CERTIFIED RHYTHM ANALYSIS TECHNICIAN
(CRAT) FINAL EXAM QUESTIONS AND CORRECT
DETAILED ANSWERS WITH RATIONALES ||
100% GUARANTEED PASS!!
<LATEST VERSION>
Question 1
A patient presents with an ECG showing a regular rhythm, a heart rate of 40 bpm,
a P wave before every QRS, and a PR interval of 0.28 seconds. What is the most
likely rhythm?
A. Sinus bradycardia
B. First-degree AV block
C. Second-degree AV block, Mobitz I
D. Third-degree AV block
Answer: B. First-degree AV block
Rationale: First-degree AV block is characterized by a prolonged PR interval
(>0.20 seconds) with a regular rhythm and a P wave preceding every QRS. The
heart rate may be normal or slightly slow.
Question 2
During telemetry monitoring, a wandering baseline artifact is noted. What is the
most appropriate corrective action?
A. Reposition electrodes and ensure skin is clean
B. Administer antiarrhythmic medication
C. Increase the paper speed on the ECG
D. Apply defibrillator pads immediately
,Answer: A. Reposition electrodes and ensure skin is clean
Rationale: Wandering baseline occurs due to poor electrode contact, loose wires,
or patient movement. Correcting electrode placement and skin preparation resolves
the artifact.
Question 3
A 65-year-old patient shows ECG with no discernible P waves and irregularly
irregular QRS complexes at 110 bpm. Which rhythm is most consistent with this
finding?
A. Atrial flutter
B. Atrial fibrillation
C. Junctional rhythm
D. Ventricular tachycardia
Answer: B. Atrial fibrillation
Rationale: Atrial fibrillation produces an irregularly irregular rhythm with absent
P waves. Ventricular response is usually rapid in uncontrolled cases.
Question 4
Which structure is responsible for initiating the electrical impulse in a normal
heart?
A. AV node
B. SA node
C. Bundle of His
D. Purkinje fibers
Answer: B. SA node
Rationale: The sinoatrial (SA) node, located in the right atrium, is the primary
pacemaker of the heart, initiating the electrical impulse that triggers atrial
contraction.
,Question 5
A patient’s ECG shows wide QRS complexes with a rate of 150 bpm and no
visible P waves. Which rhythm is most likely?
A. Ventricular tachycardia
B. Supraventricular tachycardia
C. Atrial fibrillation
D. Junctional tachycardia
Answer: A. Ventricular tachycardia
Rationale: Ventricular tachycardia presents as wide (>0.12 s) QRS complexes,
rapid rate, and absent P waves, originating in the ventricles.
Question 6
A pacemaker spike is noted immediately before each QRS on the ECG. This
indicates:
A. Ventricular pacing
B. Atrial pacing
C. Dual-chamber pacing
D. Malfunctioning pacemaker
Answer: A. Ventricular pacing
Rationale: Ventricular pacing produces a spike immediately before the QRS
complex, indicating ventricular depolarization initiated by the pacemaker.
Question 7
A patient on telemetry develops a sudden, wide-complex, irregular rhythm with no
pulse. The correct immediate action is:
A. Administer adenosine IV
B. Defibrillate immediately
C. Give IV beta-blocker
D. Continue monitoring
, Answer: B. Defibrillate immediately
Rationale: Pulseless ventricular tachycardia or ventricular fibrillation requires
immediate defibrillation per ACLS guidelines.
Question 8
Which ECG change is most indicative of acute myocardial ischemia?
A. ST-segment elevation
B. Prolonged QT interval
C. Inverted P wave
D. Short PR interval
Answer: A. ST-segment elevation
Rationale: ST-segment elevation indicates acute myocardial injury or infarction,
reflecting ischemic changes in myocardial tissue.
Question 9
Which of the following is true about a second-degree AV block, Mobitz II?
A. Progressive prolongation of PR interval before a dropped QRS
B. Randomly dropped QRS complexes without PR prolongation
C. Every P wave is conducted to the ventricles
D. Ventricular rate always exceeds atrial rate
Answer: B. Randomly dropped QRS complexes without PR prolongation
Rationale: Mobitz II shows sudden dropped QRS complexes without prior PR
prolongation. This can progress to third-degree block and is clinically significant.
