CET NHA Certified EKG Technician - Set 2 - Part 3

Correct Answer: Audit trail of every user action

Unique user IDs create an audit trail that records exactly who accessed which record and when. The audit trail supports accountability, breach investigation, and compliance with the Security Rule's access control requirements. Option a is incorrect because faster login through shared accounts would actually break accountability and is explicitly banned in health care systems. Speed is never the design goal of credentialing in an environment governed by federal privacy rules. Option b is incorrect because identical credentials across staff defeat the entire purpose of unique IDs by erasing the trail back to specific people. Shared logins make accountability impossible and would be the opposite of what the Security Rule demands. Option d is incorrect because password sharing is prohibited under HIPAA's Security Rule and most facility policies regardless of friendship. Sharing credentials lets one user's audit trail wear another user's name, which corrupts every later

Correct Answer: Use paper downtime documentation forms

Facilities use paper downtime procedure forms during electronic record outages so care and documentation continue without gaps. Paper entries are later scanned in or transcribed into the patient's chart once the system returns to service. Option a is incorrect because skipping documentation until the system returns leaves a gap that may be hard to fill accurately later. Real-time documentation is a basic record-keeping standard that downtime forms exist to preserve. Option b is incorrect because estimating times after the fact damages the accuracy that medical records require and can be challenged in any later review. Estimation also undermines the legal defensibility of the entry. Option c is incorrect because sending patients home over a system outage denies care that the facility's downtime procedures are specifically designed to support. Delays during downtime can harm patients who need timely diagnostic information.

Correct Answer: Confirm tracing attached to correct patient

Confirming that the tracing attached to the correct patient prevents one of the most common and dangerous documentation errors, namely a tracing filed under the wrong chart. This last check protects the integrity of both records involved. Option b is incorrect because printing the tracing for personal records duplicates protected information on a piece of paper that becomes another item to protect. Personal copies of patient data are a HIPAA violation outside of authorized clinical purposes. Option c is incorrect because emailing a copy to a coworker transmits protected information through a channel that may not be encrypted or authorized for clinical data. Casual email of patient data is a clear privacy breach risk. Option d is incorrect because saving a copy on a personal drive removes protected information from the facility's controlled environment entirely. Personal storage of patient data violates both facility policy and the technical safeguards required for protected inform

Correct Answer: Confidentiality of information from unauthorized eyes

Automatic logoff protects confidentiality by preventing anyone walking by from seeing a chart left open on an unattended screen. The CIA triad's confidentiality pillar covers the controls that block unauthorized viewing of protected information. Option a is incorrect because availability concerns whether information is accessible when needed and uses backup systems and downtime procedures. Automatic logoff actually blocks access temporarily and is not the design feature that supports availability. Option b is incorrect because integrity refers to whether records are accurate and unaltered, which is supported by audit controls and edit restrictions. Logoff features do not directly police changes to records, so integrity is not the pillar this serves. Option d is incorrect because speed of clinician workflow is not part of the CIA triad at all. Workflow speed is a usability concern that systems balance against the security pillars, not one of the three pillars themselves.

Correct Answer: Designed to be shared across organizations

An electronic health record is designed for interoperability so that data can be shared across multiple health care organizations and care settings. This broader design is what distinguishes it from the single-practice electronic medical record. Option a is incorrect because being used only by the original practice describes the narrower electronic medical record, not the broader electronic health record. Single-practice use is the limitation that the EHR design explicitly aims to overcome. Option b is incorrect because identical to the older paper chart describes an early digitization concept that lacks the interoperability that defines an EHR. Modern EHR design goes well beyond a digital photocopy of a paper file. Option c is incorrect because being limited to within a single clinic again describes the narrower electronic medical record concept. The EHR was built precisely to escape clinic boundaries so providers across organizations can share information.

