RELIAS Medical-Surgical Telemetry Updated 2026 | Comprehensive Study Guide,
Practice Exam Questions and Answers, Exam Prep Test Bank, Cardiac Rhythm
Interpretation, ECG Strip Analysis, Telemetry Monitoring Procedures, Dysrhythmia
Recognition and Management, Cardiovascular Patient Assessment, Hemodynamic
Monitoring, Medical-Surgical Nursing Care, and Detailed Rationales for
Competency Success
Question 1: What does the P wave on an ECG represent?
A. Atrial depolarization B. Ventricular depolarization C. Atrial repolarization D.
Ventricular repolarization
CORRECT ANSWER: A. Atrial depolarization
Rationale: The P wave reflects the electrical depolarization of the atria as the impulse
spreads from the SA node.
Question 2: What is the normal duration of the PR interval?
A. 0.04 to 0.08 seconds B. 0.12 to 0.20 seconds C. 0.24 to 0.30 seconds D. 0.32 to 0.44
seconds
CORRECT ANSWER: B. 0.12 to 0.20 seconds
Rationale: The normal PR interval ranges from 0.12 to 0.20 seconds, representing the
conduction time through the AV node.
Question 3: Which component of the ECG represents ventricular depolarization?
A. P wave B. QRS complex C. T wave D. U wave
CORRECT ANSWER: B. QRS complex
Rationale: The QRS complex reflects the rapid depolarization of the right and left
ventricles.
Question 4: What is the normal duration of the QRS complex?
A. Less than 0.04 seconds B. 0.04 to 0.10 seconds C. 0.12 to 0.20 seconds D. Greater
than 0.20 seconds
CORRECT ANSWER: B. 0.04 to 0.10 seconds
Rationale: The normal QRS duration is between 0.04 and 0.10 seconds, indicating rapid
ventricular depolarization.
Question 5: What does the T wave represent on an ECG?
A. Atrial depolarization B. Ventricular depolarization C. Ventricular repolarization D.
Atrial repolarization
CORRECT ANSWER: C. Ventricular repolarization
Rationale: The T wave represents ventricular repolarization, the recovery phase of the
ventricles before the next contraction.
,RELIAS Medical-Surgical Telemetry Updated 2026 | Comprehensive Study Guide,
Practice Exam Questions and Answers, Exam Prep Test Bank, Cardiac Rhythm
Interpretation, ECG Strip Analysis, Telemetry Monitoring Procedures, Dysrhythmia
Recognition and Management, Cardiovascular Patient Assessment, Hemodynamic
Monitoring, Medical-Surgical Nursing Care, and Detailed Rationales for
Competency Success
Question 6: What is the normal heart rate range for a normal sinus rhythm?
A. 40 to 60 beats per minute B. 60 to 100 beats per minute C. 100 to 150 beats per
minute D. 150 to 200 beats per minute
CORRECT ANSWER: B. 60 to 100 beats per minute
Rationale: Normal sinus rhythm is defined by a regular rhythm with a rate between 60
and 100 bpm originating from the SA node.
Question 7: Which part of the heart is the primary pacemaker?
A. AV node B. Bundle of His C. SA node D. Purkinje fibers
CORRECT ANSWER: C. SA node
Rationale: The sinoatrial (SA) node is the primary pacemaker of the heart, typically
firing at 60 to 100 bpm.
Question 8: What is the intrinsic firing rate of the AV node?
A. 20 to 40 bpm B. 40 to 60 bpm C. 60 to 80 bpm D. 80 to 100 bpm
CORRECT ANSWER: B. 40 to 60 bpm
Rationale: If the SA node fails, the AV node can act as a secondary pacemaker, firing at
40 to 60 bpm.
Question 9: What is the intrinsic firing rate of the ventricular myocardium?
A. 10 to 20 bpm B. 20 to 40 bpm C. 40 to 60 bpm D. 60 to 80 bpm
CORRECT ANSWER: B. 20 to 40 bpm
Rationale: The ventricular Purkinje fibers have an intrinsic firing rate of 20 to 40 bpm.
Question 10: What does the QT interval represent?
A. Atrial depolarization and repolarization B. Ventricular depolarization and
repolarization C. AV node conduction time D. Time between ventricular contractions
CORRECT ANSWER: B. Ventricular depolarization and repolarization
Rationale: The QT interval encompasses the entire period of ventricular depolarization
and repolarization.
Question 11: Where is the V1 lead placed on the chest?
