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Question 1Patient Preparation, Safety, and Infection Control
What is the minimum recommended duration for washing hands with soap and water?
- 20 seconds Correct answer.
- 15 seconds
- 5 seconds
- 10 seconds
Explanation
Guidelines recommend scrubbing all surfaces of the hands and wrists with soap and water for at least 20 seconds, then rinsing and drying thoroughly. Shorter scrubs do not give the soap enough contact time to remove transient organisms. Hand hygiene is performed before and after every patient contact.
Question 2Patient Preparation, Safety, and Infection Control
Gloves should be worn by the EKG technician in which situation?
- Only during invasive procedures such as injections
- Whenever contact with blood or fluids is likely Correct answer.
- Only if the patient has a diagnosed infection
- Only when the patient requests that you do so
Explanation
Standard precautions require gloves whenever the task may bring the technician into contact with blood, body fluids, secretions, or non-intact skin. The decision is based on the anticipated exposure, not on a known diagnosis. Gloves never replace hand hygiene.
Question 3Patient Preparation, Safety, and Infection Control
Which two identifiers are acceptable when verifying a patient before an EKG?
- The patient's insurance number and home address
- The patient's room number and bed position
- The patient's full name and date of birth Correct answer.
- The patient's diagnosis and physician name
Explanation
Two independent identifiers, typically the patient's full name and date of birth, must be used and matched to the order or armband. Room numbers and bed assignments change and are not unique identifiers. Verification occurs before any tracing is obtained.
Question 4Patient Preparation, Safety, and Infection Control
How should the skin be prepared before electrodes are attached?
- Rub the site vigorously with dry gauze for a full minute
- Apply a thin layer of lotion to improve adhesion
- Cleanse the site with alcohol and let it air dry Correct answer.
- Cleanse the site with hydrogen peroxide and blot dry
Explanation
Alcohol removes oils and residue, and allowing it to air dry improves electrode adhesion and reduces impedance. Rubbing the skin aggressively can cause irritation and does not clean it. Lotions and damp skin both interfere with a stable tracing.
Question 5Patient Preparation, Safety, and Infection Control
When choosing chest electrode sites, the technician should place electrodes over which type of tissue?
- Areas with the largest muscle mass
- Skin folds beneath the breast
- Hairy areas for better conduction
- Firm bony areas with little muscle Correct answer.
Explanation
Electrodes placed over bone are less affected by muscle movement and produce a cleaner baseline. Large muscle masses generate electrical activity and somatic tremor artifact. Hairy and folded areas also degrade electrode contact.
Question 6Patient Preparation, Safety, and Infection Control
A patient reports a known latex allergy. How should the technician prepare?
- Ask the patient to bring their own supplies
- Use latex-free gloves and latex-free electrodes Correct answer.
- Use vinyl gloves but keep the standard latex electrodes
- Double the standard gloves for extra protection
Explanation
All latex-containing items that may contact the patient, including electrodes and blood pressure cuffs, must be replaced with latex-free alternatives. Doubling latex gloves does not prevent an allergic reaction. The allergy should also be documented and communicated to the care team.
Question 7Patient Preparation, Safety, and Infection Control
How should the technician protect a patient's modesty during a 12-lead EKG?
- Leave the door open so the patient does not feel confined
- Expose only the chest and cover the rest with a drape Correct answer.
- Complete the tracing quickly without using any covering
- Ask the patient to remove all clothing from the waist up
Explanation
Only the area being examined should be exposed, and the remainder of the body is kept covered with a drape or gown. Doors and curtains are closed to provide visual privacy. Explaining each step also helps the patient feel secure.
Question 8Patient Preparation, Safety, and Infection Control
Which action best reduces a patient's anxiety before an EKG?
- Describing the procedure only if the patient asks
- Waiting until the tracing is finished to answer questions
- Telling the patient that no explanation is necessary
- Explaining each step before it is performed Correct answer.
Explanation
Telling the patient what will happen, in advance and in plain language, reduces fear and improves cooperation. Questions should be invited and answered as they arise. A calm, unhurried approach also lowers heart rate and reduces artifact.
Question 9Patient Preparation, Safety, and Infection Control
During the tracing the patient keeps shifting position and the baseline becomes unreadable. What is the best first action?
