Relias Dysrhythmia Basic B Test Prep Document | 2026/2027
Edition | 200 Verified Questions
Relias Dysrhythmia Basic B Exam 2026-2027 QUESTIONS AND ANSWERS ALREADY GRADED A+. 100%
Verified Solutions | Updated Per Latest Guidelines | Graded A+
This comprehensive study resource is meticulously designed for healthcare professionals preparing for
the Relias Dysrhythmia Basic B exam. It contains 200 verified questions that mirror the actual test
format, covering essential concepts in cardiac rhythm interpretation. Each question is accompanied by
detailed rationales to reinforce understanding and ensure exam readiness. Updated for the 2026/2027
academic year, this guide reflects the latest clinical guidelines and best practices in dysrhythmia
management.
Key Features:
ECG waveform analysis and interpretation
Identification of normal sinus rhythm and common dysrhythmias
Clinical significance and treatment protocols for each rhythm
Systematic approach to rhythm strip interpretation
Practice questions with detailed rationales
Test-taking strategies for the Relias exam
Updates for 2026:
- Revised to align with 2026 AHA guidelines for ECG interpretation
- Added new questions on advanced dysrhythmias (e.g., torsades de pointes)
- Enhanced rationales with evidence-based practice updates
- Updated answer explanations to include common pitfalls and misconceptions
- Incorporated feedback from recent test-takers to improve clarity
Abstract:
This study guide provides a rigorous review of cardiac dysrhythmia interpretation, specifically tailored for the
Relias Dysrhythmia Basic B examination. The content is structured to build foundational knowledge in
electrophysiology, then progresses to systematic analysis of ECG strips. Emphasis is placed on distinguishing
between life-threatening and non-life-threatening rhythms, understanding pharmacological and electrical
interventions, and applying clinical judgment in simulated scenarios. Each of the 200 questions is designed to
assess comprehension at multiple cognitive levels, from basic recall to application in clinical contexts. Detailed
rationales not only explain the correct answer but also discuss why alternative options are incorrect, thereby
deepening the learner's understanding. This resource is an indispensable tool for nurses, monitor technicians, and
other healthcare providers seeking to achieve a high score and demonstrate competency in dysrhythmia
recognition. The 2026/2027 edition incorporates the latest evidence-based guidelines, ensuring that users are
prepared for current practice standards.
Keywords:
Relias Dysrhythmia Basic B, ECG interpretation, Cardiac rhythm analysis, Dysrhythmia exam prep, Nursing
certification, Telemetry monitoring, AHA guidelines 2026
Answer Format:
Each question is presented in a multiple-choice format with four options. The correct answer is clearly indicated,
followed by a comprehensive rationale explaining the underlying pathophysiology, clinical significance, and
management considerations. Additionally, each rationale includes a brief discussion of why the incorrect options
are not the best choices, reinforcing critical thinking and differential diagnosis.
Page 1
,Compliance Checklist:
Aligned with 2026 AHA guidelines for ECG interpretation
Verified by experienced cardiac nurses and educators
Includes rationales for both correct and incorrect answers
Updated to reflect current clinical practice standards
Suitable for self-study and group review
Content Area Overview:
Content Area Questions Key Topics Weight
Electrophysiology and ECG 1-30 Cardiac conduction system, ECG leads, 15%
Basics waveform components, intervals
Normal Rhythms and Sinus 31-60 Normal sinus rhythm, sinus bradycardia, 15%
Rhythms sinus tachycardia, sinus arrhythmia
Atrial Dysrhythmias 61-90 Premature atrial contractions, atrial flutter, 20%
atrial fibrillation, multifocal atrial
tachycardia
Junctional Dysrhythmias 91-110 Premature junctional contractions, junctional 10%
rhythm, accelerated junctional rhythm,
junctional tachycardia
Ventricular Dysrhythmias 111-150 Premature ventricular contractions, 20%
ventricular tachycardia, ventricular
fibrillation, torsades de pointes
Heart Blocks and Conduction 151-180 First-degree AV block, second-degree AV 15%
Defects block (Mobitz I and II), third-degree AV
block, bundle branch blocks
Clinical Application and 181-200 Treatment protocols, defibrillation, 5%
Management cardioversion, pacemaker therapy,
medication administration
Page 2
,Q1. During a code blue, a patient is in pulseless electrical activity (PEA). The ECG
monitor shows a narrow-complex tachycardia at 150 bpm. Which of the following is
the most appropriate immediate intervention?
