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BAYCARE EKG COMPREHENSIVE
COMPETENCY EXAM 2026 COMPLETE (125)
CURRENT TESTING QUESTIONS AND
CORRECT ANSWERS WITH DETAILED
RATIONALES.
BAYCARE
Prepare for the BayCare EKG Comprehensive Competency Exam with
focused review materials covering cardiac anatomy and physiology,
electrophysiology, 12-lead ECG fundamentals, rhythm interpretation,
heart rate calculation, waveform analysis, cardiac conduction
abnormalities, atrial and ventricular dysrhythmias, myocardial ischemia
and infarction patterns, pacemaker rhythms, ECG artifact recognition,
patient preparation, lead placement, equipment operation, and patient
safety. Designed to build confidence in recognizing normal and abnormal
cardiac rhythms, identifying life-threatening arrhythmias, ensuring proper
lead placement, and delivering safe, high-quality patient care. Suitable
for nurses, telemetry technicians, cardiovascular technicians, allied
health professionals, and candidates preparing for the BayCare EKG
Comprehensive Competency Exam.
MULTIPLE CHOICE.
SECTION 1: CARDIAC ANATOMY & PHYSIOLOGY (Questions 1–20)
1. The heart's natural pacemaker is the:
A. Atrioventricular (AV) node
B. Sinoatrial (SA) node
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C. Bundle of His
D. Purkinje fibers
Correct answer: B
Rationale: The SA node is the primary pacemaker, possessing the
highest intrinsic rate of automaticity (60–100 bpm). Its impulses
suppress slower pacemaker cells through "overdrive suppression".
2. The inherent (intrinsic) rate of the SA node is:
A. 20–40 beats per minute
B. 40–60 beats per minute
C. 60–100 beats per minute
D. 100–180 beats per minute
Correct answer: C
Rationale: The sinoatrial (SA) node is the normal pacemaker of the heart
with an inherent firing rate of 60–100 beats per minute.
3. The inherent rate of the AV junction is:
A. 20–40 beats per minute
B. 40–60 beats per minute
C. 60–100 beats per minute
D. 100–180 beats per minute
Correct answer: B
Rationale: The atrioventricular (AV) junction, which includes the AV
node and bundle of His, has an inherent firing rate of 40–60 beats per
minute.
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4. The inherent rate of the ventricles (Purkinje fibers) is:
A. 20–40 beats per minute
B. 40–60 beats per minute
C. 60–100 beats per minute
D. 100–180 beats per minute
Correct answer: A
Rationale: The Purkinje fibers and ventricular myocardial cells have the
slowest inherent automaticity, typically firing at 20–40 beats per minute.
This idioventricular rhythm serves as the last-resort backup pacemaker.
5. The normal conduction pathway through the heart is:
A. SA node → AV node → Bundle of His → Bundle Branches → Purkinje
fibers
B. AV node → SA node → Purkinje fibers → Bundle of His
C. SA node → Bundle of His → AV node → Bundle Branches
D. Purkinje fibers → Bundle Branches → Bundle of His → AV node → SA
node
Correct answer: A
Rationale: The impulse originates in the SA node, spreads through the
atria (P wave), is delayed at the AV node to allow ventricular filling, then
travels through the Bundle of His, bundle branches, and Purkinje fibers
for ventricular depolarization (QRS complex).
6. The P wave on an EKG represents:
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A. Ventricular depolarization
B. Atrial depolarization
C. Ventricular repolarization
D. Atrial repolarization
Correct answer: B
Rationale: The P wave represents the electrical impulse traveling
through the atria, causing atrial depolarization and contraction. The QRS
complex represents ventricular depolarization, and the T wave
represents ventricular repolarization.
7. The QRS complex on an EKG represents:
A. Atrial depolarization
B. Ventricular repolarization
C. Ventricular depolarization
D. Atrial repolarization
Correct answer: C
Rationale: The QRS complex represents ventricular depolarization,
which triggers ventricular contraction. The P wave represents atrial
depolarization, and the T wave represents ventricular repolarization.
