RELIAS Medical-Surgical Telemetry Updated 2026 | Comprehensive Study
Guide, Practice Exam Questions and Answers, Exam Prep Test Bank, ECG
Rhythm Interpretation, Cardiac Telemetry Monitoring, Dysrhythmia
Identification and Management, Cardiovascular Nursing Assessment,
Hemodynamic Monitoring Concepts, Acute Care Clinical Decision-Making,
and Detailed Rationales for Telemetry Competency Excellence
Question 1: What does the P wave represent?
A. Atrial depolarization B. Ventricular depolarization C. Atrial repolarization D.
Ventricular repolarization
CORRECT ANSWER: A. Atrial depolarization
Rationale: The P wave indicates the electrical depolarization of the atria.
Question 2: What does the QRS complex represent?
A. Atrial depolarization B. Ventricular depolarization C. Atrial repolarization D.
Ventricular repolarization
CORRECT ANSWER: B. Ventricular depolarization
Rationale: The QRS complex indicates the electrical depolarization of the ventricles.
Question 3: What does the T wave represent?
A. Atrial depolarization B. Ventricular depolarization C. Ventricular repolarization D.
Atrial repolarization
CORRECT ANSWER: C. Ventricular repolarization
Rationale: The T wave indicates the electrical repolarization of the ventricles.
Question 4: What is the normal PR interval duration?
A. 0.04 to 0.10 seconds B. 0.12 to 0.20 seconds C. 0.20 to 0.30 seconds D. 0.30 to 0.40
seconds
CORRECT ANSWER: B. 0.12 to 0.20 seconds
Rationale: The normal PR interval measures between 0.12 and 0.20 seconds.
Question 5: What is the normal QRS duration?
A. Less than 0.04 seconds B. Less than 0.12 seconds C. Less than 0.20 seconds D. Less
than 0.30 seconds
CORRECT ANSWER: B. Less than 0.12 seconds
Rationale: The normal QRS duration is strictly less than 0.12 seconds.
Question 6: What is the normal QT interval range?
,A. 0.12 to 0.20 seconds B. 0.20 to 0.30 seconds C. 0.36 to 0.44 seconds D. 0.50 to 0.60
seconds
CORRECT ANSWER: C. 0.36 to 0.44 seconds
Rationale: The normal QT interval typically ranges from 0.36 to 0.44 seconds.
Question 7: How many large squares are between R waves in a 60 bpm rhythm?
A. 3 B. 4 C. 5 D. 6
CORRECT ANSWER: C. 5
Rationale: At a heart rate of 60 bpm, there are exactly 5 large squares between R waves.
Question 8: What heart rate defines sinus bradycardia?
A. Less than 40 bpm B. Less than 60 bpm C. Less than 80 bpm D. Less than 100 bpm
CORRECT ANSWER: B. Less than 60 bpm
Rationale: Sinus bradycardia is defined as a normal sinus rhythm with a rate under 60
bpm.
Question 9: What heart rate defines sinus tachycardia?
A. Greater than 80 bpm B. Greater than 100 bpm C. Greater than 120 bpm D. Greater
than 150 bpm
CORRECT ANSWER: B. Greater than 100 bpm
Rationale: Sinus tachycardia is defined as a normal sinus rhythm with a rate over 100
bpm.
Question 10: Which wave is sometimes seen after the T wave?
A. P wave B. Q wave C. U wave D. J wave
CORRECT ANSWER: C. U wave
Rationale: The U wave is a small deflection that sometimes follows the T wave.
Question 11: Where is the V1 lead placed?
A. 4th intercostal space at the right sternal border B. 4th intercostal space at the left
sternal border C. 5th intercostal space at the midclavicular line D. 5th intercostal space
at the anterior axillary line
CORRECT ANSWER: A. 4th intercostal space at the right sternal border
Rationale: The V1 electrode is placed in the 4th intercostal space at the right sternal
border.
Question 12: Where is the V2 lead placed?
,A. 4th intercostal space at the right sternal border B. 4th intercostal space at the left
sternal border C. 5th intercostal space at the midclavicular line D. 5th intercostal space
at the anterior axillary line
CORRECT ANSWER: B. 4th intercostal space at the left sternal border
Rationale: The V2 electrode is placed in the 4th intercostal space at the left sternal
border.
Question 13: Where is the V4 lead placed?
A. 4th intercostal space at the right sternal border B. 4th intercostal space at the left
sternal border C. 5th intercostal space at the midclavicular line D. 5th intercostal space
at the midaxillary line
CORRECT ANSWER: C. 5th intercostal space at the midclavicular line
Rationale: The V4 electrode is placed in the 5th intercostal space at the midclavicular
line.
Question 14: Where is the V3 lead placed?
A. Between V1 and V2 B. Between V2 and V4 C. Between V4 and V5 D. Between V5 and
V6
CORRECT ANSWER: B. Between V2 and V4
Rationale: The V3 electrode is placed exactly midway between the V2 and V4 positions.