,RELIAS Medical-Surgical Telemetry Updated 2026 | Comprehensive Study Guide,
Practice Exam Questions and Answers, Exam Prep Test Bank, Cardiac Rhythm
Interpretation, ECG Strip Analysis, Telemetry Monitoring Procedures, Dysrhythmia
Recognition and Management, Cardiovascular Patient Assessment, Hemodynamic
Monitoring, Medical-Surgical Nursing Care, and Detailed Rationales for
Competency Success
A. Fourth intercostal space at the right sternal border B. Fourth intercostal space at the
left sternal border C. Fifth intercostal space at the midclavicular line D. Fifth intercostal
space at the anterior axillary line
CORRECT ANSWER: A. Fourth intercostal space at the right sternal border
Rationale: Lead V1 is positioned at the 4th intercostal space just to the right of the
sternum.
Question 12: Where is the V4 lead placed on the chest?
A. Fourth intercostal space at the right sternal border B. Fifth intercostal space at the
midclavicular line C. Fifth intercostal space at the anterior axillary line D. Fifth
intercostal space at the midaxillary line
CORRECT ANSWER: B. Fifth intercostal space at the midclavicular line
Rationale: Lead V4 is placed in the 5th intercostal space at the left midclavicular line.
Question 13: Which telemetry lead is best for viewing P waves?
A. Lead I B. Lead II C. Lead V1 D. Lead aVF
CORRECT ANSWER: C. Lead V1
Rationale: Lead V1 is positioned over the right atrium, making it excellent for visualizing
atrial activity and P waves.
Question 14: What is the most common cause of a wandering baseline artifact?
A. Muscle tremors B. Poor electrode contact C. 60-cycle electrical interference D.
Patient shivering
CORRECT ANSWER: B. Poor electrode contact
Rationale: A wandering baseline is typically caused by poor electrode-skin contact,
patient movement, or loose leads.
Question 15: How can a nurse minimize 60-cycle interference on a telemetry
monitor?
A. Apply lotion to the skin before placing electrodes B. Ensure the patient is warm and
not shivering C. Clip excessive chest hair and ensure proper grounding D. Tighten the
electrode leads around the patient's neck
CORRECT ANSWER: C. Clip excessive chest hair and ensure proper grounding
, RELIAS Medical-Surgical Telemetry Updated 2026 | Comprehensive Study Guide,
Practice Exam Questions and Answers, Exam Prep Test Bank, Cardiac Rhythm
Interpretation, ECG Strip Analysis, Telemetry Monitoring Procedures, Dysrhythmia
Recognition and Management, Cardiovascular Patient Assessment, Hemodynamic
Monitoring, Medical-Surgical Nursing Care, and Detailed Rationales for
Competency Success
Rationale: 60-cycle interference is caused by electrical equipment; proper skin prep
and grounding reduce this artifact.
Question 16: What artifact is characterized by thick, irregular lines obscuring the
ECG?
A. Wandering baseline B. Somatic tremor C. 60-cycle interference D. Broken lead wire
CORRECT ANSWER: B. Somatic tremor
Rationale: Somatic tremor is caused by muscle movement, such as shivering, seizures,
or brushing teeth, creating thick, jagged lines.
Question 17: What is the appropriate intervention for sinus bradycardia with a heart
rate of 42 bpm and hypotension?
A. Administer adenosine B. Prepare for synchronized cardioversion C. Administer
atropine D. Perform immediate defibrillation
CORRECT ANSWER: C. Administer atropine
Rationale: Symptomatic sinus bradycardia is initially treated with atropine to increase
the heart rate.
Question 18: Which rhythm is characterized by a heart rate of 180 bpm with no
visible P waves?
A. Sinus tachycardia B. Supraventricular tachycardia (SVT) C. Atrial flutter D. Ventricular
tachycardia
CORRECT ANSWER: B. Supraventricular tachycardia (SVT)
Rationale: SVT typically presents with a rapid, regular rate (150-250 bpm) where P
waves are hidden within the QRS or T waves.
Question 19: What is the hallmark ECG finding of atrial fibrillation?
A. Sawtooth flutter waves B. Absent P waves with an irregularly irregular rhythm C.
Prolonged PR interval D. Wide QRS complexes
CORRECT ANSWER: B. Absent P waves with an irregularly irregular rhythm
Rationale: Atrial fibrillation is identified by chaotic atrial activity, absent P waves, and
an irregularly irregular ventricular response.
