkalemia
C. Pulmonary embolism
