Relias Dysrhythmia Basic Test (Basic A) - Full Exam
150 Questions with ANSWERs and Rationales
2026/2027 Edition .
SECTION 1: NORMAL SINUS RHYTHM & SINUS DYSRHYTHMIAS
Questions 1-20
1. What are the criteria for Normal Sinus Rhythm (NSR)?
A) Rate 40-60, irregular, P wave absent
B) Rate 60-100, regular, P wave present and upright, PR interval 0.12-0.20 sec, QRS <0.12 sec
C) Rate 100-150, regular, P wave inverted
D) Rate 60-100, irregular, P wave hidden
ANSWER: B
Rationale: Normal Sinus Rhythm originates from the SA node with a rate of 60-100 bpm. The rhythm is
regular, P waves are present and upright in lead II, PR interval is 0.12-0.20 seconds, and QRS complex is
<0.12 seconds .
2. What is the heart rate range for Sinus Bradycardia?
A) 60-100 bpm
B) Less than 60 bpm
,C) 100-150 bpm
D) 150-250 bpm
ANSWER: B
Rationale: Sinus Bradycardia is defined as a heart rate less than 60 bpm with all other NSR
characteristics remaining normal. It can be normal in athletes or indicate underlying pathology .
3. A patient presents with a heart rate of 130 bpm, regular rhythm, normal P waves, and normal PR
interval. What is the rhythm?
A) Normal Sinus Rhythm
B) Sinus Bradycardia
C) Sinus Tachycardia
D) Atrial Fibrillation
ANSWER: C
Rationale: Sinus Tachycardia is a regular rhythm originating from the SA node with a rate of 100-150
bpm. All other characteristics of NSR remain normal .
4. Which statement best describes Sinus Arrhythmia?
A) Regular rhythm with rate 60-100
B) Irregular rhythm where rate increases with inspiration and decreases with expiration
,C) Irregular rhythm with no P waves
D) Regular rhythm with inverted P waves
ANSWER: B
Rationale: Sinus Arrhythmia is characterized by an irregular rhythm that varies with the respiratory
cycle. The rate typically increases during inspiration and decreases during expiration ("IN=IN") .
5. Sinus Pause/Arrest is characterized by:
A) Progressive prolongation of PR interval
B) Absence of P waves for a complete cycle with the pause length NOT a multiple of the normal R-R
interval
C) Sudden dropped QRS complexes
D) Narrow QRS with rate <40
ANSWER: B
Rationale: Sinus Pause occurs when the SA node fails to fire, resulting in a complete missed cycle. The
pause length is not a multiple of the normal R-R interval, distinguishing it from sinus arrhythmia .
6. Which of the following is NOT a characteristic of Sinus Tachycardia?
A) Rate 100-150 bpm
B) P waves present and upright
C) Irregular rhythm
, D) PR interval 0.12-0.20 seconds
ANSWER: C
Rationale: Sinus Tachycardia maintains regular rhythm characteristics. All features except rate remain
identical to NSR. Irregularity would indicate a different rhythm .
7. How is heart rate calculated using the 6-second method?
A) Count QRS complexes in 30 large boxes and multiply by 10
B) Count QRS complexes in 6 seconds and multiply by 10
C) Count large boxes between R waves and divide into 300
D) Count small boxes between R waves and divide into 1500
ANSWER: B
Rationale: The 6-second method involves counting the number of R waves in a 6-second strip (30 large
boxes) and multiplying by 10. This is the preferred method for irregular rhythms .
8. Sinus Bradycardia with a rate of 50 bpm in a well-conditioned athlete is:
A) Always pathological and requires treatment
B) Usually benign and requires no intervention
C) A sign of impending cardiac arrest
150 Questions with ANSWERs and Rationales
2026/2027 Edition .
SECTION 1: NORMAL SINUS RHYTHM & SINUS DYSRHYTHMIAS
Questions 1-20
1. What are the criteria for Normal Sinus Rhythm (NSR)?
A) Rate 40-60, irregular, P wave absent
B) Rate 60-100, regular, P wave present and upright, PR interval 0.12-0.20 sec, QRS <0.12 sec
C) Rate 100-150, regular, P wave inverted
D) Rate 60-100, irregular, P wave hidden
ANSWER: B
Rationale: Normal Sinus Rhythm originates from the SA node with a rate of 60-100 bpm. The rhythm is
regular, P waves are present and upright in lead II, PR interval is 0.12-0.20 seconds, and QRS complex is
<0.12 seconds .
2. What is the heart rate range for Sinus Bradycardia?
A) 60-100 bpm
B) Less than 60 bpm
,C) 100-150 bpm
D) 150-250 bpm
ANSWER: B
Rationale: Sinus Bradycardia is defined as a heart rate less than 60 bpm with all other NSR
characteristics remaining normal. It can be normal in athletes or indicate underlying pathology .
3. A patient presents with a heart rate of 130 bpm, regular rhythm, normal P waves, and normal PR
interval. What is the rhythm?
A) Normal Sinus Rhythm
B) Sinus Bradycardia
C) Sinus Tachycardia
D) Atrial Fibrillation
ANSWER: C
Rationale: Sinus Tachycardia is a regular rhythm originating from the SA node with a rate of 100-150
bpm. All other characteristics of NSR remain normal .
4. Which statement best describes Sinus Arrhythmia?
A) Regular rhythm with rate 60-100
B) Irregular rhythm where rate increases with inspiration and decreases with expiration
,C) Irregular rhythm with no P waves
D) Regular rhythm with inverted P waves
ANSWER: B
Rationale: Sinus Arrhythmia is characterized by an irregular rhythm that varies with the respiratory
cycle. The rate typically increases during inspiration and decreases during expiration ("IN=IN") .
5. Sinus Pause/Arrest is characterized by:
A) Progressive prolongation of PR interval
B) Absence of P waves for a complete cycle with the pause length NOT a multiple of the normal R-R
interval
C) Sudden dropped QRS complexes
D) Narrow QRS with rate <40
ANSWER: B
Rationale: Sinus Pause occurs when the SA node fails to fire, resulting in a complete missed cycle. The
pause length is not a multiple of the normal R-R interval, distinguishing it from sinus arrhythmia .
6. Which of the following is NOT a characteristic of Sinus Tachycardia?
A) Rate 100-150 bpm
B) P waves present and upright
C) Irregular rhythm
, D) PR interval 0.12-0.20 seconds
ANSWER: C
Rationale: Sinus Tachycardia maintains regular rhythm characteristics. All features except rate remain
identical to NSR. Irregularity would indicate a different rhythm .
7. How is heart rate calculated using the 6-second method?
A) Count QRS complexes in 30 large boxes and multiply by 10
B) Count QRS complexes in 6 seconds and multiply by 10
C) Count large boxes between R waves and divide into 300
D) Count small boxes between R waves and divide into 1500
ANSWER: B
Rationale: The 6-second method involves counting the number of R waves in a 6-second strip (30 large
boxes) and multiplying by 10. This is the preferred method for irregular rhythms .
8. Sinus Bradycardia with a rate of 50 bpm in a well-conditioned athlete is:
A) Always pathological and requires treatment
B) Usually benign and requires no intervention
C) A sign of impending cardiac arrest