- Increase the paper speed to override the artifact
- Reposition the limb leads onto the patient's ankles
- Continue and document the artifact in the report
- Ask the patient to lie still and breathe normally Correct answer.
Explanation
Movement artifact is corrected at its source by helping the patient relax, lie still, and breathe quietly. Changing machine settings does not remove the underlying interference. If artifact persists, electrode contact and cable placement are checked next.
Question 10Patient Preparation, Safety, and Infection Control
How should reusable electrodes be handled between patients?
- Disinfect them with an approved agent per policy Correct answer.
- Rinse them in water and let them air dry
- Store them in the patient's room until next use
- Wipe them with a dry paper towel and reuse them
Explanation
Reusable equipment is cleaned and then disinfected with a facility-approved product between patients. A dry wipe alone does not reduce pathogens. Manufacturer instructions determine the correct contact time and compatible agents.
Question 11Patient Preparation, Safety, and Infection Control
The technician is stuck by a contaminated needle left on the bed. What is the first action?
- Squeeze the wound and apply a tight bandage
- Clean the wound with alcohol and finish the shift first
- Wait to see whether symptoms develop before reporting
- Wash the site with soap and water and report immediately Correct answer.
Explanation
After a sharps injury the site is washed with soap and water, and the exposure is reported and evaluated right away so post-exposure care can begin. Time-sensitive prophylaxis may be needed. Delaying evaluation can reduce the effectiveness of treatment.
Question 12Patient Preparation, Safety, and Infection Control
A patient with a C. difficile infection is in contact precautions. How should the technician proceed?
- Use only gloves, since contact precautions do not require a gown
- Wear a respirator and move the patient to a negative-pressure room
- Perform the EKG in the hallway to avoid entering the room
- Don a gown and gloves and use dedicated equipment in the room Correct answer.
Explanation
Contact precautions require a gown and gloves for entry, with equipment dedicated to that patient or cleaned before it leaves the room. Alcohol-based rubs do not reliably kill C. difficile spores, so soap and water handwashing is used. The door may remain closed and the precaution sign is followed.
Question 13Patient Preparation, Safety, and Infection Control
Midway through the EKG the patient becomes pale, diaphoretic, and reports feeling faint. What should the technician do?
- Stop the test, lower the patient flat, and call for help Correct answer.
- Give the patient water and continue the procedure
- Finish the tracing quickly and then help the patient sit up
- Ask the patient to take several rapid deep breaths
Explanation
These signs suggest a vasovagal or hypotensive response, so the test stops and the patient is positioned safely with the head level or lowered while help is summoned. Continuing the tracing risks a fall or loss of consciousness. Vital signs and mental status are monitored until assistance arrives.
Question 14Patient Preparation, Safety, and Infection Control
Which practice supports electrical safety when using an EKG machine?
- Operating the machine with the case open to cool it
- Using extension cords when the wall outlet is far away
- Inspecting the power cord and plug before each use Correct answer.
- Routing cables across the floor for easy access
Explanation
Cords and plugs are checked for fraying, cracks, and damage before use, and faulty equipment is removed from service. Cables are kept clear of walkways and away from liquids. Only grounded outlets and facility-approved equipment are used.
Question 15Patient Preparation, Safety, and Infection Control
An adult patient has dense chest hair at the V1 and V2 electrode sites. What should the technician do?
- Apply extra gel and press the electrodes down firmly
- Clip the hair at the site and then apply the electrodes Correct answer.
- Cancel the test until the patient shaves the area
- Move the electrodes to the shoulders where hair is thinner
Explanation
Hair prevents the electrode from contacting the skin and causes artifact, so it is clipped at the site if needed. Electrode positions must not be moved, because lead placement determines what the tracing represents. Clipping rather than shaving avoids abrasion and is more comfortable.
Question 16Patient Preparation, Safety, and Infection Control
A patient who speaks limited English needs an EKG. What should the technician do?
- Proceed without explanation to avoid confusion
- Ask the patient's young child to translate the instructions
- Arrange a qualified medical interpreter before starting Correct answer.
- Speak more loudly while pointing to the equipment
Explanation
A qualified interpreter, in person or by phone, ensures that instructions and consent are understood accurately. Family members, especially children, should not be used as interpreters. Speaking loudly does not overcome a language barrier.
