22 Patient Safety & Professional Practice Practice Questions & Answers

1. 1. A technician arrives at the bedside to record a 12-lead EKG on a hospitalized patient. Which action correctly verifies the patient's identity before beginning?

   • A.Ask "Are you Mr. Alvarez?" and begin as soon as the patient nods
   • B.Ask the family member at the bedside to confirm that this is the correct patient
   • C.Confirm that the room number and bed number match the ones printed on the requisition
   • D.Ask the patient to state their full name and date of birth, then compare both with the wristband and the order✓ Answer

   Two identifiers must be pieces of information specific to the individual, such as full name plus date of birth or medical record number. Room and bed numbers identify a location, not a person, and patients are moved between rooms, so they are never acceptable identifiers. Asking a closed question like "Are you Mr. Alvarez?" invites a false confirmation from a patient who is anxious, hard of hearing, or confused.

   Source: NHA CET Test Plan, communication with patients; Joint Commission NPSG.01.01.01 (two patient identifiers)Report a problem with this question

2. 2. A patient scheduled for a routine 12-lead EKG says she is nervous because she is afraid the machine will shock her. Which response by the technician is most appropriate?

   • A.Explain that the EKG only records the electrical signals the heart already produces and does not send any electricity into the body✓ Answer
   • B.Work as quickly as possible so the test is over before she becomes more upset
   • C.Tell her that all questions about the equipment have to be answered by her physician
   • D.Tell her not to worry because there is really nothing to be nervous about

   Explaining the procedure in plain language is within the technician's scope and is the most effective way to reduce anxiety, and an accurate explanation also improves cooperation and reduces movement artifact. False reassurance such as "there's nothing to worry about" dismisses the concern without correcting the misunderstanding, and deferring a simple equipment question to the physician is unnecessary because it is not a request for diagnosis or results.

   Source: NHA CET Test Plan, communication methods; explaining the procedure and confirming understandingReport a problem with this question

3. 3. A patient with severe shortness of breath cannot tolerate lying flat for a 12-lead EKG. What should the technician do?

   • A.Record the tracing with the patient in semi-Fowler's position and document that position on the tracing✓ Answer
   • B.Insist that the patient lie supine, because any other position makes the tracing invalid
   • C.Cancel the test and ask the nurse to reschedule it for when the patient can lie flat
   • D.Record the tracing in semi-Fowler's position and say nothing, since the electrodes go in the same places

   Patient safety and comfort come first, so a patient who cannot lie flat is recorded in semi-Fowler's position. Because a change in torso position shifts the heart relative to the chest electrodes and can alter axis and waveform amplitude, the deviation must be written on the tracing so the interpreting provider does not attribute the change to disease or compare it incorrectly with a prior supine tracing.

   Source: NHA CET Test Plan and patient-positioning/documentation tasks (record deviations from standard technique)Report a problem with this question

4. 4. While preparing a female patient for a 12-lead EKG in a semi-private room, what is the best way for the technician to protect the patient's privacy and dignity?

   • A.Close the door or privacy curtain and drape the patient so only the site being worked on is uncovered✓ Answer
   • B.Ask the visitors to remain at the bedside so the patient feels supported while her chest is exposed
   • C.Leave the gown fully open for the entire procedure so all sites stay visible and the test goes faster
   • D.Leave the gown in place and apply the chest electrodes over the fabric

   Respecting dignity means exposing only what is necessary, only for as long as necessary, and shielding the patient from view with a door, curtain, and drape. Visitors should be asked to step out unless the patient specifically wants them present, and electrodes must contact clean, bare skin because clothing prevents conduction and produces an unusable tracing.

   Source: NHA CET Test Plan and 1.D (patient privacy, draping, and communication)Report a problem with this question

5. 5. A patient with limited English proficiency needs a 12-lead EKG, and his adult daughter offers to translate the instructions. What should the technician do?

   • A.Arrange a qualified medical interpreter and speak directly to the patient✓ Answer
   • B.Let the daughter interpret, since she knows the patient's history better than anyone
   • C.Ask another patient in the waiting area who speaks the same language to help
   • D.Use hand gestures and begin without an explanation to avoid a delay

   A qualified medical interpreter is used because family members and bystanders are untrained in medical terminology, may edit or soften what is said, and their involvement exposes the patient's health information to someone the patient may not have authorized. Speaking directly to the patient, rather than to the interpreter, keeps the patient at the center of the exchange.