(CRAT) FINAL EXAM QUESTIONS AND CORRECT
DETAILED ANSWERS WITH RATIONALES ||
100% GUARANTEED PASS!!
<LATEST VERSION>
Question 1
A patient presents with an ECG showing a regular rhythm, a heart rate of 40 bpm,
a P wave before every QRS, and a PR interval of 0.28 seconds. What is the most
likely rhythm?
A. Sinus bradycardia
B. First-degree AV block
C. Second-degree AV block, Mobitz I
D. Third-degree AV block
Answer: B. First-degree AV block
Rationale: First-degree AV block is characterized by a prolonged PR interval
(>0.20 seconds) with a regular rhythm and a P wave preceding every QRS. The
heart rate may be normal or slightly slow.
Question 2
During telemetry monitoring, a wandering baseline artifact is noted. What is the
most appropriate corrective action?
A. Reposition electrodes and ensure skin is clean
B. Administer antiarrhythmic medication
C. Increase the paper speed on the ECG
D. Apply defibrillator pads immediately
,Answer: A. Reposition electrodes and ensure skin is clean
Rationale: Wandering baseline occurs due to poor electrode contact, loose wires,
or patient movement. Correcting electrode placement and skin preparation resolves
the artifact.
Question 3
A 65-year-old patient shows ECG with no discernible P waves and irregularly
irregular QRS complexes at 110 bpm. Which rhythm is most consistent with this
finding?
A. Atrial flutter
B. Atrial fibrillation
C. Junctional rhythm
D. Ventricular tachycardia
Answer: B. Atrial fibrillation
Rationale: Atrial fibrillation produces an irregularly irregular rhythm with absent
P waves. Ventricular response is usually rapid in uncontrolled cases.
Question 4
Which structure is responsible for initiating the electrical impulse in a normal
heart?
A. AV node
B. SA node
C. Bundle of His
D. Purkinje fibers
Answer: B. SA node
Rationale: The sinoatrial (SA) node, located in the right atrium, is the primary
pacemaker of the heart, initiating the electrical impulse that triggers atrial
contraction.
,Question 5
A patient’s ECG shows wide QRS complexes with a rate of 150 bpm and no
visible P waves. Which rhythm is most likely?
A. Ventricular tachycardia
B. Supraventricular tachycardia
C. Atrial fibrillation
D. Junctional tachycardia
Answer: A. Ventricular tachycardia
Rationale: Ventricular tachycardia presents as wide (>0.12 s) QRS complexes,
rapid rate, and absent P waves, originating in the ventricles.
Question 6
A pacemaker spike is noted immediately before each QRS on the ECG. This
indicates:
A. Ventricular pacing
B. Atrial pacing
C. Dual-chamber pacing
D. Malfunctioning pacemaker
Answer: A. Ventricular pacing
Rationale: Ventricular pacing produces a spike immediately before the QRS
complex, indicating ventricular depolarization initiated by the pacemaker.
Question 7
A patient on telemetry develops a sudden, wide-complex, irregular rhythm with no
pulse. The correct immediate action is:
A. Administer adenosine IV
B. Defibrillate immediately
C. Give IV beta-blocker
D. Continue monitoring
, Answer: B. Defibrillate immediately
Rationale: Pulseless ventricular tachycardia or ventricular fibrillation requires
immediate defibrillation per ACLS guidelines.
Question 8
Which ECG change is most indicative of acute myocardial ischemia?
A. ST-segment elevation
B. Prolonged QT interval
C. Inverted P wave
D. Short PR interval
Answer: A. ST-segment elevation
Rationale: ST-segment elevation indicates acute myocardial injury or infarction,
reflecting ischemic changes in myocardial tissue.
Question 9
Which of the following is true about a second-degree AV block, Mobitz II?
A. Progressive prolongation of PR interval before a dropped QRS
B. Randomly dropped QRS complexes without PR prolongation
C. Every P wave is conducted to the ventricles
D. Ventricular rate always exceeds atrial rate
Answer: B. Randomly dropped QRS complexes without PR prolongation
Rationale: Mobitz II shows sudden dropped QRS complexes without prior PR
prolongation. This can progress to third-degree block and is clinically significant.
