HealthcareSeptember 25, 20267 min read

NHA CET EKG Exam Content Outline 2026: What Gets Tested

Every NHA CET domain, how much of the paper it is, what its questions ask you to do and the order to study it in, straight from the NHA outline.

3Domains
120Questions
120 minTime
44%Heaviest area
$134Exam fee

NHA CET exam content outline 2026 with domain weights

The outline at a glance
What each domain actually asks
Study it in this order
How the exam is built
Where candidates lose marks
FAQ
Sources

The outline at a glance

National Healthcareer Association publishes the CET outline that every NHA CET question is written against (Current CET test plan is based on a job analysis completed in 2017 and remains in force through 2026. NHA announced (September 2026) a new CET exam for Winter 2027/2028, with new study materials in Fall 2027 and 'minimal impact to exam topics and content areas'.). This page turns that document into what you actually need before you study: how big each area is, what the questions in it ask you to do, and the order to learn it in.

EKG Acquisition~44 questions44%
Safety, Compliance, and Coordinated Patient Care~32 questions32%
EKG Analysis and Interpretation~24 questions24%

100 scored items in 3 domains (item counts equal percentages). 'Core Knowledge' (basic cardiac anatomy and physiology, emergencies related to cardiac testing, CPR/BLS) is not a standalone domain but can appear in any domain. The test plan says items may require recall and critical thinking. The 2017-based plan is older than the CPT plan, which was refreshed for January 2026.

What each domain actually asks

The official outline describes what each area covers. Below is what the questions in it ask you to do, which is what decides how you should study it.

EKG Acquisition

44%~44 items

It asks you to: The biggest domain. It asks where each electrode goes (including right-sided, posterior, and amputee modifications), which artifact a tracing shows and how to fix it, and which setting is wrong when a tracing looks too large or too fast.

Maintain EKG equipment (paper, clips, disinfection)
Verify machine settings (paper speed, gain)
Skin preparation and patient positioning (incl. amputees, late-term pregnancy, respiratory issues)
Electrode placement for 12-lead, Holter/event, stress, telemetry, right-sided and posterior leads, pediatric
Verify all leads recorded; elements of a complete tracing
Identify and fix artifact (wandering baseline, somatic tremor, AC interference)
Mount tracings; monitor patients and support during stress-test complications

Safety, Compliance, and Coordinated Patient Care

32%~32 items

It asks you to: Questions put you with a patient before or during a cardiac test: what to tell someone starting a Holter monitor or stress test, whether a vital sign is abnormal for the patient's age, and what to do when a patient reports chest pain or becomes syncopal.

HIPAA regulations
Infection control (OSHA, universal precautions)
Scope of practice and ethics (NHA Code of Ethics)
Communication with patients and the interdisciplinary team
Obtain and interpret vital signs across the lifespan
Patient instruction for stress testing and ambulatory (Holter, event) monitors
Enter data in EMR/EHR
Recognize signs of cardiopulmonary compromise; CPR/BLS

EKG Analysis and Interpretation

24%~24 items

It asks you to: You read strips: calculate a rate, measure a PR interval or QRS duration, name the rhythm or block, spot pacer spikes or ST changes, and choose the correct immediate action when a strip shows V-fib or V-tach.

Calculate heart rate (6-second method, R-R interval, sequencing); max/target heart rate formulas
Determine rhythm regularity
Measure PR interval, QRS duration, QT interval on graph paper
Inspect P waves, QRS complexes, ST segments, T waves; electrolyte effects
Identify sinus, atrial, junctional, ventricular rhythms and heart blocks
Recognize pacemaker spikes
Identify ischemia, injury and infarction; act on life-threatening arrhythmias (VF, VT)

Study it in this order

Weight is the only honest guide to where your hours go. The areas that make up the first half of the paper are core; the next third is support; whatever is left is a quick win you review last, not skip.

Domain	Weight	Items	Priority
EKG Acquisition	44%	~44	Core
Safety, Compliance, and Coordinated Patient Care	32%	~32	Core
EKG Analysis and Interpretation	24%	~24	Support

Item counts are the weight applied to 100 scored questions and rounded, so treat them as approximate.

How the exam is built

Item	Detail
Questions	120
Scored questions	100
Unscored pretest items	20
Time	120 minutes
Delivery	At your school/training institution, at a PSI testing center, or via live remote proctoring (LRP)
Passing standard	Scaled score method; scaled scores range from 200 to 500 and a scaled score of 390 or higher is required to pass (NHA Candidate Handbook, updated 06/01/2026)
Fee	$134 — $134 is the list price of the CET Exam Application in the NHA online store (checked September 2026). Candidates testing through a partner school may pay a different/institution price. A full fee is due for every attempt, including retakes.
Retakes	After a failed first attempt you may retake after a 30-day waiting period. Up to three attempts are allowed with at least 30 days between each; after each failure beyond the third you must wait one year. Each retake requires re-registration and the full exam price. NHA notes that anyone who fails within 30 days before the new CET exam launches (Winter 2027/2028) will retest on the new exam.

Where candidates lose marks

These are the places the outline and the real exam part ways, the parts of the outline candidates misjudge most often:

EKG Acquisition is 44% of the exam, not rhythm reading. Candidates who spend most of their time on arrhythmias under-prepare for lead placement, machine settings, and artifact troubleshooting.
Lead placement variants such as right-sided, posterior, amputee, and pediatric placements, plus Holter, telemetry, and stress-test configurations, are listed explicitly. Knowing only the standard 12-lead layout is not enough.
Artifact identification: know which pattern is a wandering baseline, somatic tremor, or 60-cycle (AC) interference, and the fix for each (skin prep, patient relaxation, unplugging nearby equipment).
Graph-paper math: small box = 0.04 s, large box = 0.20 s at standard 25 mm/s. Mixing up the 6-second, R-R, and sequencing rate methods, or measuring PR/QRS in the wrong units, leads to wrong answers.
The first domain (32%) covers vitals, patient instruction, HIPAA, and emergency response, and it gets skipped by candidates who treat CET as a pure EKG-reading test.

Turn the outline into practice

ExamCert AI has 650 NHA CET practice questions with explanations, built around the same outline this page walks through. Work them by domain, find the weak area, and fix it before test day.

Practise NHA CET on ExamCert AI How to Become an EKG Technician in 2026

FAQ

How many questions are on the NHA CET exam?

The CET has 120 questions: 100 scored and 20 unscored pretest items, with 2 hours to finish. The scored items fall into three domains: Safety, Compliance, and Coordinated Patient Care (32), EKG Acquisition (44), and EKG Analysis and Interpretation (24).

Is the CET test plan changing?

The 2017-based test plan is still in use for 2026. In September 2026, NHA announced new CET study materials for Fall 2027 and a new exam for Winter 2027/2028, with minimal impact on exam topics. Candidates who fail within 30 days before the launch will retest on the new exam.

What score do you need to pass the CET?

NHA uses a 200-500 scaled score, and you need 390 or higher to pass. Scaling accounts for small difficulty differences between exam forms.

How much rhythm interpretation is on the CET?

EKG Analysis and Interpretation is 24 of the 100 scored items. It covers heart rate calculation, regularity, interval measurement, waveform inspection, arrhythmias and heart blocks, pacemaker spikes, ischemia/injury/infarction, and responding to life-threatening rhythms. Acquisition (44 items) carries almost twice the weight.

Sources

Figures on this page come from NHA and the other primary sources below:

Checked September 25, 2026. Fees, outlines and eligibility rules change — confirm with NHA before you book.

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