HCA Healthcare Telemetry ECG/EKG Interpretation
Exam Advanced Practice Question Bank for
Healthcare Professionals
SECTION 1: CARDIAC CONDUCTION SYSTEM & BASIC ELECTROPHYSIOLOGY (Questions 1-15)
1. What is the intrinsic firing rate of the atrioventricular (AV) node when the primary
pacemaker of the heart fails?
A) 60–100 beats per minute
B) 40–60 beats per minute
C) 20–40 beats per minute
D) 15–30 beats per minute
Correct Answer: B
Rationale: The AV node serves as the heart's secondary pacemaker. If the sinoatrial (SA) node
fails, the AV node assumes control with an intrinsic escape rate of 40 to 60 beats per minute,
usually producing a junctional rhythm. The SA node fires at 60-100 BPM, and ventricular
pacemakers fire at 20-40 BPM .
,2. Which of the following correctly describes the sequence of electrical conduction through
the heart?
A) SA node → Bundle of His → AV node → Purkinje fibers → Bundle branches
B) SA node → AV node → Bundle of His → Bundle branches → Purkinje fibers
C) AV node → SA node → Bundle of His → Purkinje fibers → Bundle branches
D) Bundle of His → SA node → AV node → Bundle branches → Purkinje fibers
Correct Answer: B
Rationale: The normal sequence of cardiac conduction begins at the sinoatrial (SA) node,
travels to the atrioventricular (AV) node, then through the Bundle of His, down the left and
right bundle branches, and finally to the Purkinje fibers for ventricular depolarization.
3. What electrical event in the cardiac cycle does the U wave on an EKG strip represent when
visible?
A) Depolarization of the atrial appendages
B) Delayed repolarization of the Purkinje fibers or papillary muscles
,C) Early depolarization of the ventricular septum
D) The absolute refractory period of the AV node
Correct Answer: B
Rationale: The U wave is a small deflection following the T wave. It represents the delayed
repolarization of the Purkinje fibers or papillary muscles. Prominent U waves are frequently
associated with severe hypokalemia .
4. Which component of the cardiac conduction system has the fastest intrinsic rate?
A) AV node
B) Bundle of His
C) Purkinje fibers
D) SA node
Correct Answer: D
Rationale: The SA node has the fastest intrinsic rate (60-100 BPM) and normally functions as
the primary pacemaker of the heart. The AV node has a rate of 40-60 BPM, and Purkinje fibers
have an intrinsic rate of 20-40 BPM.
, 5. A patient's telemetry strip shows a regular rhythm with a rate of 38 beats per minute. The
P waves are absent, and the QRS complexes are wide and distorted, measuring 0.14 seconds.
What is this rhythm?
A) Sinus Bradycardia
B) Junctional Bradycardia
C) Idioventricular Rhythm
D) Second-Degree AV Block Type II
Correct Answer: C
Rationale: An Idioventricular Rhythm (IVR) occurs when ventricular escape pacemakers take
over at their intrinsic rate of 20 to 40 beats per minute. Key features include a slow ventricular
rate, absent P waves, and wide, bizarre QRS complexes .
6. The PR interval represents which physiological event?
A) Ventricular depolarization
B) Atrial depolarization
Exam Advanced Practice Question Bank for
Healthcare Professionals
SECTION 1: CARDIAC CONDUCTION SYSTEM & BASIC ELECTROPHYSIOLOGY (Questions 1-15)
1. What is the intrinsic firing rate of the atrioventricular (AV) node when the primary
pacemaker of the heart fails?
A) 60–100 beats per minute
B) 40–60 beats per minute
C) 20–40 beats per minute
D) 15–30 beats per minute
Correct Answer: B
Rationale: The AV node serves as the heart's secondary pacemaker. If the sinoatrial (SA) node
fails, the AV node assumes control with an intrinsic escape rate of 40 to 60 beats per minute,
usually producing a junctional rhythm. The SA node fires at 60-100 BPM, and ventricular
pacemakers fire at 20-40 BPM .
,2. Which of the following correctly describes the sequence of electrical conduction through
the heart?
A) SA node → Bundle of His → AV node → Purkinje fibers → Bundle branches
B) SA node → AV node → Bundle of His → Bundle branches → Purkinje fibers
C) AV node → SA node → Bundle of His → Purkinje fibers → Bundle branches
D) Bundle of His → SA node → AV node → Bundle branches → Purkinje fibers
Correct Answer: B
Rationale: The normal sequence of cardiac conduction begins at the sinoatrial (SA) node,
travels to the atrioventricular (AV) node, then through the Bundle of His, down the left and
right bundle branches, and finally to the Purkinje fibers for ventricular depolarization.
3. What electrical event in the cardiac cycle does the U wave on an EKG strip represent when
visible?
A) Depolarization of the atrial appendages
B) Delayed repolarization of the Purkinje fibers or papillary muscles
,C) Early depolarization of the ventricular septum
D) The absolute refractory period of the AV node
Correct Answer: B
Rationale: The U wave is a small deflection following the T wave. It represents the delayed
repolarization of the Purkinje fibers or papillary muscles. Prominent U waves are frequently
associated with severe hypokalemia .
4. Which component of the cardiac conduction system has the fastest intrinsic rate?
A) AV node
B) Bundle of His
C) Purkinje fibers
D) SA node
Correct Answer: D
Rationale: The SA node has the fastest intrinsic rate (60-100 BPM) and normally functions as
the primary pacemaker of the heart. The AV node has a rate of 40-60 BPM, and Purkinje fibers
have an intrinsic rate of 20-40 BPM.
, 5. A patient's telemetry strip shows a regular rhythm with a rate of 38 beats per minute. The
P waves are absent, and the QRS complexes are wide and distorted, measuring 0.14 seconds.
What is this rhythm?
A) Sinus Bradycardia
B) Junctional Bradycardia
C) Idioventricular Rhythm
D) Second-Degree AV Block Type II
Correct Answer: C
Rationale: An Idioventricular Rhythm (IVR) occurs when ventricular escape pacemakers take
over at their intrinsic rate of 20 to 40 beats per minute. Key features include a slow ventricular
rate, absent P waves, and wide, bizarre QRS complexes .
6. The PR interval represents which physiological event?
A) Ventricular depolarization
B) Atrial depolarization