Question 20: Which condition carries the highest risk for thromboembolism and
stroke?
Practice Exam Questions and Answers, Exam Prep Test Bank, Cardiac Rhythm
Interpretation, ECG Strip Analysis, Telemetry Monitoring Procedures, Dysrhythmia
Recognition and Management, Cardiovascular Patient Assessment, Hemodynamic
Monitoring, Medical-Surgical Nursing Care, and Detailed Rationales for
Competency Success
Question 1: What does the P wave on an ECG represent?
A. Atrial depolarization B. Ventricular depolarization C. Atrial repolarization D.
Ventricular repolarization
CORRECT ANSWER: A. Atrial depolarization
Rationale: The P wave reflects the electrical depolarization of the atria as the impulse
spreads from the SA node.
Question 2: What is the normal duration of the PR interval?
A. 0.04 to 0.08 seconds B. 0.12 to 0.20 seconds C. 0.24 to 0.30 seconds D. 0.32 to 0.44
seconds
CORRECT ANSWER: B. 0.12 to 0.20 seconds
Rationale: The normal PR interval ranges from 0.12 to 0.20 seconds, representing the
conduction time through the AV node.
Question 3: Which component of the ECG represents ventricular depolarization?
A. P wave B. QRS complex C. T wave D. U wave
CORRECT ANSWER: B. QRS complex
Rationale: The QRS complex reflects the rapid depolarization of the right and left
ventricles.
Question 4: What is the normal duration of the QRS complex?
A. Less than 0.04 seconds B. 0.04 to 0.10 seconds C. 0.12 to 0.20 seconds D. Greater
than 0.20 seconds
CORRECT ANSWER: B. 0.04 to 0.10 seconds
Rationale: The normal QRS duration is between 0.04 and 0.10 seconds, indicating rapid
ventricular depolarization.
Question 5: What does the T wave represent on an ECG?
A. Atrial depolarization B. Ventricular depolarization C. Ventricular repolarization D.
Atrial repolarization
CORRECT ANSWER: C. Ventricular repolarization
Rationale: The T wave represents ventricular repolarization, the recovery phase of the
ventricles before the next contraction.
,RELIAS Medical-Surgical Telemetry Updated 2026 | Comprehensive Study Guide,
Practice Exam Questions and Answers, Exam Prep Test Bank, Cardiac Rhythm
Interpretation, ECG Strip Analysis, Telemetry Monitoring Procedures, Dysrhythmia
Recognition and Management, Cardiovascular Patient Assessment, Hemodynamic
Monitoring, Medical-Surgical Nursing Care, and Detailed Rationales for
Competency Success
Question 6: What is the normal heart rate range for a normal sinus rhythm?
A. 40 to 60 beats per minute B. 60 to 100 beats per minute C. 100 to 150 beats per
minute D. 150 to 200 beats per minute
CORRECT ANSWER: B. 60 to 100 beats per minute
Rationale: Normal sinus rhythm is defined by a regular rhythm with a rate between 60
and 100 bpm originating from the SA node.
Question 7: Which part of the heart is the primary pacemaker?
A. AV node B. Bundle of His C. SA node D. Purkinje fibers
CORRECT ANSWER: C. SA node
Rationale: The sinoatrial (SA) node is the primary pacemaker of the heart, typically
firing at 60 to 100 bpm.
Question 8: What is the intrinsic firing rate of the AV node?
A. 20 to 40 bpm B. 40 to 60 bpm C. 60 to 80 bpm D. 80 to 100 bpm
CORRECT ANSWER: B. 40 to 60 bpm
Rationale: If the SA node fails, the AV node can act as a secondary pacemaker, firing at
40 to 60 bpm.
Question 9: What is the intrinsic firing rate of the ventricular myocardium?
A. 10 to 20 bpm B. 20 to 40 bpm C. 40 to 60 bpm D. 60 to 80 bpm
CORRECT ANSWER: B. 20 to 40 bpm
Rationale: The ventricular Purkinje fibers have an intrinsic firing rate of 20 to 40 bpm.
Question 10: What does the QT interval represent?
A. Atrial depolarization and repolarization B. Ventricular depolarization and
repolarization C. AV node conduction time D. Time between ventricular contractions
CORRECT ANSWER: B. Ventricular depolarization and repolarization
Rationale: The QT interval encompasses the entire period of ventricular depolarization
and repolarization.
Question 11: Where is the V1 lead placed on the chest?