Question 15: Where is the V5 lead placed?
A. Anterior axillary line at the same level as V4 B. Midaxillary line at the same level as V4
C. Midclavicular line at the same level as V4 D. Posterior axillary line at the same level
as V4
CORRECT ANSWER: A. Anterior axillary line at the same level as V4
Rationale: The V5 electrode is placed at the anterior axillary line, level with V4.
Question 16: Where is the V6 lead placed?
A. Anterior axillary line at the same level as V4 B. Midaxillary line at the same level as V4
C. Midclavicular line at the same level as V4 D. Posterior axillary line at the same level
as V4
CORRECT ANSWER: B. Midaxillary line at the same level as V4
Rationale: The V6 electrode is placed at the midaxillary line, level with V4 and V5.
Question 17: What color is the right arm telemetry lead?
A. White B. Black C. Green D. Red
CORRECT ANSWER: A. White
, Rationale: The right arm lead is white, often remembered by "White on right".
Question 18: What color is the left arm telemetry lead?
A. White B. Black C. Green D. Red
CORRECT ANSWER: B. Black
Rationale: The left arm lead is black, often remembered by "Black on back" or just left
side.
Question 19: What color is the right leg telemetry lead?
A. White B. Black C. Green D. Red
CORRECT ANSWER: C. Green
Rationale: The right leg lead is green, often remembered by "Green on right" or "clouds
over grass".
Question 20: What color is the left leg telemetry lead?
A. White B. Black C. Green D. Red
CORRECT ANSWER: D. Red
Rationale: The left leg lead is red, often remembered by "smoke over fire".
Question 21: What is the most common cause of a wandering baseline artifact?
A. Muscle tremors B. Loose electrodes or poor skin contact C. Electrical interference
from IV pumps D. Patient shivering
CORRECT ANSWER: B. Loose electrodes or poor skin contact
Rationale: A wandering baseline is typically caused by poor electrode adhesion, dried
gel, or patient movement.
Question 22: What causes somatic tremor artifact on an ECG?
A. 60-cycle electrical interference B. Loose lead wires C. Patient muscle movement or
shivering D. Defective telemetry box
CORRECT ANSWER: C. Patient muscle movement or shivering
Rationale: Somatic tremor is caused by skeletal muscle activity obscuring the ECG
waveform.
Question 23: What causes 60-cycle interference on an ECG?
A. Patient muscle movement B. Loose electrodes C. Electrical interference from nearby
equipment D. Dry electrode gel
CORRECT ANSWER: C. Electrical interference from nearby equipment
Guide, Practice Exam Questions and Answers, Exam Prep Test Bank, ECG
Rhythm Interpretation, Cardiac Telemetry Monitoring, Dysrhythmia
Identification and Management, Cardiovascular Nursing Assessment,
Hemodynamic Monitoring Concepts, Acute Care Clinical Decision-Making,
and Detailed Rationales for Telemetry Competency Excellence
Question 1: What does the P wave represent?
A. Atrial depolarization B. Ventricular depolarization C. Atrial repolarization D.
Ventricular repolarization
CORRECT ANSWER: A. Atrial depolarization
Rationale: The P wave indicates the electrical depolarization of the atria.
Question 2: What does the QRS complex represent?
A. Atrial depolarization B. Ventricular depolarization C. Atrial repolarization D.
Ventricular repolarization
CORRECT ANSWER: B. Ventricular depolarization
Rationale: The QRS complex indicates the electrical depolarization of the ventricles.
Question 3: What does the T wave represent?
A. Atrial depolarization B. Ventricular depolarization C. Ventricular repolarization D.
Atrial repolarization
CORRECT ANSWER: C. Ventricular repolarization
Rationale: The T wave indicates the electrical repolarization of the ventricles.
Question 4: What is the normal PR interval duration?
A. 0.04 to 0.10 seconds B. 0.12 to 0.20 seconds C. 0.20 to 0.30 seconds D. 0.30 to 0.40
seconds
CORRECT ANSWER: B. 0.12 to 0.20 seconds
Rationale: The normal PR interval measures between 0.12 and 0.20 seconds.
Question 5: What is the normal QRS duration?
A. Less than 0.04 seconds B. Less than 0.12 seconds C. Less than 0.20 seconds D. Less
than 0.30 seconds
CORRECT ANSWER: B. Less than 0.12 seconds
Rationale: The normal QRS duration is strictly less than 0.12 seconds.
Question 6: What is the normal QT interval range?
,A. 0.12 to 0.20 seconds B. 0.20 to 0.30 seconds C. 0.36 to 0.44 seconds D. 0.50 to 0.60
seconds
CORRECT ANSWER: C. 0.36 to 0.44 seconds
Rationale: The normal QT interval typically ranges from 0.36 to 0.44 seconds.
Question 7: How many large squares are between R waves in a 60 bpm rhythm?
A. 3 B. 4 C. 5 D. 6
CORRECT ANSWER: C. 5
Rationale: At a heart rate of 60 bpm, there are exactly 5 large squares between R waves.
