Relias Advanced Dysrhythmia Exam A & B
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SECTION 1: RELIAS ADVANCED DYSRHYTHMIA EXAM
A (Questions 1-52)
Question 1
A rhythm strip shows a rate of 88 bpm, regular rhythm, normal P waves, PR interval 0.16
seconds, QRS 0.08 seconds. What is the rhythm?
A) Atrial fibrillation
B) Normal sinus rhythm
C) Sinus tachycardia
D) Sinus bradycardia
Answer: B) Normal sinus rhythm
, Step-by-step rationale:
1. Rate 88 bpm (60-100 bpm) → normal
2. Regular R-R intervals → regular
3. P waves present, upright, normal morphology
4. PR interval 0.16 sec (0.12-0.20) → normal
5. QRS 0.08 sec (<0.12) → narrow
6. All criteria match normal sinus rhythm
Question 2
A patient has a rhythm with no identifiable P waves, irregular rhythm, and QRS 0.10
seconds. What is the rhythm?
A) Atrial fibrillation
B) Sinus arrhythmia
C) Junctional rhythm
D) Ventricular tachycardia
Answer: A) Atrial fibrillation
Step-by-step rationale:
1. P waves: absent (no discernible atrial activity)
2. Rhythm: irregularly irregular
3. QRS: 0.10 sec (narrow, <0.12)
4. Sinus arrhythmia has P waves; junctional has inverted/absent P waves but usually
regular; VT has wide QRS
5. Absent P waves + irregularly irregular = atrial fibrillation
Question 3
A rhythm shows a rate of 50 bpm, regular rhythm, P waves before each QRS, PR interval
0.24 seconds, QRS 0.10 seconds. What is the rhythm?
, A) First-degree heart block
B) Second-degree heart block Type I
C) Sinus tachycardia
D) Third-degree heart block
Answer: A) First-degree heart block
Step-by-step rationale:
1. Rate 50 bpm → bradycardia but not diagnostic
2. Rhythm: regular
3. P waves: present before each QRS
4. PR interval: 0.24 sec (>0.20 sec) → prolonged
5. No dropped beats → first-degree AV block
Question 4
A rhythm strip shows a rate of 42 bpm, regular rhythm, no P waves, wide QRS (0.14
seconds). What is the rhythm?
A) Atrial fibrillation
B) Junctional rhythm
C) Idioventricular rhythm
D) Sinus bradycardia
Answer: C) Idioventricular rhythm
Step-by-step rationale:
1. Rate 42 bpm (20-40 bpm typical for idioventricular)
2. No P waves → no atrial activity conducted
3. Wide QRS (>0.12 sec) → ventricular origin
4. Regular rhythm
5. Idioventricular rhythm is an escape rhythm from Purkinje fibers
, Question 5
A patient has a rhythm with a rate of 150 bpm, regular rhythm, no P waves, wide QRS
(0.16 seconds). What is the rhythm?
A) Supraventricular tachycardia
B) Atrial flutter
C) Ventricular tachycardia
D) Sinus tachycardia
Answer: C) Ventricular tachycardia
Step-by-step rationale:
1. Rate 150 bpm → tachycardia
2. No P waves
3. Wide QRS (>0.12 sec) → ventricular origin
4. Regular rhythm (monomorphic VT)
5. Ventricular tachycardia is life-threatening and requires immediate intervention
Question 6
A rhythm shows sawtooth flutter waves at a rate of 300 bpm, ventricular rate 150 bpm,
regular QRS narrow. What is the rhythm?
A) Atrial fibrillation
B) Atrial flutter with 2:1 conduction
C) Multifocal atrial tachycardia
D) Junctional tachycardia
Answer: B) Atrial flutter with 2:1 conduction
Step-by-step rationale:
1. Sawtooth flutter waves (F waves) at 300 bpm
2. Ventricular rate 150 bpm → 300/150 = 2:1 conduction
3. QRS narrow → supraventricular
4. Regular ventricular rhythm
5. Atrial flutter is typically 2:1, 3:1, or 4:1 block
| Complete 100+ Questions & Answers
| Latest 2026/2027 | 100% Verified
Complete Study Guide – Both Exams with
Step-by-Step Explanations | instant pdf
download
Latest 2026/2027 | 100% Verified | Step-by-Step
Explanations
SECTION 1: RELIAS ADVANCED DYSRHYTHMIA EXAM
A (Questions 1-52)
Question 1
A rhythm strip shows a rate of 88 bpm, regular rhythm, normal P waves, PR interval 0.16
seconds, QRS 0.08 seconds. What is the rhythm?