   Source: NHA CET Test Plan, factors affecting communication: language and culture; HHS language-access requirement for qualified interpretersReport a problem with this question

6. 6. An older patient with a significant hearing impairment is having trouble following the technician's instructions during electrode placement. Which approach is most effective?

   • A.Give all of the instructions to the patient's spouse instead
   • B.Face the patient, speak clearly at a normal volume and pace, and reduce background noise✓ Answer
   • C.Skip the explanation and simply position the patient's arms and legs by hand
   • D.Shout each instruction from across the room so the words carry

   Facing the patient lets them use lip movement and facial expression, and lowering background noise improves the signal the patient is trying to hear. Shouting distorts speech sounds and can be perceived as disrespectful, and routing the instructions to a spouse bypasses the patient's own right to receive information and to cooperate with the procedure.

   Source: NHA CET Test Plan, factors affecting communication: disability and developmental levelReport a problem with this question

7. 7. A 6-year-old is scheduled for a 12-lead EKG and is frightened by the electrodes and wires. Which technician action is most appropriate?

   • A.Explain in simple, honest words, let the child hold an electrode first, and involve the caregiver✓ Answer
   • B.Give the child the same clinical explanation used for adult patients
   • C.Say nothing and apply the electrodes quickly so it is over before the child reacts
   • D.Ask the caregiver to leave the room so the child has no one to protest to

   Communication must be matched to developmental level, so a school-age child needs short, concrete, truthful explanations and some control over the situation, which reduces fear and therefore reduces the movement and muscle-tremor artifact that a struggling child produces. A trusted caregiver should stay unless the caregiver's presence is making the child more distressed.

   Source: NHA CET Test Plan, factors affecting communication: developmental levelReport a problem with this question

8. 8. An older adult arrives for an EKG with a companion who answers every question on the patient's behalf, although the patient is alert and oriented. What should the technician do?

   • A.Direct all questions to the companion because it moves the appointment along faster
   • B.Speak very loudly and use simplified, childlike language with the patient
   • C.Assume the patient is confused and take the required information from the companion
   • D.Speak directly to the patient, allow extra time for a reply, and include the companion only as the patient wishes✓ Answer

   Age alone does not impair capacity, so an alert, oriented adult remains the source of their own information and the person whose consent and cooperation matter. Speaking through the companion undermines the patient's autonomy and risks inaccurate history, while elderspeak, or exaggerated loud, childlike speech, is demeaning and does not improve comprehension.

   Source: NHA CET Test Plan, communication with patients; patient autonomy and dignityReport a problem with this question

9. 9. A technician has just finished a 12-lead EKG on a patient in contact isolation for Clostridioides difficile. After removing gloves and gown inside the room, what hand hygiene is required?

   • A.No hand hygiene is needed, because gloves were worn for the entire procedure
   • B.Use alcohol-based hand rub only, because it acts faster and is less drying
   • C.Apply alcohol-based hand rub and then put on a second pair of gloves
   • D.Wash the hands with soap and water, because alcohol-based hand rub does not kill C. difficile spores✓ Answer

   C. difficile forms spores that are resistant to alcohol, so the mechanical action of soap, running water, and friction is needed to physically remove them from the skin. Soap and water are likewise required whenever hands are visibly soiled; gloves reduce but never eliminate contamination, because hands can be contaminated during removal or through unnoticed defects.

   Source: CDC Guideline for Hand Hygiene in Health-Care Settings (soap and water for spore-forming organisms and visibly soiled hands); NHA CET Test PlanReport a problem with this question

10. 10. Which statement best describes when standard precautions apply during EKG procedures?

    • A.They apply only in the emergency department and intensive care unit, where patients are sicker
    • B.They apply to every patient regardless of diagnosis, treating all blood and body fluids as potentially infectious✓ Answer
    • C.They apply only to patients with a documented bloodborne infection listed in the chart
    • D.They apply only when the technician expects to come into contact with blood

    Standard precautions exist precisely because infection status is often unknown at the time of care, since many patients are asymptomatic carriers or have not yet been tested. Applying the same baseline protections to everyone removes the need to guess who is infectious and protects both the patient and the technician.