Question 17Patient Preparation, Safety, and Infection Control
Which action complies with patient privacy requirements during an EKG?
- Giving results to a caller who states the patient's name
- Posting the rhythm strip on the unit bulletin board
- Discussing the patient's results only with the care team Correct answer.
- Sharing the tracing with anyone who asks about the patient
Explanation
Protected health information may be shared only with those involved in the patient's care or as authorized by the patient. Identifying information should not be posted or given out over the phone without verification and authorization. Discussing findings in public areas should also be avoided.
Question 18Patient Preparation, Safety, and Infection Control
A competent adult tells the technician he does not want the ordered EKG performed. What should the technician do?
- Ask a family member to convince the patient
- Perform the test anyway because it was ordered
- Respect the refusal and notify the licensed provider Correct answer.
- Tell the patient a waiver must be signed before refusing
Explanation
A competent patient may refuse any procedure, and the technician should honor that decision while informing the provider and documenting the refusal. The technician does not coerce or pressure the patient. Any questions the patient has should be answered or referred.
Question 19Patient Preparation, Safety, and Infection Control
Standard precautions should be applied in which way?
- Only in the emergency department and intensive care
- To every patient regardless of diagnosis Correct answer.
- Only when the patient's history is unknown
- Only to patients with a known bloodborne infection
Explanation
Standard precautions treat all blood and body fluids as potentially infectious and are used with every patient in every setting. A known diagnosis is not required to trigger them. This approach protects both patients and staff when a diagnosis is unknown.
Question 20Patient Preparation, Safety, and Infection Control
An older adult with an unsteady gait needs to lie down for an EKG. What should the technician do?
- Provide a steadying hand and lower the table first Correct answer.
- Position the table at its highest height first
- Ask the patient to stand on a rolling stool
- Let the patient climb up alone to preserve independence
Explanation
The table is lowered before the patient gets on, and the technician offers a steadying hand or gait belt per policy, then raises the table to a comfortable working height. This reduces the risk of falling during transfer. Fall risk should be reassessed throughout the visit.
Question 21Patient Preparation, Safety, and Infection Control
A contaminated item that could puncture the skin should be discarded in which container?
- A rigid puncture-resistant sharps container Correct answer.
- A biohazard box lined with a plastic bag
- A sealed paper bag labeled with the room number
- A double-bagged plastic trash can
Explanation
Sharps go directly into a rigid, puncture-resistant, closable container that is not overfilled and is replaced when full. Recapping or bending sharps is avoided. Other biohazard waste is handled according to facility policy.
Question 22Patient Preparation, Safety, and Infection Control
After caring for a patient with C. difficile, which hand hygiene method is required?
- Rinsing the hands with water only
- Wearing gloves without any hand hygiene
- Washing with soap and water Correct answer.
- An alcohol-based hand rub alone
Explanation
Alcohol-based rubs do not reliably kill C. difficile spores, so soap and water handwashing is required after contact with affected patients. Mechanical washing helps remove the spores from the hands. Hand hygiene is still performed even when gloves were worn.
Question 23Patient Preparation, Safety, and Infection Control
How should contaminated gloves be removed?
- Turn the gloves inside out as they are removed Correct answer.
- Peel both gloves off by the fingertips simultaneously
- Wash the gloves with soap before taking them off
- Remove the gloves and skip hand hygiene if hands look clean
Explanation
Gloves are removed so that they turn inside out, keeping the contaminated outer surface contained, and hand hygiene follows immediately. Touching the skin with the contaminated surface spreads organisms. Gloves are never washed and reused.
Question 24Patient Preparation, Safety, and Infection Control
While attaching leads, the patient reports new crushing chest pain. What should the technician do?
- Give the patient an aspirin from the unit supply
- Reassure the patient that chest pain is common during EKG
- Complete the 12-lead tracing before doing anything else
- Stop, stay with the patient, and call for help Correct answer.
Explanation
New crushing chest pain may signal an acute cardiac event, so the technician stays with the patient, summons emergency help, and notifies licensed staff immediately. The technician does not administer medications or leave the patient alone. Monitoring and documentation continue until help arrives.
Question 25Patient Preparation, Safety, and Infection Control
Which skin condition at a proposed electrode site should be avoided?
