Certified EkG technician (CET) Practice Exam

When preparing to perform a 12-lead EKG on a patient with dextrocardia, where should lead V1 be placed?

1. Right sternal border, fourth intercostal space

2. Left sternal border, fourth intercostal space

3. Midclavicular line, second intercostal space

4. Over the xiphoid process

The correct answer is: Right sternal border, fourth intercostal space

When preparing to perform a 12-lead EKG on a patient with dextrocardia, lead V1 should be placed at the right sternal border in the fourth intercostal space. Dextrocardia is a condition where the heart is positioned on the right side of the thorax instead of the left. In a standard EKG, lead V1 is typically placed on the left side of the chest in the same anatomical location; however, because the heart's orientation is reversed in patients with dextrocardia, the placement of lead V1 also shifts to the right side. This allows for accurate monitoring of the electrical activity of the heart in relation to its actual location within the chest cavity. Therefore, placing lead V1 at the right sternal border, fourth intercostal space, ensures that the EKG readings will properly reflect the heart's electrical impulses. The other options do not account for the positional changes required in cases of dextrocardia. The placements at the left sternal border or in the midclavicular line would not provide accurate readings for a heart that is oriented differently, and placing lead V1 over the xiphoid process does not align with traditional lead placements,