    Source: CDC Guideline for Isolation Precautions (Standard Precautions); OSHA 29 CFR 1910.1030 universal precautions; NHA CET Test PlanReport a problem with this question

11. 11. Between patients, how should the technician handle the reusable lead wires, patient cable, and limb clamps?

    • A.Submerge them in disinfectant solution and let them soak until the next patient arrives
    • B.Wipe them with an approved hospital disinfectant following the manufacturer's instructions for use✓ Answer
    • C.Disinfect them at the end of each shift; wiping between patients is unnecessary
    • D.Wipe them with dry gauze, because visible soiling is the only reason to disinfect them

    Lead wires and cables touch the skin of every patient and are a recognized vehicle for transferring organisms, so they are disinfected between patients even when they look clean. They must never be submerged or have liquid poured on them, because fluid entering the connectors corrodes contacts, degrades insulation, and creates both signal failure and an electrical hazard.

    Source: NHA CET Test Plan and 2.A (maintain and disinfect EKG equipment); device manufacturer instructions for useReport a problem with this question

12. 12. After a 12-lead tracing is completed, what should be done with the disposable adhesive electrodes?

    • A.Rinse and disinfect them before applying them to the next patient
    • B.Remove them and discard them in the appropriate waste container, because they are single-use and are never reused✓ Answer
    • C.Reuse them on the next patient if the conductive gel is still moist
    • D.Peel them off and store them in a sealed pouch for that same patient's next EKG

    Adhesive electrodes are labeled single-use: the adhesive and conductive gel cannot be effectively disinfected, and reusing them transfers skin flora and body fluids between patients. Once removed, the gel also begins to dry, which raises impedance and causes poor conduction and skin irritation, which is why packages that are unsealed, dried out, or past their expiration date are discarded rather than used.

    Source: NHA CET Test Plan, EKG supplies and equipment maintenance; single-use device labelingReport a problem with this question

13. 13. A technician wearing a gown, mask, goggles, and gloves finishes an EKG in an isolation room. What is the correct order for removing the personal protective equipment?

    • A.Gloves, then goggles, then gown, then mask, removing the mask after leaving the room✓ Answer
    • B.Mask, then goggles, then gown, then gloves, all inside the room
    • C.Gown, then gloves, then goggles, then mask, all inside the room
    • D.Gloves, then gown, then mask, then goggles, all out in the hallway

    Gloves are the most heavily contaminated item and come off first so they do not spread organisms to the face and clothing. The mask or respirator is removed last and outside the room because it protects the airway until the technician has left the contaminated air space, and hand hygiene is performed immediately after doffing.

    Source: CDC Sequence for Donning and Doffing Personal Protective Equipment; NHA CET Test PlanReport a problem with this question

14. 14. A large surgical dressing covers the standard V4 site, so the technician places the V4 electrode as near the correct site as the dressing allows and records the tracing. What else must the technician do?

    • A.Remove the dressing so that standard placement can be used
    • B.Nothing further, because a small change in electrode position has no effect on the tracing
    • C.Label the tracing as a standard 12-lead and mention the change verbally to whoever is available
    • D.Document the modified electrode location on the tracing and in the record so the interpreting provider is not misled✓ Answer

    Precordial electrode position determines the amplitude and morphology recorded in those leads, so a displaced V4 can mimic or mask R-wave progression changes and will not compare validly with earlier tracings. Written documentation on the tracing itself is required because the person interpreting it is usually not present and a verbal comment does not travel with the record; the technician also does not remove a dressing placed by the treatment team.

    Source: NHA CET Test Plan and 2.H (EMR/EHR data entry and mounting/identifying the completed tracing; document deviations from standard technique)Report a problem with this question

15. 15. Before a bedside EKG, the technician notices that the insulation on the machine's power cord is cracked and bare wire is visible. What should the technician do?