- Skin on the lower legs above the ankles
- Skin over the sternum between the ribs
- Skin below the clavicle on either side
- Skin that is broken, irritated, or covered by a rash Correct answer.
Explanation
Electrodes should not be placed on broken, irritated, or inflamed skin because this increases discomfort and the risk of infection. Alternative sites are chosen and the condition is documented. Intact, dry skin is required for good adhesion.
Question 26Patient Preparation, Safety, and Infection Control
Before applying EKG electrodes, how should the technician confirm that the correct patient is being tested?
- Check the name on the door sign and proceed if it matches.
- Match the requisition to the armband and verify name and birth date. Correct answer.
- Ask the patient to confirm the room number and bed assignment.
- Use the name on the previous tracing in the chart.
Explanation
Patient identification requires at least two identifiers, such as name and date of birth, checked against the requisition and armband. Room numbers, door signs, and prior tracings are not reliable identifiers.
Question 27Patient Preparation, Safety, and Infection Control
The technician finishes an EKG and removes gloves before moving to the next patient. What should happen next?
- Perform hand hygiene before touching the next patient or equipment. Correct answer.
- Rinse the hands with water only and dry them.
- Apply alcohol-based rub to the gloved hands immediately before removing them.
- Wait until the end of the shift to wash the hands.
Explanation
Hand hygiene is required after glove removal and before contact with the next patient or clean equipment. Gloves do not replace hand hygiene.
Question 28Patient Preparation, Safety, and Infection Control
After identifying the patient, what is the best way for the technician to begin the EKG?
- Explain the steps and invite the patient's questions. Correct answer.
- Skip the explanation when the patient appears calm.
- Tell the patient to remain silent until the tracing is finished.
- Apply the limb leads first and explain the test afterward.
Explanation
Explaining the procedure and inviting questions supports cooperation and reduces anxiety. The explanation should occur before electrode placement, not afterward.
Question 29Patient Preparation, Safety, and Infection Control
How should an adult patient be positioned for a routine 12-lead EKG?
- Seated upright with both feet flat on the floor.
- Standing with the arms raised above the head.
- Supine, with arms at the sides and legs uncrossed. Correct answer.
- Lying on the side with the knees drawn to the chest.
Explanation
A routine EKG is usually obtained with the patient supine, arms resting at the sides, and legs uncrossed to reduce muscle tension and artifact. Positioning should also maintain comfort and privacy.
Question 30Patient Preparation, Safety, and Infection Control
A patient reports that adhesive electrodes leave a red, itchy rash. What should the technician do?
- Use hypoallergenic electrodes and monitor the skin. Correct answer.
- Cancel the EKG because electrodes cannot be used.
- Apply lotion before attaching the standard electrodes.
- Place the standard electrodes over the previous rash.
Explanation
A history of adhesive reaction calls for a hypoallergenic or alternative electrode and observation of the skin. Standard adhesive electrodes should not be placed over already irritated skin.
Question 31Patient Preparation, Safety, and Infection Control
A patient with suspected influenza is on droplet precautions. Which PPE should the technician use for the EKG?
- A gown and gloves only, without a mask.
- No PPE if the EKG takes less than five minutes.
- A fit-tested N95 respirator alone, without gloves or gown.
- A surgical mask, plus gloves and gown for contact. Correct answer.
Explanation
Droplet precautions require a surgical mask for close contact. Standard precautions also require gloves and a gown when contact with the patient or contaminated items is expected.
Question 32Patient Preparation, Safety, and Infection Control
A patient with suspected active tuberculosis is in an airborne-infection isolation room. What should the technician do before entering?
- Enter without PPE and finish the EKG quickly.
- Put on a surgical mask and leave the room door open.
- Perform hand hygiene and use a fit-tested N95. Correct answer.
- Wear gloves only and keep the door closed.
Explanation
Airborne precautions for tuberculosis require a fit-tested N95 respirator or equivalent. Hand hygiene and standard precautions are also part of safe practice.
Question 33Patient Preparation, Safety, and Infection Control
A patient with MRSA in a wound is on contact precautions. How should the technician prepare for the EKG?
- Use the shared EKG machine without cleaning it afterward.
- Put on gown and gloves and clean equipment after use. Correct answer.
- Wear a surgical mask and no gown or gloves.
- Ask the patient to come to the hallway for the tracing.