A. Immediate synchronized cardioversion at 100 J
B. Epinephrine 1 mg IV push every 3-5 minutes
C. Adenosine 6 mg rapid IV push followed by saline flush
D. Perform a 12-lead ECG to confirm rhythm before acting
Correct Answer: B. Epinephrine 1 mg IV push every 3-5 minutes
Rationale: In PEA, the priority is high-quality CPR and epinephrine administration per
ACLS guidelines. Synchronized cardioversion is for unstable tachyarrhythmias with a
pulse; PEA is a form of cardiac arrest, so defibrillation/cardioversion is not indicated.
Adenosine is contraindicated in pulseless patients. Delaying treatment for a 12-lead ECG
is inappropriate during cardiac arrest.
Why Wrong:
A - Synchronized cardioversion requires a perfusing rhythm; it is not used in PEA.
C - Adenosine is only for supraventricular tachycardia in patients with a pulse.
D - Obtaining a 12-lead ECG during cardiac arrest delays life-saving interventions.
Reference: American Heart Association. (2020). 2020 AHA Guidelines for CPR and ECC,
Part 7: Adult Advanced Cardiovascular Life Support.
Q2. A patient's ECG shows regular PP intervals at 80/min and regular RR intervals
at 40/min. Which of the following best explains this finding?
A. Complete heart block with a ventricular escape rhythm
B. Second-degree AV block Mobitz I with 2:1 conduction
C. Atrial flutter with 2:1 AV conduction
D. Sinus bradycardia with first-degree AV block
Correct Answer: A. Complete heart block with a ventricular escape rhythm
Rationale: Regular PP intervals at 80/min and RR intervals at 40/min indicate that the
atria and ventricles are beating independently, with the atrial rate faster than the
ventricular rate. This atrioventricular dissociation is characteristic of complete
(third-degree) heart block, where no atrial impulses conduct to the ventricles. In Mobitz I
with 2:1 conduction, the PP intervals would be regular but the PR intervals would be
constant (since only one P per QRS is seen, but it's actually second-degree block, not
complete dissociation). Atrial flutter would show flutter waves rather than P waves. Sinus
bradycardia with first-degree AV block would have a 1:1 relationship with a prolonged PR
interval.
Why Wrong:
B - In 2:1 Mobitz I, there is still a relationship between P waves and QRS complexes;
the underlying mechanism is not complete dissociation.
C - Atrial flutter is characterized by sawtooth flutter waves, not discrete P waves, and
Page 3
, typically has a 2:1 or variable block, but not complete AV dissociation.
D - First-degree AV block has a 1:1 AV relationship with a prolonged PR interval, so
RR intervals would equal PP intervals.
Reference: Guyton, A.C., & Hall, J.E. (2021). Textbook of Medical Physiology, 14th Ed.,
Ch. 10.
Q3. A patient with chronic renal failure and a potassium level of 6.8 mEq/L develops
a sine wave pattern on the ECG. Which dysrhythmia is most likely to occur next if
left untreated?
A. Atrial fibrillation with rapid ventricular response
B. Ventricular fibrillation
C. Third-degree AV block with junctional escape
D. Torsades de pointes
Correct Answer: B. Ventricular fibrillation
Rationale: Severe hyperkalemia causes progressive ECG changes: peaked T waves, then
PR prolongation, QRS widening, and eventually a sine wave pattern, which is a
pre-terminal rhythm that degenerates into ventricular fibrillation or asystole. Ventricular
fibrillation is the immediate life-threatening dysrhythmia. Atrial fibrillation is not a direct
consequence of hyperkalemia. Third-degree AV block can occur but is not the most
imminent. Torsades de pointes is associated with QT prolongation, not hyperkalemia.
Why Wrong:
A - Hyperkalemia typically slows conduction and depresses automaticity; atrial
fibrillation is not a characteristic manifestation.
C - While hyperkalemia can cause AV block, the sine wave pattern specifically
indicates impending VF, not just AV block.
D - Torsades de pointes is linked to prolonged QT, not hyperkalemia.
Reference: Lehne, R.A. (2026). Pharmacology for Nursing Care, 12th Ed., Ch. 52.
Q4. A patient with a history of myocardial infarction presents with a wide QRS
tachycardia at 180 bpm. The rhythm is regular, and the patient is hemodynamically
stable. Which of the following findings on the ECG would most strongly differentiate
ventricular tachycardia (VT) from supraventricular tachycardia with aberrancy?