    • A.Wrap the damaged section with tape and use the machine for the rest of the day's tracings
    • B.Open the housing, repair the wire, and then continue with the scheduled EKGs
    • C.Take the machine out of service, tag it, obtain a different machine, and report it to biomedical engineering✓ Answer
    • D.Run the machine on battery for this patient and then return it to the equipment rack

    Damaged electrical equipment must be removed from service and tagged so no one else uses it, and repair is done only by qualified biomedical or electrical personnel. The technician does not troubleshoot or repair internal electrical faults, because an untrained repair can defeat the protective ground, leave energized conductors exposed, and expose the patient and staff to shock or fire; taping the cord or quietly returning the machine to the rack leaves the hazard in place for the next user.

    Source: OSHA 29 CFR 1910.334(a)(2) (equipment with damaged cords removed from service until repaired by qualified personnel); NHA CET Test PlanReport a problem with this question

16. 16. A technician is about to record an EKG on a patient with temporary epicardial pacing wires and a central venous catheter, and notices that the ground prong is missing from the machine's plug and a two-prong adapter has been fitted. What should the technician do?

    • A.Not use that machine, obtain a properly grounded unit, and report the defective plug✓ Answer
    • B.Use the machine, because the two-prong adapter restores the ground path
    • C.Plug it into an extension cord that runs to an outlet on a different circuit
    • D.Use it just for this short tracing, since the patient is already on a monitor

    The third prong provides a low-resistance path that carries leakage current safely to ground; a two-prong adapter or a broken ground pin eliminates that path and lets leakage current find another route. This patient is electrically sensitive because pacing wires and a central catheter conduct current directly to the myocardium, bypassing the resistance of the skin, so a current far too small to be felt on intact skin can induce ventricular fibrillation.

    Source: NFPA 99 Health Care Facilities Code and OSHA 29 CFR 1910.304(g) grounding requirements for patient-care electrical equipment; microshock hazard in the electrically susceptible patientReport a problem with this question

17. 17. A 12-lead tracing shows a uniform, fine, spiky oscillation of the baseline that is present in all leads at a constant rapid rate, while the patient is lying still, relaxed, and warm. What is the most likely cause and the appropriate correction?

    • A.Alternating-current interference; separate the lead wires from the power cord, move or unplug nearby powered equipment, and confirm the machine is properly grounded✓ Answer
    • B.Wandering baseline; re-prep the skin, remove lotion, and replace the electrodes
    • C.A broken lead wire; replace the affected limb electrode and rerun the tracing
    • D.Somatic tremor; warm the patient, support the limbs, and ask the patient to relax

    Alternating-current interference is recognized by its perfectly regular, uniform, fine spikes that make the baseline look thick, and it comes from surrounding electrical fields coupling into the patient cable, typically when lead wires cross or lie on the power cord, other powered devices are close by, or the machine's ground is not intact. Somatic tremor is irregular and jagged and follows patient movement or shivering, while wandering baseline is a slow undulation caused by respiration, loose electrodes, or oily skin, so both would be inconsistent with a still, relaxed patient and a constant fine oscillation.

    Source: NHA CET Test Plan, identify and resolve artifact; characteristics of AC (60-Hz) interference versus somatic tremor and wandering baselineReport a problem with this question

18. 18. As the technician removes the electrodes, the patient asks, "Did my EKG look normal? Am I having a heart attack?" What is the appropriate response?

    • A.Explain that the tracing goes to the provider, who will review it and discuss the results with the patient✓ Answer
    • B.Reassure the patient that the tracing looks normal, since nothing obviously abnormal was seen
    • C.Tell the patient not to worry because the machine's printed interpretation says the tracing is normal
    • D.Show the patient the tracing and point out the parts that look unusual

    The EKG technician acquires and records the tracing and may recognize and report findings to the licensed provider, but interpreting or disclosing results to the patient is outside the scope of practice and constitutes practicing medicine without a license. This holds even when the tracing looks unremarkable, and the machine's computer-generated statement is only a preliminary suggestion that requires physician overread, so repeating it to the patient can produce false reassurance or unnecessary alarm.

    Source: NHA CET Test Plan, scope of practice of the EKG technician; ethical standardsReport a problem with this question

19. 19. During a routine 12-lead on a hospitalized patient, the tracing abruptly becomes a chaotic, irregular, undulating baseline with no identifiable P waves, QRS complexes, or T waves, and the patient does not respond when spoken to and shaken. What should the technician do first?