8. The T wave on an EKG represents:
A. Atrial depolarization
B. Ventricular depolarization
C. Atrial repolarization
D. Ventricular repolarization
Correct answer: D
BAYCARE EKG COMPREHENSIVE
COMPETENCY EXAM 2026 COMPLETE (125)
CURRENT TESTING QUESTIONS AND
CORRECT ANSWERS WITH DETAILED
RATIONALES.
BAYCARE
Prepare for the BayCare EKG Comprehensive Competency Exam with
focused review materials covering cardiac anatomy and physiology,
electrophysiology, 12-lead ECG fundamentals, rhythm interpretation,
heart rate calculation, waveform analysis, cardiac conduction
abnormalities, atrial and ventricular dysrhythmias, myocardial ischemia
and infarction patterns, pacemaker rhythms, ECG artifact recognition,
patient preparation, lead placement, equipment operation, and patient
safety. Designed to build confidence in recognizing normal and abnormal
cardiac rhythms, identifying life-threatening arrhythmias, ensuring proper
lead placement, and delivering safe, high-quality patient care. Suitable
for nurses, telemetry technicians, cardiovascular technicians, allied
health professionals, and candidates preparing for the BayCare EKG
Comprehensive Competency Exam.
MULTIPLE CHOICE.
SECTION 1: CARDIAC ANATOMY & PHYSIOLOGY (Questions 1–20)
1. The heart's natural pacemaker is the:
A. Atrioventricular (AV) node
B. Sinoatrial (SA) node
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C. Bundle of His
D. Purkinje fibers
Correct answer: B
Rationale: The SA node is the primary pacemaker, possessing the
highest intrinsic rate of automaticity (60–100 bpm). Its impulses
suppress slower pacemaker cells through "overdrive suppression".
2. The inherent (intrinsic) rate of the SA node is:
A. 20–40 beats per minute
B. 40–60 beats per minute
C. 60–100 beats per minute
D. 100–180 beats per minute
Correct answer: C
Rationale: The sinoatrial (SA) node is the normal pacemaker of the heart
with an inherent firing rate of 60–100 beats per minute.
3. The inherent rate of the AV junction is:
A. 20–40 beats per minute
B. 40–60 beats per minute
C. 60–100 beats per minute
D. 100–180 beats per minute
Correct answer: B
Rationale: The atrioventricular (AV) junction, which includes the AV
node and bundle of His, has an inherent firing rate of 40–60 beats per
minute.
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4. The inherent rate of the ventricles (Purkinje fibers) is:
A. 20–40 beats per minute
B. 40–60 beats per minute
C. 60–100 beats per minute
D. 100–180 beats per minute
Correct answer: A
Rationale: The Purkinje fibers and ventricular myocardial cells have the
slowest inherent automaticity, typically firing at 20–40 beats per minute.
This idioventricular rhythm serves as the last-resort backup pacemaker.
5. The normal conduction pathway through the heart is:
A. SA node → AV node → Bundle of His → Bundle Branches → Purkinje
fibers
B. AV node → SA node → Purkinje fibers → Bundle of His
C. SA node → Bundle of His → AV node → Bundle Branches
D. Purkinje fibers → Bundle Branches → Bundle of His → AV node → SA
node
Correct answer: A
Rationale: The impulse originates in the SA node, spreads through the
atria (P wave), is delayed at the AV node to allow ventricular filling, then
travels through the Bundle of His, bundle branches, and Purkinje fibers
for ventricular depolarization (QRS complex).
6. The P wave on an EKG represents:
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A. Ventricular depolarization
B. Atrial depolarization
C. Ventricular repolarization
D. Atrial repolarization
Correct answer: B
Rationale: The P wave represents the electrical impulse traveling
through the atria, causing atrial depolarization and contraction. The QRS
complex represents ventricular depolarization, and the T wave
represents ventricular repolarization.
7. The QRS complex on an EKG represents:
A. Atrial depolarization
B. Ventricular repolarization
C. Ventricular depolarization
D. Atrial repolarization
Correct answer: C
Rationale: The QRS complex represents ventricular depolarization,
which triggers ventricular contraction. The P wave represents atrial
depolarization, and the T wave represents ventricular repolarization.
8. The T wave on an EKG represents:
A. Atrial depolarization
B. Ventricular depolarization
C. Atrial repolarization
D. Ventricular repolarization
Correct answer: D