Explanation
Contact precautions require gown and gloves for entering the room and touching the patient or contaminated surfaces. Reusable equipment should be cleaned or disinfected according to policy after use.
Question 34Patient Preparation, Safety, and Infection Control
The technician must enter a contact-isolation room and may contact body fluids. What is the correct order for donning PPE?
- Mask, gloves, gown, eye protection, and hand hygiene last.
- Hand hygiene, gown, mask, eye protection, gloves. Correct answer.
- Gown, gloves, hand hygiene, mask, eye protection.
- Gloves first, then gown, mask, eye protection, and hand hygiene last.
Explanation
PPE is donned after hand hygiene, with gloves applied last to cover the cuffs of the gown. This sequence reduces the chance of contaminating the gloves during application.
Question 35Patient Preparation, Safety, and Infection Control
After completing an EKG in a contact-isolation room, what is the correct order for removing PPE?
- Gloves, eye protection, gown, mask; then hand hygiene. Correct answer.
- Remove mask, then gown, then gloves, then eye protection.
- Remove gown, gloves, mask, eye protection; wash hands first.
- Remove eye protection, mask, gloves, then gown.
Explanation
PPE is removed in a sequence that avoids contaminating the face, generally gloves first, then eye protection, gown, and mask, followed by hand hygiene. The exact sequence should follow facility policy.
Question 36Patient Preparation, Safety, and Infection Control
A small amount of blood spills on the floor beside the EKG table. What should the technician do?
- Don gloves, absorb the spill, then disinfect. Correct answer.
- Wipe it with a dry paper towel and continue the EKG.
- Leave it for housekeeping and warn the patient.
- Pour water on it and mop it toward the drain.
Explanation
Blood spills are cleaned while wearing appropriate PPE, absorbed, and then disinfected with an approved agent for the required contact time. The area should be secured until cleanup is complete.
Question 37Patient Preparation, Safety, and Infection Control
A patient has a pacemaker generator visible on the upper chest. How should the technician place chest electrodes?
- Place all chest electrodes directly over the generator.
- Omit all chest leads to avoid the device.
- Move the generator aside before applying electrodes.
- Avoid an electrode directly over the generator. Correct answer.
Explanation
Chest electrodes should be placed at standard positions while avoiding direct placement over an implanted device generator when possible. This helps prevent artifact and follows common device-safety practice.
Question 38Patient Preparation, Safety, and Infection Control
A patient has oily skin at the chest electrode sites. What should the technician do to improve electrode contact?
- Apply a thin layer of lotion before placement.
- Scrub the skin until it is red and raw.
- Attach electrodes while the skin is still wet.
- Cleanse with alcohol and let the skin dry. Correct answer.
Explanation
Oily skin can prevent electrodes from adhering and can increase artifact. Cleansing with alcohol and allowing the skin to dry improves contact without damaging the skin.
Question 39Patient Preparation, Safety, and Infection Control
During preparation, the patient is sweating heavily on the chest. What should the technician do?
- Dry the skin and use fresh electrodes. Correct answer.
- Apply powder and leave it under the electrodes.
- Place electrodes over the moisture to save time.
- Stop the EKG and send the patient home.
Explanation
Moisture prevents electrodes from adhering and can create artifact. Drying the skin and using fresh electrodes improves contact.
Question 40Patient Preparation, Safety, and Infection Control
A school-age child is anxious about an EKG. How should the technician prepare the child?
- Apply the electrodes without explaining the procedure.
- Promise the child that the test will not cause any discomfort.
- Use simple words and let a caregiver stay nearby. Correct answer.
- Ask the parent to leave the room immediately.
Explanation
Children benefit from simple, age-appropriate explanations and reassurance. Allowing a caregiver to remain nearby, when consistent with policy, can reduce anxiety.
Question 41Patient Preparation, Safety, and Infection Control
A patient is deaf and reads lips. How should the technician communicate during the EKG?
- Ask another patient to interpret the instructions.
- Speak very loudly from another room.
- Proceed without giving any instructions.
- Face the patient and use written instructions. Correct answer.
Explanation
The technician should face the patient, speak clearly, and use written or visual aids as needed. A qualified interpreter should be used according to facility policy when necessary.