    • A.Go to the nurses' station and document the finding in the patient's chart
    • B.Call for help and activate the emergency response system, stay with the patient, and begin CPR while the defibrillator or AED is brought✓ Answer
    • C.Check every lead wire and electrode first, because artifact is far more common than this rhythm
    • D.Complete the remaining leads so the physician receives a full 12-lead tracing

    A chaotic baseline with no organized complexes in an unresponsive patient is ventricular fibrillation, a pulseless arrest in which survival falls with every minute that compressions and defibrillation are delayed. Artifact can look similar, but artifact does not make a patient unresponsive, so the clinical assessment settles it; documenting and finishing the tracing are later steps, and the technician stays with the patient rather than leaving to find someone.

    Source: NHA CET Test Plan and 1.I (recognize and report life-threatening findings; cardiopulmonary compromise) with core-knowledge CPR/BLS; AHA BLS adult cardiac arrest sequenceReport a problem with this question

20. 20. A patient's spouse telephones the EKG department and asks the technician to email a copy of the tracing recorded that morning. What should the technician do?

    • A.Send the copy if the spouse can correctly state the patient's date of birth
    • B.Explain that records are released only through the facility's medical-records process with the patient's written authorization✓ Answer
    • C.Read the machine's interpretive statement over the phone instead of emailing the tracing
    • D.Send the copy, because disclosure to a spouse falls under treatment, payment, and health care operations

    Protected health information may be used or disclosed without authorization only for treatment, payment, and health care operations; a spouse is not part of the treatment team, so releasing the tracing requires the patient's written authorization. Reading the interpretation aloud is the same disclosure in another form, and knowing a date of birth verifies nothing about authorization because that information is widely known to family and acquaintances.

    Source: HIPAA Privacy Rule, 45 CFR 164.502 and 164.508 (authorization required for disclosures outside treatment, payment, and health care operations)Report a problem with this question

21. 21. Which information must appear on every completed EKG tracing before it is submitted for interpretation?

    • A.The patient's name and the technician's interpretation of the rhythm
    • B.The patient's full name, a second identifier such as date of birth or medical record number, the date and time of acquisition, and the technician's identification✓ Answer
    • C.The date only, because the electronic record supplies everything else automatically
    • D.The patient's room number, the ordering provider's name, and the working diagnosis

    Two patient-specific identifiers prevent a tracing from being filed under the wrong chart, the time of acquisition allows the tracing to be correlated with symptoms, medications, and prior tracings, and the technician's identification establishes who performed the study and can answer questions about technique. Room number is not a patient identifier because patients move, and the technician does not add an interpretation.

    Source: NHA CET Test Plan and 2.H (EMR/EHR entry and identification of the completed tracing)Report a problem with this question

22. 22. After the tracing is printed, the technician realizes it was labeled with the wrong patient's name. What is the correct way to handle the error?

    • A.Erase the entry or cover it with correction fluid so the record stays clean and easy to read
    • B.Discard the tracing without telling anyone and simply repeat the EKG
    • C.Draw a single line through the incorrect entry, write the correct information, and initial and date the correction✓ Answer
    • D.Write firmly over the incorrect name so that only the correct name remains legible

    The tracing is part of the legal medical record, so an error is corrected in a way that leaves the original entry readable and shows who changed what and when. Erasing, obliterating, or overwriting destroys the audit trail and can be read as concealment or falsification, and discarding the tracing without reporting hides a misidentification that may already have reached the chart of the wrong patient.

    Source: NHA CET Test Plan, documentation in the EMR/EHR; legal health record standard for single-line error correction with initials and dateReport a problem with this question

Practice questions based on the NHA Certified EKG Technician (CET) test plan, the standard 12-lead electrode positions defined by anatomical landmark, and durable cardiac electrophysiology. CET is a mark of the National Healthcareer Association; this site is not affiliated with or endorsed by NHA. An EKG technician records tracings and does not diagnose. Always follow your facility's policies, your state's scope of practice, and the direction of the ordering provider. About the CET exam →