Correct Answer: Diaphoresis, pallor, dyspnea, radiating chest pressure

Diaphoresis, pallor, dyspnea, and radiating chest pressure together form a classic cardiopulmonary compromise presentation that often signals acute coronary syndrome. The combination demands immediate help, monitoring, and notification of the supervising clinician. Option b is incorrect because a mild dry cough with stable vital signs is not a feature of acute cardiopulmonary compromise. Many benign causes produce isolated coughs without any of the warning signs the scenario described. Option c is incorrect because a small bruise on the arm is a localized finding unrelated to cardiopulmonary status. A bruise has no direct implication for the heart or lungs and does not match the urgent presentation described. Option d is incorrect because a patient complaint about cold room air points to environmental comfort, not to cardiopulmonary compromise. Comfort complaints are easily addressed and do not signal the kind of clinical emergency the scenario describes.

Correct Answer: Call for help, start CPR, get AED

The first actions are to call for help, begin high-quality CPR, and ensure the automated external defibrillator is brought to the bedside. Early CPR and rapid defibrillation are the key links in the in-hospital chain of survival. Option a is incorrect because continuing the EKG ignores the immediate cardiac arrest unfolding in front of the technician. Producing a tracing has no value when the patient has no circulation, and the priority shifts entirely to resuscitation. Option b is incorrect because leaving the room for any non-emergency reason abandons a patient in cardiac arrest and wastes irreplaceable minutes. Personal needs do not interrupt life-threatening clinical situations under any standard of practice. Option d is incorrect because waiting for rounds delays the resuscitation that minutes-matter survival depends on. Passive waiting during cardiac arrest is among the most preventable causes of poor outcomes documented in resuscitation literature.

Correct Answer: About one hundred to one twenty per minute

AHA guidelines call for adult chest compressions at one hundred to one hundred twenty per minute to maximize forward blood flow during resuscitation. Slower or faster rates reduce the effectiveness of cardiac output during the arrest. Option a is incorrect because sixty per minute is well below the recommended rate and does not produce enough cardiac output during cardiac arrest. Slow compressions allow the heart and brain to remain underperfused throughout the resuscitation attempt. Option b is incorrect because eighty per minute also falls short of the recommended floor of one hundred. While faster than sixty, this rate still fails to generate the forward flow that the recommended range produces in practice. Option c is incorrect because fifty per minute is so slow that it almost guarantees inadequate perfusion. Compressions this slow are sometimes seen with rescuer fatigue or hesitation and require immediate course correction by switching providers or coaching.

Correct Answer: Ventricular fibrillation and pulseless ventricular tachycardia

Ventricular fibrillation and pulseless ventricular tachycardia are the two shockable rhythms an AED is designed to recognize and treat. The device delivers an unsynchronized shock to attempt to convert the chaotic electrical activity back to organized rhythm. Option b is incorrect because asystole and pulseless electrical activity are non-shockable rhythms that require high-quality CPR and epinephrine rather than defibrillation. Delivering a shock to these rhythms would not restore circulation. Option c is incorrect because normal sinus rhythm with a sinus pause is not a cardiac arrest pattern and certainly not shockable. The AED would not advise a shock for a patient who is not in arrest, even with a pause. Option d is incorrect because atrial fibrillation with a normal ventricular response is not a cardiac arrest rhythm. Atrial fibrillation may be treated with synchronized cardioversion in unstable cases by clinicians, but it is not an AED-shockable arrest rhythm.

Correct Answer: Place pads at least one inch from device and remove patch

AED pads should be placed at least one inch away from any implanted device, and transdermal medication patches should be removed before pad placement. These adjustments preserve effective current flow without damaging the implant. Option a is incorrect because placing a pad directly over an implanted device can damage the device circuitry and reduce the shock's effectiveness on the heart. The recommended one-inch offset both protects the implant and improves the chance of conversion. Option c is incorrect because skipping the shock when the AED advises one denies the patient a time-critical intervention that may restore circulation. The implant and patch can be managed with placement adjustments rather than withholding therapy. Option d is incorrect because placing pads only on the lower back deviates from the standard anterior-anterior or anterior-posterior arrangements the AED is designed to use. Device instructions specify pad locations that the lower back placement does not ma