Stress Testing Midterm Exam
Select the best answer. Use powerpoint to find answers.
1. What heart rhythm wave form is monitored during a stress test?
a. QRS complex
b. J-point of the ST segment
c. PRI
2. What is the MET level used for known CAD patients:
a. 6 METs
b. 2 METs
c. 4 METs
3. What stress test protocol is used for elderly patients of patients with diagnosed heart disease?
a. Naughton
b. James
c. Modified Bruce
4. What is the other term used for double product?
a. Rate pressure product
b. Rate product
c. Pressure product
5. What is the THR for a 50 year old patient?
a. 130 bpm
b. 170 bpm
c. 200 bpm
6. What is the % of the heart rate that is achieved during a stress test?
a. 90%
b. 85%
c. 60%
7. What is the % of the heart rate used for post MI patients during a stress test?
a. 50 %
b. 20%
c. 70%
8. What is calculated to determine the level of exercise to be achieved with a stress test?
a. Double product
b. Double heart rate
c. Single product
9. What is the double product for an acceptable level of exercise achieved in a stress test?
a. Greater than 50,000
b. Greater than 10,000
c. Greater than 20,000
10. What would be the cause of a stress test double product being 20,000 or less?
a. Early termination of the test
b. Presence of heart disease
c. Report of a false positive
11. A patient is scheduled for a stress test, his heart rate is 100, and his SBP is 130. What is the double
product for this patient?
a. 150,000
b. 130,000
c. 110,000
12. Tall P waves are a normal ECG change during a stress test.
a. True
b. False
13. Chronotropic incompetence refers to heart rate not increasing with stress.
a. True
b. False
14. Inotropic reserve refers to an increase in blood pressure with exercise.
a. True
b. False
15. A nuclear stress test involves the injection of a medication to increase the patient’s heart rate.
a. True
b. False
16. A nuclear stress test provides a picture of heart muscle functioning.
a. True
b. False
17. With exercise, what two factors increase and lead to an increase in cardiac output?
a. Heart rate and stroke volume
b. Pulmonary and systematic resistance
c. Systolic and diastolic blood pressure
d. End diastolic and end systolic volumes
18. A positive chronotropic effect will result in:
a. A decrease in heart rate
b. An increase in heart rate
c. A decrease in force of contraction
d. An increase in force of contraction
19. Which of the following procedures would you have a patient perform prior to exercise
stress testing to rule out normal ST-T wave changes?
a. Hyperventilation
b. Valsalva maneuver
c. Jog in place for three minutes
d. Raise arms above head for three minutes
20. The ability of a positive exercise stress test to correctly identify patients with documented
coronary artery disease is known as the test:
a. Sensitivity
b. Specificity
c. Relative risk
d. Predictive value
21. The normal electrocardiographic response to exercise is :
a. Increase PR and R-R intervals
b. Decrease PR and R-R intervals
c. Increase PR interval and decrease R-R interval
d. Decrease PR interval and increase R-R interval
22. Which of the following is used in the formula to predict the maximal heart rate for an
exercise stress test?
a. Age
b. Prothrombin time
c. Height and weight
d. Resting heart rate
23. Metabolic equivalents (METs) are commonly used in exercise protocols to express the:
a. Degree of patient anxiety
b. Workload in various stages (intensity of exercise)
c. Functional aerobic impairment
d. Targeted end point for the exam
24. Which of the following is an absolute contraindication for exercise stress testing?
a. Brachy- arrhythmias
b. Artificial pacemakers
c. Patient taking digitalis
d. Unstable or crescendo angina
25. Where electrodes should be placed to reduce artifact produced by muscular movements?
a. Over the ribs
b. Between the ribs
c. Low on the arms
d. High on the arms
26. What are the indications for intracardiac electrophysiology study of patients with
unexplained syncope?
a. Positive head-down tilt test
b. Negative head-up tilt test
c. No known structural heart disease
27. All of the following are absolute contraindications for stress testing EXCEPT
a. Acute MI
b. Controlled BP
c. Severe anemia
d. Uncontrolled ventricular rhythms
28. Stress testing requires informed consent.
a. True
b. False
29. 12 Lead EKG electrode placement for stress test is:
a. Limb leads are arms and ankles
b. Mason-Likar format
c. 12 lead electrode placement is not used
30. Chronotropic incompetence is:
a. Heart rate increases with exercise
b. Heart rate decreases with exercise
c. Heart rate is unchanged with exercise
31. An inotropic reserve is:
a. Increase in blood pressure with exercise
b. Decrease in blood pressure with exercise
c. Blood pressure unchanged with exercise
32. With stress testing, what is a normal change to the J-point?
a. J-point elevation
b. J-point unchanged
c. J-point depression
33. All of the following wave changes indicates a positive stress test EXCEPT:
a. ST segment unchanged
b. ST segment elevation or depression
c. U wave inversion or new appearance
34. A positive stress test with a positive angiogram indicates the:
a. Sensitivity of the test
b. Specificity of the test
c. Incomplete test results
35. When a stress test is positive and the angiogram results is also positive, confirming CAD:
a. The test results is called False positive
b. The test results is called False negative
c. The test results is called True positive
36. A poor prognostic finding for a stress test procedure includes:
a. Low workload
b. METs less than 6.5
c. Low peak heart rate
d. All of the above
e. None of the above
37. What stress test protocol should be used for post MI patients?
a. Bruce
b. Modified Bruce
c. Naughton
38. Of the following which EKG change is most indicative of CAD?
a. Up-sloping ST – segment
b. Horizontal ST- segment
c. Down-sloping ST – segment
39. Lexiscan is a
a. Pharmacological stress test without radioactive substance
b. Test using a radioactive substance without exercise
c. Stress test (exercise) and using a radioactive substance\
Short Answers
40. Describe one type of treatment for a positive stress test. (5 pts)
41. Describe an echocardiogram. (5 pts)