A coworker in the cardiology clinic who is not involved in a patient's care asks an EKG technician to show her the patient's tracing because the patient is her neighbor. What should the technician do?

Decline, because she has no work-related need to see the tracing

Tell the coworker the result verbally instead of showing the printout

Show the tracing, since all clinic employees may view any patient record

Show the tracing only if the coworker promises to keep it private

A 72-year-old woman with diabetes tells the EKG technician she has felt unusually tired, short of breath and nauseated since this morning, but she has no chest pain. How should the technician view these symptoms?

As possible cardiac warning signs that should be reported

As important only if chest pain also develops later today

As expected signs of aging that do not need to be reported to anyone

As signs of a stomach illness unrelated to the heart

An EKG technician is preparing to record a routine resting 12-lead EKG on an adult. Which machine settings should be used unless the provider orders otherwise?

Paper speed 25 mm/s and gain 10 mm/mV

Paper speed 50 mm/s and gain 10 mm/mV

Paper speed 50 mm/s and gain 5 mm/mV

Paper speed 25 mm/s and gain 20 mm/mV

A telemetry technician is applying a 3-lead monitoring system using the standard US color code. Where should the white electrode be placed?

Lower right abdomen or rib cage

An EKG technician wants to post a photo on social media celebrating her first unusual tracing. The photo crops out the patient's name but shows the date, time and room number. What is the best action?

Do not post it, because the details could still identify the patient

Post it, because removing the name makes the tracing fully anonymous to readers

Post it after one week, when the patient has gone home

Post it only to friends who do not work at the hospital

A provider asks for a tracing at 50 mm/s on a patient with a very fast heart rate. How will the complexes look compared with a 25 mm/s recording?

Twice as wide, and the speed must be noted

Unchanged, because only the rhythm strip changes

Twice as tall, and the gain must be noted

Half as wide, and no note is needed

Using the standard US color code for a 3-lead cardiac monitor, where should the red electrode be placed?

4th intercostal space, right sternal border

Certified EKG Technician Exam

Free EKG Technician (CET) Practice Questions

10 sample questions for the Certified EKG Technician Exam, with the correct answer and an explanation for each. No account needed. Try each one before you open the answer.

Sections covered on the exam: Safety, Infection Control and HIPAA, Scope of Practice, Ethics, Communication and the EHR, Vital Signs, Cardiopulmonary Compromise and BLS, EKG Equipment, Supplies and Machine Settings, Skin Preparation, Positioning and 12-Lead Placement, Patient Instruction for Stress Tests and Ambulatory Monitors, Artifacts, Lead Verification and Tracing Documentation, Ambulatory, Telemetry, Stress Test and Special Lead Placement, Sinus, Atrial, Junctional Rhythms and Heart Blocks, Ventricular Rhythms, Pacemakers, Ischemia and Emergencies.