,RELIAS Medical-Surgical Telemetry Updated 2026 | Comprehensive Study Guide,
Practice Exam Questions and Answers, Exam Prep Test Bank, Cardiac Rhythm
Interpretation, ECG Strip Analysis, Telemetry Monitoring Procedures, Dysrhythmia
Recognition and Management, Cardiovascular Patient Assessment, Hemodynamic
Monitoring, Medical-Surgical Nursing Care, and Detailed Rationales for
Competency Success
A. Fourth intercostal space at the right sternal border B. Fourth intercostal space at the
left sternal border C. Fifth intercostal space at the midclavicular line D. Fifth intercostal
space at the anterior axillary line
CORRECT ANSWER: A. Fourth intercostal space at the right sternal border
Rationale: Lead V1 is positioned at the 4th intercostal space just to the right of the
sternum.
Question 12: Where is the V4 lead placed on the chest?
A. Fourth intercostal space at the right sternal border B. Fifth intercostal space at the
midclavicular line C. Fifth intercostal space at the anterior axillary line D. Fifth
intercostal space at the midaxillary line
CORRECT ANSWER: B. Fifth intercostal space at the midclavicular line
Rationale: Lead V4 is placed in the 5th intercostal space at the left midclavicular line.
Question 13: Which telemetry lead is best for viewing P waves?
A. Lead I B. Lead II C. Lead V1 D. Lead aVF
CORRECT ANSWER: C. Lead V1
Rationale: Lead V1 is positioned over the right atrium, making it excellent for visualizing
atrial activity and P waves.
Question 14: What is the most common cause of a wandering baseline artifact?
A. Muscle tremors B. Poor electrode contact C. 60-cycle electrical interference D.
Patient shivering
CORRECT ANSWER: B. Poor electrode contact
Rationale: A wandering baseline is typically caused by poor electrode-skin contact,
patient movement, or loose leads.
Question 15: How can a nurse minimize 60-cycle interference on a telemetry
monitor?
A. Apply lotion to the skin before placing electrodes B. Ensure the patient is warm and
not shivering C. Clip excessive chest hair and ensure proper grounding D. Tighten the
electrode leads around the patient's neck
CORRECT ANSWER: C. Clip excessive chest hair and ensure proper grounding
, RELIAS Medical-Surgical Telemetry Updated 2026 | Comprehensive Study Guide,
Practice Exam Questions and Answers, Exam Prep Test Bank, Cardiac Rhythm
Interpretation, ECG Strip Analysis, Telemetry Monitoring Procedures, Dysrhythmia
Recognition and Management, Cardiovascular Patient Assessment, Hemodynamic
Monitoring, Medical-Surgical Nursing Care, and Detailed Rationales for
Competency Success
Rationale: 60-cycle interference is caused by electrical equipment; proper skin prep
and grounding reduce this artifact.
Question 16: What artifact is characterized by thick, irregular lines obscuring the
ECG?
A. Wandering baseline B. Somatic tremor C. 60-cycle interference D. Broken lead wire
CORRECT ANSWER: B. Somatic tremor
Rationale: Somatic tremor is caused by muscle movement, such as shivering, seizures,
or brushing teeth, creating thick, jagged lines.
Question 17: What is the appropriate intervention for sinus bradycardia with a heart
rate of 42 bpm and hypotension?
A. Administer adenosine B. Prepare for synchronized cardioversion C. Administer
atropine D. Perform immediate defibrillation
CORRECT ANSWER: C. Administer atropine
Rationale: Symptomatic sinus bradycardia is initially treated with atropine to increase
the heart rate.
Question 18: Which rhythm is characterized by a heart rate of 180 bpm with no
visible P waves?
A. Sinus tachycardia B. Supraventricular tachycardia (SVT) C. Atrial flutter D. Ventricular
tachycardia
CORRECT ANSWER: B. Supraventricular tachycardia (SVT)
Rationale: SVT typically presents with a rapid, regular rate (150-250 bpm) where P
waves are hidden within the QRS or T waves.
Question 19: What is the hallmark ECG finding of atrial fibrillation?
A. Sawtooth flutter waves B. Absent P waves with an irregularly irregular rhythm C.
Prolonged PR interval D. Wide QRS complexes
CORRECT ANSWER: B. Absent P waves with an irregularly irregular rhythm
Rationale: Atrial fibrillation is identified by chaotic atrial activity, absent P waves, and
an irregularly irregular ventricular response.
Question 20: Which condition carries the highest risk for thromboembolism and
stroke?
