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Normal QRS duration is:

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B
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to track
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Key Facts: CCT Exam

130

Total Items

110 scored + 20 unscored

2 hrs

Exam Time

CCI

$175

Exam Fee

CCI

650/900

Passing Scaled Score

CCI

CCI CCT (Certified Cardiographic Technician) is the entry-level cardiac monitor tech credential. 130 items (110 scored + 20 unscored), 2 hours, $175, scaled passing 650/900. Eligibility: HS diploma + CV-tech educational/work background. Master 12-lead lead placement, dysrhythmia recognition, Bruce protocol stages, and target HR (85% × (220-age)).

Sample CCT Practice Questions

Try these sample questions to test your CCT exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1Where is the V1 precordial electrode placed on a standard 12-lead ECG?
A.4th intercostal space at the left sternal border
B.4th intercostal space at the right sternal border
C.5th intercostal space at the midclavicular line
D.5th intercostal space at the anterior axillary line
Explanation: V1 is placed at the 4th intercostal space immediately to the right of the sternum. This anatomic landmark provides a direct view of the right ventricle and septum, and is the reference for QRS morphology used to identify right-sided pathology and bundle branch blocks.
2Which leads form Einthoven's triangle on a standard 12-lead ECG?
A.Leads V1, V2, and V3
B.Leads aVR, aVL, and aVF
C.Leads I, II, and III
D.Leads I, aVF, and V6
Explanation: Einthoven's triangle is formed by the three standard bipolar limb leads I (RA-LA), II (RA-LL), and III (LA-LL). The triangle is the geometric basis for calculating the augmented limb leads and the frontal-plane axis.
3On a standard ECG recording at default settings, 1 mV of voltage produces a deflection of how many millimeters?
A.5 mm
B.10 mm
C.15 mm
D.20 mm
Explanation: Standard ECG calibration is 1 mV = 10 mm vertical deflection at a paper speed of 25 mm/sec. The square calibration mark at the start of each tracing verifies this gain so that voltage measurements (e.g., for hypertrophy criteria) are accurate.
4What is the standard paper speed for a 12-lead ECG recording?
A.10 mm/sec
B.25 mm/sec
C.50 mm/sec
D.100 mm/sec
Explanation: Standard ECG paper speed is 25 mm/sec. At this speed each small (1 mm) box equals 0.04 seconds and each large (5 mm) box equals 0.20 seconds, which forms the basis for all interval and rate measurements.
5A patient's V5 electrode is placed too low and too lateral. Which finding is MOST likely on the tracing?
A.Tall peaked T waves in V5
B.Loss of normal R wave progression and altered QRS morphology
C.Sawtooth flutter waves
D.Prolonged QT interval
Explanation: Misplacement of precordial electrodes alters the spatial vector recorded and disturbs normal R wave progression across V1-V6. Diagnostic errors include false suggestions of MI, hypertrophy, or bundle branch block, so careful anatomic placement is essential.
6Which leads are considered the inferior leads on a 12-lead ECG?
A.V1, V2, V3
B.I, aVL, V5, V6
C.II, III, aVF
D.aVR and V1
Explanation: Leads II, III, and aVF view the inferior wall of the left ventricle, typically supplied by the right coronary artery. ST changes in these three leads localize ischemia or infarction to the inferior wall.
7Normal R wave progression on the precordial leads is described as:
A.R wave amplitude decreases progressively from V1 to V6
B.R wave amplitude increases progressively from V1 through V4 or V5
C.R waves are absent in V1 through V4
D.R wave is largest in V1 and smallest in V6
Explanation: Normal R wave progression shows a small R in V1 that increases in amplitude through V4 or V5 with the transition zone (R = S) typically at V3-V4. Poor R wave progression suggests anterior MI, LVH, or lead misplacement.
8Where is the V6 electrode placed?
A.Anterior axillary line, same horizontal level as V4
B.Midaxillary line, same horizontal level as V4
C.Posterior axillary line, 5th intercostal space
D.Midclavicular line, 5th intercostal space
Explanation: V6 is placed at the midaxillary line on the same horizontal level as V4 and V5. V4-V6 are aligned horizontally rather than following intercostal spaces.
9Reversal of the right arm and left arm electrodes typically produces which finding?
A.Inverted P, QRS, and T waves in lead I
B.Tall R waves in V1
C.ST elevation in inferior leads
D.A prolonged PR interval
Explanation: RA/LA limb-lead reversal inverts the polarity of lead I and swaps aVR with aVL. The classic clue is a globally negative P-QRS-T in lead I with normal precordial morphology, which is impossible from true cardiac pathology and indicates the swap.
10When preparing skin for electrode placement, which step BEST improves signal quality?
A.Apply electrodes directly over hair without preparation
B.Wipe with alcohol and lightly abrade the skin to remove dead cells and oils
C.Moisten the skin with sterile saline only
D.Place electrodes over a thin layer of lotion to improve adhesion
Explanation: Cleansing with alcohol followed by gentle skin abrasion lowers skin impedance by removing dead epithelial cells and surface oils, dramatically improving electrode contact and reducing baseline wander and motion artifact.

