CET NHA Certified EKG Technician - Set 4 - Part 3

Correct Answer: Stop the treadmill and assist the clinician

Sustained ventricular tachycardia is an absolute termination criterion that requires immediate stopping of the treadmill and clinician intervention. The technician's role includes stopping the equipment, assessing the patient, and assisting the supervising clinician with the response. Option a is incorrect because continuing the test in the face of sustained VT exposes the patient to potential decompensation and hemodynamic collapse. The arrhythmia meets stop criteria and continuing would be unsafe. Option b is incorrect because cardioversion is a clinician-directed intervention outside the technician's independent scope of practice. The technician's role is to summon and assist, not to deliver synchronized shocks autonomously. Option c is incorrect because increasing treadmill speed would worsen the arrhythmia by increasing cardiac demand at exactly the wrong moment. Speed escalation is precisely the opposite of the appropriate response to sustained VT.

Correct Answer: Stop the treadmill and assist patient to safe position

Stopping the treadmill safely and assisting the patient into a supine position with legs elevated addresses syncope by improving cerebral perfusion. The technician then takes vital signs and assists the supervising clinician with the response. Option a is incorrect because continuing the test during syncope risks the patient falling and injuring themselves on the treadmill. The test must stop immediately to prevent secondary injury. Option b is incorrect because waiting passively for an unresponsive or near-unresponsive patient to recover ignores the safety risk on a moving treadmill. Action is required to prevent falls and assess perfusion. Option d is incorrect because increasing treadmill speed during syncope worsens the situation by stressing an already compromised circulatory system. Acceleration is the opposite of the appropriate response.

Correct Answer: A defibrillator or AED with monitor capability

A defibrillator with monitor capability, or at minimum an AED, must be present in every stress test laboratory because cardiac arrest is a recognized complication. Oxygen, crash cart medications, suction, and airway adjuncts are also required equipment. Option b is incorrect because a blood gas analyzer is laboratory equipment that is not part of standard stress test emergency supplies. Blood gas analysis is performed by the lab, not at the bedside during a stress test. Option c is incorrect because an x-ray machine is large fixed equipment that does not belong in a stress test room. Imaging is performed elsewhere and is not part of the immediate stress test emergency response setup. Option d is incorrect because a dialysis machine treats kidney failure and is not part of cardiac emergency response equipment. Dialysis equipment is unrelated to the cardiac complications of stress testing.

Correct Answer: Begin CPR and assist with defibrillator setup

The technician's immediate role is to begin high-quality CPR and assist with bringing and applying the defibrillator under the clinician's direction. Compressions and rapid defibrillation are the key links in surviving pulseless VT. Option a is incorrect because pushing antiarrhythmic medications is outside the technician's scope of practice and requires licensed personnel. Medication administration is a clinician role, not a technician responsibility. Option b is incorrect because the technician does not independently perform manual defibrillation, although she can apply AED pads and follow AED prompts. Manual defibrillator operation is a clinician role during a code. Option d is incorrect because passive observation during pulseless VT lets minutes elapse without the CPR that survival depends on. Documentation continues during the code but does not replace active resuscitation.

Correct Answer: Stop the test, observe, and notify the clinician

The appropriate response is to stop the test, observe the patient, and notify the supervising clinician for medication or further direction. Blood pressure often falls promptly with rest, but the technician does not administer antihypertensives independently. Option a is incorrect because administering antihypertensives is outside the technician's scope of practice. Medication decisions during a hypertensive crisis belong to the supervising clinician with appropriate orders. Option b is incorrect because continuing to peak exercise during a hypertensive crisis dangerously increases the cardiac load on an already stressed system. Continuing the test could trigger a stroke or other vascular event. Option c is incorrect because dismissing a high blood pressure reading as a false alarm without verification risks missing a real emergency. The reading must be evaluated, not ignored, even if the cuff size or technique might be at fault.

Correct Answer: At least six minutes or until baseline

Recovery monitoring continues for at least six minutes or until heart rate and blood pressure return toward baseline, with vital signs and EKG recorded at regular intervals. This phase captures delayed ischemic responses after exercise stops. Option b is incorrect because less than thirty seconds is far too brief to catch the delayed responses that recovery monitoring is meant to detect. Most ischemic recovery changes appear over minutes, not seconds. Option c is incorrect because monitoring until the patient leaves the building is not a defined duration and depends on logistics rather than physiology. Recovery monitoring is based on vital sign trends and EKG response. Option d is incorrect because twenty-four hours of monitoring is appropriate for ambulatory Holter studies, not for post-stress test recovery. The recovery phase is measured in minutes, not days.

Correct Answer: About ten seconds of rhythm strip

The rhythm strip at the bottom of a standard twelve-lead EKG is typically about ten seconds long, which equals thirty large boxes at standard paper speed. This duration captures enough beats to assess rhythm regularity reliably. Option a is incorrect because two seconds is shorter than even a single lead snapshot and far too brief for rhythm interpretation. Rhythm strips need many seconds to capture meaningful rhythm patterns. Option b is incorrect because five seconds is half the standard duration and may miss intermittent findings that the longer strip would catch. Standard practice uses ten seconds for a reason. Option c is incorrect because twenty seconds exceeds the standard mounted strip and is longer than necessary for routine interpretation. Standard mounting uses ten seconds, with longer strips reserved for specific situations.

Correct Answer: Stop the test and notify the supervising clinician

Severe leg claudication is a relative termination criterion that calls for stopping the test and notifying the supervising clinician for evaluation. Continued exercise on painful legs risks both injury and further compromise of peripheral circulation. Option a is incorrect because increasing the speed during severe claudication worsens the pain and risks falls. Pushing past significant lower-extremity pain is not part of any stress test protocol. Option b is incorrect because ignoring severe pain denies the patient the response they are clearly signaling and risks worse outcomes if claudication reflects significant vascular disease. The pain must be addressed by stopping the test. Option d is incorrect because pushing pain medication is outside the technician's scope and is not the immediate response to claudication. Stopping the test and notifying the clinician is the appropriate action sequence.

Correct Answer: Relative termination criterion to consider stopping

Frequent multifocal PVCs, triplets, and non-sustained ventricular tachycardia meet relative termination criteria for stress testing, prompting consideration of stopping the test. The supervising clinician makes the final decision based on the overall clinical picture. Option a is incorrect because absolute termination criteria for VF apply to ventricular fibrillation itself rather than to multifocal PVCs and non-sustained VT runs. The findings described meet relative, not absolute, stopping criteria. Option c is incorrect because dismissing these arrhythmias as not meeting any termination criterion ignores the clear relative criteria that include multifocal PVCs and non-sustained VT. The findings are clinically significant and warrant attention. Option d is incorrect because mandatory continuation through stage five contradicts the entire purpose of relative termination criteria, which exist to prompt earlier stopping when warranted. No protocol mandates pushing through significant arr

Correct Answer: Start CPR, get the defibrillator, assist team

The technician immediately starts high-quality CPR, helps bring the defibrillator to the bedside, and assists the team under the clinician's direction. Early CPR and rapid defibrillation are the key actions in surviving ventricular fibrillation arrest. Option b is incorrect because pushing intravenous epinephrine is outside the technician's scope and requires licensed clinician orders. Medication administration during a code belongs to nursing or physician personnel. Option c is incorrect because passive documentation during a code leaves the patient without the CPR and team support that survival requires. Documentation occurs alongside active resuscitation rather than instead of it. Option d is incorrect because making the diagnosis verbally is a clinician role rather than the technician's responsibility. The clinician interprets and calls treatment decisions, while the technician supports the response physically.