A. QRS duration of 140 ms
B. Presence of fusion beats
C. Right bundle branch block morphology
D. Heart rate of 180 bpm
Correct Answer: B. Presence of fusion beats
Rationale: Fusion beats (and capture beats) are pathognomonic for VT, as they occur
when a supraventricular impulse partially activates the ventricles during VT. QRS
duration >120 ms is seen in both VT and aberrancy. RBBB morphology can be seen in
Page 4
Edition | 200 Verified Questions
Relias Dysrhythmia Basic B Exam 2026-2027 QUESTIONS AND ANSWERS ALREADY GRADED A+. 100%
Verified Solutions | Updated Per Latest Guidelines | Graded A+
This comprehensive study resource is meticulously designed for healthcare professionals preparing for
the Relias Dysrhythmia Basic B exam. It contains 200 verified questions that mirror the actual test
format, covering essential concepts in cardiac rhythm interpretation. Each question is accompanied by
detailed rationales to reinforce understanding and ensure exam readiness. Updated for the 2026/2027
academic year, this guide reflects the latest clinical guidelines and best practices in dysrhythmia
management.
Key Features:
ECG waveform analysis and interpretation
Identification of normal sinus rhythm and common dysrhythmias
Clinical significance and treatment protocols for each rhythm
Systematic approach to rhythm strip interpretation
Practice questions with detailed rationales
Test-taking strategies for the Relias exam
Updates for 2026:
- Revised to align with 2026 AHA guidelines for ECG interpretation
- Added new questions on advanced dysrhythmias (e.g., torsades de pointes)
- Enhanced rationales with evidence-based practice updates
- Updated answer explanations to include common pitfalls and misconceptions
- Incorporated feedback from recent test-takers to improve clarity
Abstract:
This study guide provides a rigorous review of cardiac dysrhythmia interpretation, specifically tailored for the
Relias Dysrhythmia Basic B examination. The content is structured to build foundational knowledge in
electrophysiology, then progresses to systematic analysis of ECG strips. Emphasis is placed on distinguishing
between life-threatening and non-life-threatening rhythms, understanding pharmacological and electrical
interventions, and applying clinical judgment in simulated scenarios. Each of the 200 questions is designed to
assess comprehension at multiple cognitive levels, from basic recall to application in clinical contexts. Detailed
rationales not only explain the correct answer but also discuss why alternative options are incorrect, thereby
deepening the learner's understanding. This resource is an indispensable tool for nurses, monitor technicians, and
other healthcare providers seeking to achieve a high score and demonstrate competency in dysrhythmia
recognition. The 2026/2027 edition incorporates the latest evidence-based guidelines, ensuring that users are
prepared for current practice standards.
Keywords:
Relias Dysrhythmia Basic B, ECG interpretation, Cardiac rhythm analysis, Dysrhythmia exam prep, Nursing
certification, Telemetry monitoring, AHA guidelines 2026
Answer Format:
Each question is presented in a multiple-choice format with four options. The correct answer is clearly indicated,
followed by a comprehensive rationale explaining the underlying pathophysiology, clinical significance, and
management considerations. Additionally, each rationale includes a brief discussion of why the incorrect options
are not the best choices, reinforcing critical thinking and differential diagnosis.
Page 1
,Compliance Checklist:
Aligned with 2026 AHA guidelines for ECG interpretation
Verified by experienced cardiac nurses and educators
Includes rationales for both correct and incorrect answers
Updated to reflect current clinical practice standards
Suitable for self-study and group review
Content Area Overview:
Content Area Questions Key Topics Weight
Electrophysiology and ECG 1-30 Cardiac conduction system, ECG leads, 15%
Basics waveform components, intervals
Normal Rhythms and Sinus 31-60 Normal sinus rhythm, sinus bradycardia, 15%
Rhythms sinus tachycardia, sinus arrhythmia
Atrial Dysrhythmias 61-90 Premature atrial contractions, atrial flutter, 20%
atrial fibrillation, multifocal atrial
tachycardia
Junctional Dysrhythmias 91-110 Premature junctional contractions, junctional 10%
rhythm, accelerated junctional rhythm,
junctional tachycardia
Ventricular Dysrhythmias 111-150 Premature ventricular contractions, 20%
ventricular tachycardia, ventricular
fibrillation, torsades de pointes
Heart Blocks and Conduction 151-180 First-degree AV block, second-degree AV 15%
Defects block (Mobitz I and II), third-degree AV
block, bundle branch blocks
Clinical Application and 181-200 Treatment protocols, defibrillation, 5%
Management cardioversion, pacemaker therapy,
medication administration
Page 2
,Q1. During a code blue, a patient is in pulseless electrical activity (PEA). The ECG
monitor shows a narrow-complex tachycardia at 150 bpm. Which of the following is
the most appropriate immediate intervention?