About the CCT Exam

CCI entry-level credential for ECG, Holter, and stress-test technicians. Validates expertise in 12-lead ECG anatomy and lead placement, rhythm recognition (sinus, atrial, junctional, ventricular, AV blocks, bundle branch blocks, paced, WPW), Holter/ambulatory monitoring, exercise treadmill stress testing (Bruce protocol) and pharmacologic stress agents, patient care/safety, and equipment QA.

Questions

130 scored questions

Time Limit

2 hours

Passing Score

Scaled 650/900

Exam Fee

$175 (CCI)

CCT Exam Content Outline

25%

ECG (12-Lead, Lead Placement, Anatomy)

Einthoven's triangle, V1-V6 placement (V1 4th ICS R sternal), R wave progression

25%

Rhythm Recognition

Sinus, atrial (PAC, AFib, AFlutter), junctional, ventricular (PVC, VT, VF), AV blocks, BBB, paced

15%

Holter / Ambulatory ECG

24-48h Holter, event monitor, MCT, patient diary, electrode placement

15%

Stress Testing

Bruce protocol, modified Bruce, target HR, contraindications, pharmacologic (regadenoson, dobutamine, adenosine)

10%

Patient Care, Safety, Communication

Skin prep, electrode adhesion, consent, identification, infection control

10%

Equipment, Quality, Compliance

Calibration (1mV=10mm; 25 mm/sec), filter settings, artifact recognition

How to Pass the CCT Exam

What You Need to Know

  • Passing score: Scaled 650/900
  • Exam length: 130 questions
  • Time limit: 2 hours
  • Exam fee: $175

Keys to Passing

  • Complete 500+ practice questions
  • Score 80%+ consistently before scheduling
  • Focus on highest-weighted sections
  • Use our AI tutor for tough concepts

CCT Study Tips from Top Performers

1Master V1-V6 lead placement: V1 4th ICS R sternal, V2 4th ICS L sternal, V4 5th ICS MCL, V3 between V2/V4, V5 anterior axillary, V6 mid-axillary
2Memorize target HR: 85% × (220 − age); know absolute contraindications (acute MI, unstable angina, severe AS, acute PE)
3Know rhythm hallmarks: AFib (irregularly irregular, no P waves), AFlutter (sawtooth at 250-350 atrial), 3° AV block (P-QRS dissociation, regular but unrelated)
4Apply ECG calibration: 1 mV = 10 mm vertical; paper speed 25 mm/sec (1 small box = 0.04 sec; 1 large box = 0.20 sec)
5Recognize artifacts: 60 Hz electrical (regular fast spikes), muscle tremor (irregular high-frequency), baseline wander (slow drift), lead misplacement (unexpected R-wave progression)

Frequently Asked Questions

Where do V1-V6 leads go?

V1: 4th intercostal space, RIGHT sternal border. V2: 4th ICS, LEFT sternal border. V4: 5th ICS, midclavicular line. V3: midway between V2 and V4. V5: 5th ICS (same horizontal as V4), anterior axillary line. V6: 5th ICS, midaxillary line. Common error: V1/V2 too high (1st-2nd ICS) → falsely altered R-wave progression.

What is target heart rate for stress testing?

Target HR = 85% × (220 − age) for diagnostic adequacy. Example: 50-year-old's max HR = 220 − 50 = 170; target = 0.85 × 170 = ~145 bpm. Achieving 85% of age-predicted max indicates an adequate diagnostic stress. Test termination criteria: target HR achieved + clinical/ECG indicators (chest pain, ST depression ≥2mm, BP drop >10 mmHg, sustained ventricular arrhythmia, severe symptoms, patient request).

What is the Bruce protocol?

Standard Bruce protocol uses 3-minute stages with progressive increases in treadmill speed AND incline. Stage 1: 1.7 mph at 10% grade. Stage 2: 2.5 mph at 12%. Stage 3: 3.4 mph at 14%. Stage 4: 4.2 mph at 16%. Stage 5: 5.0 mph at 18%. Stage 6: 5.5 mph at 20%. Stage 7: 6.0 mph at 22%. Modified Bruce starts with 2 lower-intensity stages (1.7 mph at 0% then 5%) for elderly/deconditioned patients.

How should I study for CCI CCT?

Plan 40-60 hours over 6-8 weeks. Focus on ECG anatomy/lead placement (25%) and rhythm recognition (25%) — together half the exam. Master the 12-lead system, common dysrhythmias (especially AFib, AFlutter, AV blocks, VT/VF), Bruce protocol stages, target HR calculation, and Holter monitoring basics.