A) Atrial fibrillation
B) Normal sinus rhythm
C) Sinus tachycardia
D) Sinus bradycardia
Answer: B) Normal sinus rhythm
, Step-by-step rationale:
1. Rate 88 bpm (60-100 bpm) → normal
2. Regular R-R intervals → regular
3. P waves present, upright, normal morphology
4. PR interval 0.16 sec (0.12-0.20) → normal
5. QRS 0.08 sec (<0.12) → narrow
6. All criteria match normal sinus rhythm
Question 2
A patient has a rhythm with no identifiable P waves, irregular rhythm, and QRS 0.10
seconds. What is the rhythm?
A) Atrial fibrillation
B) Sinus arrhythmia
C) Junctional rhythm
D) Ventricular tachycardia
Answer: A) Atrial fibrillation
Step-by-step rationale:
1. P waves: absent (no discernible atrial activity)
2. Rhythm: irregularly irregular
3. QRS: 0.10 sec (narrow, <0.12)
4. Sinus arrhythmia has P waves; junctional has inverted/absent P waves but usually
regular; VT has wide QRS
5. Absent P waves + irregularly irregular = atrial fibrillation
Question 3
A rhythm shows a rate of 50 bpm, regular rhythm, P waves before each QRS, PR interval
0.24 seconds, QRS 0.10 seconds. What is the rhythm?
, A) First-degree heart block
B) Second-degree heart block Type I
C) Sinus tachycardia
D) Third-degree heart block
Answer: A) First-degree heart block
Step-by-step rationale:
1. Rate 50 bpm → bradycardia but not diagnostic
2. Rhythm: regular
3. P waves: present before each QRS
4. PR interval: 0.24 sec (>0.20 sec) → prolonged
5. No dropped beats → first-degree AV block
Question 4
A rhythm strip shows a rate of 42 bpm, regular rhythm, no P waves, wide QRS (0.14
seconds). What is the rhythm?
A) Atrial fibrillation
B) Junctional rhythm
C) Idioventricular rhythm
D) Sinus bradycardia
Answer: C) Idioventricular rhythm
Step-by-step rationale:
1. Rate 42 bpm (20-40 bpm typical for idioventricular)
2. No P waves → no atrial activity conducted
3. Wide QRS (>0.12 sec) → ventricular origin
4. Regular rhythm
5. Idioventricular rhythm is an escape rhythm from Purkinje fibers
, Question 5
A patient has a rhythm with a rate of 150 bpm, regular rhythm, no P waves, wide QRS
(0.16 seconds). What is the rhythm?
A) Supraventricular tachycardia
B) Atrial flutter
C) Ventricular tachycardia
D) Sinus tachycardia
Answer: C) Ventricular tachycardia
Step-by-step rationale:
1. Rate 150 bpm → tachycardia
2. No P waves
3. Wide QRS (>0.12 sec) → ventricular origin
4. Regular rhythm (monomorphic VT)
5. Ventricular tachycardia is life-threatening and requires immediate intervention
Question 6
A rhythm shows sawtooth flutter waves at a rate of 300 bpm, ventricular rate 150 bpm,
regular QRS narrow. What is the rhythm?
A) Atrial fibrillation
B) Atrial flutter with 2:1 conduction
C) Multifocal atrial tachycardia
D) Junctional tachycardia
Answer: B) Atrial flutter with 2:1 conduction
Step-by-step rationale:
1. Sawtooth flutter waves (F waves) at 300 bpm
2. Ventricular rate 150 bpm → 300/150 = 2:1 conduction
3. QRS narrow → supraventricular
4. Regular ventricular rhythm
5. Atrial flutter is typically 2:1, 3:1, or 4:1 block