A. Immediate synchronized cardioversion at 100 J
B. Epinephrine 1 mg IV push every 3-5 minutes
C. Adenosine 6 mg rapid IV push followed by saline flush
D. Perform a 12-lead ECG to confirm rhythm before acting
Correct Answer: B. Epinephrine 1 mg IV push every 3-5 minutes
Rationale: In PEA, the priority is high-quality CPR and epinephrine administration per
ACLS guidelines. Synchronized cardioversion is for unstable tachyarrhythmias with a
pulse; PEA is a form of cardiac arrest, so defibrillation/cardioversion is not indicated.
Adenosine is contraindicated in pulseless patients. Delaying treatment for a 12-lead ECG
is inappropriate during cardiac arrest.
Why Wrong:
A - Synchronized cardioversion requires a perfusing rhythm; it is not used in PEA.
C - Adenosine is only for supraventricular tachycardia in patients with a pulse.
D - Obtaining a 12-lead ECG during cardiac arrest delays life-saving interventions.
Reference: American Heart Association. (2020). 2020 AHA Guidelines for CPR and ECC,
Part 7: Adult Advanced Cardiovascular Life Support.
Q2. A patient's ECG shows regular PP intervals at 80/min and regular RR intervals
at 40/min. Which of the following best explains this finding?
A. Complete heart block with a ventricular escape rhythm
B. Second-degree AV block Mobitz I with 2:1 conduction
C. Atrial flutter with 2:1 AV conduction
D. Sinus bradycardia with first-degree AV block
Correct Answer: A. Complete heart block with a ventricular escape rhythm
Rationale: Regular PP intervals at 80/min and RR intervals at 40/min indicate that the
atria and ventricles are beating independently, with the atrial rate faster than the
ventricular rate. This atrioventricular dissociation is characteristic of complete
(third-degree) heart block, where no atrial impulses conduct to the ventricles. In Mobitz I
with 2:1 conduction, the PP intervals would be regular but the PR intervals would be
constant (since only one P per QRS is seen, but it's actually second-degree block, not
complete dissociation). Atrial flutter would show flutter waves rather than P waves. Sinus
bradycardia with first-degree AV block would have a 1:1 relationship with a prolonged PR
interval.
Why Wrong:
B - In 2:1 Mobitz I, there is still a relationship between P waves and QRS complexes;
the underlying mechanism is not complete dissociation.
C - Atrial flutter is characterized by sawtooth flutter waves, not discrete P waves, and
Page 3
, typically has a 2:1 or variable block, but not complete AV dissociation.
D - First-degree AV block has a 1:1 AV relationship with a prolonged PR interval, so
RR intervals would equal PP intervals.
Reference: Guyton, A.C., & Hall, J.E. (2021). Textbook of Medical Physiology, 14th Ed.,
Ch. 10.
Q3. A patient with chronic renal failure and a potassium level of 6.8 mEq/L develops
a sine wave pattern on the ECG. Which dysrhythmia is most likely to occur next if
left untreated?
A. Atrial fibrillation with rapid ventricular response
B. Ventricular fibrillation
C. Third-degree AV block with junctional escape
D. Torsades de pointes
Correct Answer: B. Ventricular fibrillation
Rationale: Severe hyperkalemia causes progressive ECG changes: peaked T waves, then
PR prolongation, QRS widening, and eventually a sine wave pattern, which is a
pre-terminal rhythm that degenerates into ventricular fibrillation or asystole. Ventricular
fibrillation is the immediate life-threatening dysrhythmia. Atrial fibrillation is not a direct
consequence of hyperkalemia. Third-degree AV block can occur but is not the most
imminent. Torsades de pointes is associated with QT prolongation, not hyperkalemia.
Why Wrong:
A - Hyperkalemia typically slows conduction and depresses automaticity; atrial
fibrillation is not a characteristic manifestation.
C - While hyperkalemia can cause AV block, the sine wave pattern specifically
indicates impending VF, not just AV block.
D - Torsades de pointes is linked to prolonged QT, not hyperkalemia.
Reference: Lehne, R.A. (2026). Pharmacology for Nursing Care, 12th Ed., Ch. 52.
Q4. A patient with a history of myocardial infarction presents with a wide QRS
tachycardia at 180 bpm. The rhythm is regular, and the patient is hemodynamically
stable. Which of the following findings on the ECG would most strongly differentiate
ventricular tachycardia (VT) from supraventricular tachycardia with aberrancy?
A. QRS duration of 140 ms
B. Presence of fusion beats
C. Right bundle branch block morphology
D. Heart rate of 180 bpm
Correct Answer: B. Presence of fusion beats
Rationale: Fusion beats (and capture beats) are pathognomonic for VT, as they occur
when a supraventricular impulse partially activates the ventricles during VT. QRS
duration >120 ms is seen in both VT and aberrancy. RBBB morphology can be seen in
Page 4