Question 42Patient Preparation, Safety, and Infection Control
The technician sees an isolation sign on a patient's door. What should be done before entering?
- Remove the sign so the equipment can be brought in.
- Bring the EKG machine in before putting on PPE.
- Read the sign and don the required PPE outside the room. Correct answer.
- Enter first to ask the patient which precautions apply.
Explanation
Isolation signage tells staff which precautions are required. PPE is applied before entering the room, using the correct sequence and equipment.
Question 43Patient Preparation, Safety, and Infection Control
When does standard precautions require the technician to wear gloves during an EKG?
- When contact with blood, body fluids, or nonintact skin is likely. Correct answer.
- Only after the electrodes have been attached.
- Only when the patient asks the technician to wear them.
- For every patient, even when no body fluid contact is expected.
Explanation
Gloves are required when contact with blood, body fluids, secretions, excretions, nonintact skin, or contaminated surfaces is anticipated. Gloves are not automatically required for every intact-skin contact.
Question 44Patient Preparation, Safety, and Infection Control
After an EKG, the reusable lead cables are visibly clean but were in contact with the patient. What should the technician do?
- Disinfect the cables with an approved agent. Correct answer.
- Spray the cables with alcohol while they are plugged in.
- Store the cables immediately for the next patient.
- Rinse the cables in water and hang them to dry.
Explanation
Reusable equipment that contacts patients must be cleaned or disinfected between patients according to facility policy and manufacturer instructions. Visible cleanliness alone does not replace disinfection.
Question 45Patient Preparation, Safety, and Infection Control
The patient's identification band is missing before an EKG. What is the best action?
- Write a new band by hand and apply it.
- Stop and follow facility policy to verify identity. Correct answer.
- Ask the roommate to confirm the patient's identity.
- Use the name on the door and begin the tracing.
Explanation
The EKG should not proceed until the patient's identity is verified using approved identifiers. The technician should follow facility policy to obtain proper identification.
Question 46Patient Preparation, Safety, and Infection Control
Before plugging in the EKG machine, what should the technician check?
- The number of tracings left in the paper tray.
- Whether the machine has a recent battery charge.
- Power cord and lead wires for damage. Correct answer.
- The patient's age and insurance information.
Explanation
Damaged cords or lead wires can cause electrical hazards or poor signal quality. Equipment should be inspected before use and taken out of service if damaged.
Question 47Patient Preparation, Safety, and Infection Control
A patient has a new productive cough but is not on isolation precautions. What should the technician do?
- Wear a gown but no mask during the tracing.
- Ask the patient to suppress the cough throughout the test.
- Refuse to perform the EKG until the cough resolves.
- Offer a mask and perform hand hygiene before contact. Correct answer.
Explanation
Source control, such as offering a mask, can reduce the spread of respiratory secretions. Standard precautions and hand hygiene should be used, and isolation precautions should be followed if they are later ordered.
Question 48Patient Preparation, Safety, and Infection Control
The EKG room is cold, and the patient is shivering before the tracing begins. What should the technician do?
- Warm the room or cover the patient, then proceed. Correct answer.
- Begin the tracing and ignore the shivering.
- Ask the patient to hold still despite the shivering.
- Place electrodes over the patient's clothing.
Explanation
Shivering causes muscle artifact and can make the tracing unreadable. Warming the room or covering the patient improves comfort and reduces artifact.
Question 49Patient Preparation, Safety, and Infection Control
The technician's hands are visibly soiled with blood after removing gloves. What should be done?
- Use an alcohol-based hand rub only.
- Wash with soap and water before continuing. Correct answer.
- Put on new gloves without washing the hands.
- Wipe the hands with a dry paper towel.
Explanation
When hands are visibly soiled with blood or body fluids, soap and water are required. Alcohol-based hand rub is not sufficient for visibly contaminated hands.
Question 50Patient Preparation, Safety, and Infection Control
A patient reports a skin allergy to alcohol. What should the technician use to prepare intact electrode sites?
- Alcohol pads, but only on the chest.
- No cleaning, because allergies prevent preparation.
- Mild soap and water, then dry the skin. Correct answer.
- An abrasive pad until the skin bleeds.
Explanation
When alcohol is not tolerated, mild soap and water can clean intact skin, followed by thorough drying. The technician should avoid agents that cause a reaction and should not damage the skin.