Question 8: What heart rate defines sinus bradycardia?
A. Less than 40 bpm B. Less than 60 bpm C. Less than 80 bpm D. Less than 100 bpm
CORRECT ANSWER: B. Less than 60 bpm
Rationale: Sinus bradycardia is defined as a normal sinus rhythm with a rate under 60
bpm.
Question 9: What heart rate defines sinus tachycardia?
A. Greater than 80 bpm B. Greater than 100 bpm C. Greater than 120 bpm D. Greater
than 150 bpm
CORRECT ANSWER: B. Greater than 100 bpm
Rationale: Sinus tachycardia is defined as a normal sinus rhythm with a rate over 100
bpm.
Question 10: Which wave is sometimes seen after the T wave?
A. P wave B. Q wave C. U wave D. J wave
CORRECT ANSWER: C. U wave
Rationale: The U wave is a small deflection that sometimes follows the T wave.
Question 11: Where is the V1 lead placed?
A. 4th intercostal space at the right sternal border B. 4th intercostal space at the left
sternal border C. 5th intercostal space at the midclavicular line D. 5th intercostal space
at the anterior axillary line
CORRECT ANSWER: A. 4th intercostal space at the right sternal border
Rationale: The V1 electrode is placed in the 4th intercostal space at the right sternal
border.
Question 12: Where is the V2 lead placed?
,A. 4th intercostal space at the right sternal border B. 4th intercostal space at the left
sternal border C. 5th intercostal space at the midclavicular line D. 5th intercostal space
at the anterior axillary line
CORRECT ANSWER: B. 4th intercostal space at the left sternal border
Rationale: The V2 electrode is placed in the 4th intercostal space at the left sternal
border.
Question 13: Where is the V4 lead placed?
A. 4th intercostal space at the right sternal border B. 4th intercostal space at the left
sternal border C. 5th intercostal space at the midclavicular line D. 5th intercostal space
at the midaxillary line
CORRECT ANSWER: C. 5th intercostal space at the midclavicular line
Rationale: The V4 electrode is placed in the 5th intercostal space at the midclavicular
line.
Question 14: Where is the V3 lead placed?
A. Between V1 and V2 B. Between V2 and V4 C. Between V4 and V5 D. Between V5 and
V6
CORRECT ANSWER: B. Between V2 and V4
Rationale: The V3 electrode is placed exactly midway between the V2 and V4 positions.
Question 15: Where is the V5 lead placed?
A. Anterior axillary line at the same level as V4 B. Midaxillary line at the same level as V4
C. Midclavicular line at the same level as V4 D. Posterior axillary line at the same level
as V4
CORRECT ANSWER: A. Anterior axillary line at the same level as V4
Rationale: The V5 electrode is placed at the anterior axillary line, level with V4.
Question 16: Where is the V6 lead placed?
A. Anterior axillary line at the same level as V4 B. Midaxillary line at the same level as V4
C. Midclavicular line at the same level as V4 D. Posterior axillary line at the same level
as V4
CORRECT ANSWER: B. Midaxillary line at the same level as V4
Rationale: The V6 electrode is placed at the midaxillary line, level with V4 and V5.
Question 17: What color is the right arm telemetry lead?
A. White B. Black C. Green D. Red
CORRECT ANSWER: A. White
, Rationale: The right arm lead is white, often remembered by "White on right".
Question 18: What color is the left arm telemetry lead?
A. White B. Black C. Green D. Red
CORRECT ANSWER: B. Black
Rationale: The left arm lead is black, often remembered by "Black on back" or just left
side.
Question 19: What color is the right leg telemetry lead?
A. White B. Black C. Green D. Red
CORRECT ANSWER: C. Green
Rationale: The right leg lead is green, often remembered by "Green on right" or "clouds
over grass".
Question 20: What color is the left leg telemetry lead?
A. White B. Black C. Green D. Red
CORRECT ANSWER: D. Red
Rationale: The left leg lead is red, often remembered by "smoke over fire".
Question 21: What is the most common cause of a wandering baseline artifact?
A. Muscle tremors B. Loose electrodes or poor skin contact C. Electrical interference
from IV pumps D. Patient shivering
CORRECT ANSWER: B. Loose electrodes or poor skin contact
Rationale: A wandering baseline is typically caused by poor electrode adhesion, dried
gel, or patient movement.
Question 22: What causes somatic tremor artifact on an ECG?
A. 60-cycle electrical interference B. Loose lead wires C. Patient muscle movement or
shivering D. Defective telemetry box
CORRECT ANSWER: C. Patient muscle movement or shivering
Rationale: Somatic tremor is caused by skeletal muscle activity obscuring the ECG
waveform.
Question 23: What causes 60-cycle interference on an ECG?
A. Patient muscle movement B. Loose electrodes C. Electrical interference from nearby
equipment D. Dry electrode gel
CORRECT ANSWER: C. Electrical interference from nearby equipment