Question 1 · Safety, Infection Control and HIPAA
A coworker in the cardiology clinic who is not involved in a patient's care asks an EKG technician to show her the patient's tracing because the patient is her neighbor. What should the technician do?
- A.Tell the coworker the result verbally instead of showing the printout
- B.Show the tracing, since all clinic employees may view any patient record
- C.Show the tracing only if the coworker promises to keep it private
- D.Decline, because she has no work-related need to see the tracing
Show answer and explanation
Answer: D. Decline, because she has no work-related need to see the tracing
Under the HIPAA Privacy Rule, staff may access protected health information only when they need it for their job (the minimum necessary standard). A promise of privacy or a verbal summary is still an improper disclosure, and working in the same clinic does not give access to every record.
Question 2 · Vital Signs, Cardiopulmonary Compromise and BLS
A 72-year-old woman with diabetes tells the EKG technician she has felt unusually tired, short of breath and nauseated since this morning, but she has no chest pain. How should the technician view these symptoms?
- A.As important only if chest pain also develops later today
- B.As possible cardiac warning signs that should be reported
- C.As expected signs of aging that do not need to be reported to anyone
- D.As signs of a stomach illness unrelated to the heart
Show answer and explanation
Answer: B. As possible cardiac warning signs that should be reported
Women, older adults and people with diabetes often have atypical cardiac symptoms such as fatigue, shortness of breath, nausea or indigestion instead of classic chest pain. The technician recognizes these as possible cardiopulmonary compromise and reports them to the nurse or provider rather than dismissing them.
Question 3 · EKG Equipment, Supplies and Machine Settings
An EKG technician is preparing to record a routine resting 12-lead EKG on an adult. Which machine settings should be used unless the provider orders otherwise?
- A.Paper speed 50 mm/s and gain 10 mm/mV
- B.Paper speed 50 mm/s and gain 5 mm/mV
- C.Paper speed 25 mm/s and gain 10 mm/mV
- D.Paper speed 25 mm/s and gain 20 mm/mV
Show answer and explanation
Answer: C. Paper speed 25 mm/s and gain 10 mm/mV
Standard settings are a paper speed of 25 mm/s and a gain of 10 mm/mV, the values every interval and amplitude norm is based on. A speed of 50 mm/s or a gain of 5 or 20 mm/mV is used only for specific reasons and must be noted on the tracing.
Question 4 · Patient Instruction for Stress Tests and Ambulatory Monitors
A telemetry technician is applying a 3-lead monitoring system using the standard US color code. Where should the white electrode be placed?
- A.Just below the right clavicle
- B.Lower right abdomen or rib cage
- C.Just below the left clavicle
- D.Lower left abdomen or rib cage
Show answer and explanation
Answer: A. Just below the right clavicle
The white (right arm) electrode goes just under the right clavicle, the black (left arm) electrode goes under the left clavicle and the red (left leg) electrode goes on the lower left rib cage or abdomen. The lower right area is used for the green electrode in a 5-lead system.
Question 5 · Ambulatory, Telemetry, Stress Test and Special Lead Placement
At the standard paper speed of 25 mm/s, how much time does one small box represent on the horizontal axis of EKG paper?
- A.0.04 second
- B.0.02 second
- C.0.10 second
- D.0.20 second
Show answer and explanation
Answer: A. 0.04 second
At 25 mm/s, each 1 mm small box equals 1/25 of a second, or 0.04 second. A large box (5 small boxes) equals 0.20 second; 0.02 second would apply at 50 mm/s, and 0.10 is a vertical voltage value (mV), not a time.
Question 6 · Safety, Infection Control and HIPAA
An EKG technician wants to post a photo on social media celebrating her first unusual tracing. The photo crops out the patient's name but shows the date, time and room number. What is the best action?
- A.Do not post it, because the details could still identify the patient
- B.Post it, because removing the name makes the tracing fully anonymous to readers
- C.Post it after one week, when the patient has gone home
- D.Post it only to friends who do not work at the hospital
Show answer and explanation
Answer: A. Do not post it, because the details could still identify the patient
Dates, times, room numbers and other details can identify a patient, so the photo is still protected health information and posting it would violate the HIPAA Privacy Rule. Limiting the audience or waiting does not make the disclosure acceptable; PHI should never be posted on social media.
Question 7 · Vital Signs, Cardiopulmonary Compromise and BLS
Two EKG technicians are performing CPR on an unresponsive, pulseless 6-year-old in a pediatric clinic. What compression-to-breath ratio should they use?
- A.15 compressions to 2 breaths
- B.5 compressions to 1 breath
- C.15 compressions to 1 breath
- D.30 compressions to 2 breaths
Show answer and explanation
Answer: A. 15 compressions to 2 breaths
For children and infants, two rescuers use a 15:2 ratio, while a single rescuer uses 30:2. The 30:2 ratio applies to all adults and to one-rescuer pediatric CPR, and the other ratios are not part of current BLS guidelines.
Question 8 · EKG Equipment, Supplies and Machine Settings
A provider asks for a tracing at 50 mm/s on a patient with a very fast heart rate. How will the complexes look compared with a 25 mm/s recording?
- A.Unchanged, because only the rhythm strip changes
- B.Twice as tall, and the gain must be noted
- C.Half as wide, and no note is needed
- D.Twice as wide, and the speed must be noted
Show answer and explanation
Answer: D. Twice as wide, and the speed must be noted
Doubling the paper speed spreads each complex over twice as much paper, making waves twice as wide and easier to separate at fast rates; the speed must be noted so intervals are not misread. Paper speed does not change height, and the change affects every lead, not just the rhythm strip.
Question 9 · Patient Instruction for Stress Tests and Ambulatory Monitors
Using the standard US color code for a 3-lead cardiac monitor, where should the red electrode be placed?
- A.Just below the right clavicle
- B.Just below the left clavicle
- C.4th intercostal space, right sternal border
- D.Lower left rib cage or abdomen
Show answer and explanation
Answer: D. Lower left rib cage or abdomen
The red (left leg) electrode goes on the lower left rib cage or abdomen; 'smoke over fire' reminds that black sits above red on the left side. White goes below the right clavicle, black below the left clavicle, and the right sternal border is the usual brown chest electrode site in a 5-lead system.
Question 10 · Ambulatory, Telemetry, Stress Test and Special Lead Placement
The EKG machine is set to standard gain, 10 mm/mV, and the calibration pulse is 10 mm tall. An R wave in lead V5 measures 15 small boxes tall. What voltage does this R wave represent?
- A.3.0 mV
- B.0.6 mV
- C.1.5 mV
- D.15 mV
Show answer and explanation
Answer: C. 1.5 mV
At standard gain each small box vertically equals 0.1 mV, so 15 x 0.1 = 1.5 mV (15 mm / 10 mm per mV). A value of 3.0 mV would apply if the machine were at half gain (5 mm/mV), 15 mV mistakes millimeters for millivolts, and 0.6 mV confuses height with time.

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