Relias Dysrhythmia Basic Test - Dysrhythmia Basic A 2026/2027 Edition
CARDIAC RHYTHM INTERPRETATION - NURSING EDUCATION COMPETENCY PREPARATION SERIES
Relias Dysrhythmia Basic Test Answers
Dysrhythmia - Basic A
2026/2027 Edition - 65-Question Competency Assessment (A+ GRADED 100% VERIFIED)
Aligned with the Relias learning platform dysrhythmia competency format and current 2026-2027 ACLS-aligned
dysrhythmia guidelines
65 8 A-D 70%
Multiple-Choice Questions Rhythm Domains Four Options, One Correct Scenario Strip-Style Items
ASSESSMENT INSTRUCTIONS
1. Select the ONE best answer (A-D) for each of the 65 questions. Each question is followed by the correct answer and a
dysrhythmia-specific rationale for study review.
2. Rhythm strips are presented as written strip descriptions, such as (The monitor shows...), consistent with the Relias
text-based format. Rate methods: the 300 method counts large boxes between R waves, and the 1500 method counts small
boxes for regular rhythms.
3. Cognitive level distribution: approximately 25% recall, 55% application, 20% analysis. Approximately 70% of items are
scenario or rhythm-strip based; 30% are direct recall or measurement questions.
4. Content reflects current 2026/2027 guideline practice: atropine 1 mg IV for symptomatic bradycardia, synchronized
cardioversion for unstable tachydysrhythmias, and unsynchronized defibrillation for pulseless ventricular dysrhythmias.
SECTION 1: CARDIAC ANATOMY AND PHYSIOLOGY (HEART
STRUCTURES, CONDUCTION SYSTEM, AND ELECTROPHYSIOLOGY)
Questions 1-10 | 10 items
Q1. Which chamber of the heart receives oxygenated blood returning from the lungs through the four
pulmonary veins?
A. Right atrium
B. Left atrium [CORRECT]
C. Right ventricle
D. Left ventricle
Correct Answer: B
Rationale: The left atrium receives freshly oxygenated blood from the pulmonary veins and passes it
through the mitral valve into the left ventricle for delivery to the systemic circulation. The right atrium
instead receives deoxygenated blood from the superior and inferior vena cavae, and the right ventricle pumps
that blood toward the lungs. The left ventricle receives blood from the left atrium, not directly from the
pulmonary veins, making the other three options anatomically incorrect.
1
,Relias Dysrhythmia Basic Test - Dysrhythmia Basic A 2026/2027 Edition
Q2. Which cardiac valve lies between the left atrium and the left ventricle and closes during
ventricular systole to prevent retrograde flow?
A. Tricuspid valve
B. Aortic valve
C. Mitral (bicuspid) valve [CORRECT]
D. Pulmonic valve
Correct Answer: C
Rationale: The mitral (bicuspid) valve guards the left atrioventricular junction; when the left ventricle
contracts, it snaps shut to keep blood from regurgitating back into the left atrium. The tricuspid valve
occupies the same position on the right side of the heart, while the aortic and pulmonic valves guard the
ventricular outflow tracts. Confusing atrioventricular valves with semilunar valves is a classic Relias exam
trap, so anchor each valve to the chamber pair it separates.
Q3. The sinoatrial (SA) node serves as the dominant pacemaker of the heart primarily because it:
A. Has the fastest intrinsic firing rate of 60 to 100 impulses per minute [CORRECT]
B. Is the largest structure within the conduction system
C. Has the slowest intrinsic rate, which allows complete ventricular filling
D. Is the only conduction tissue supplied by the coronary arteries
Correct Answer: A
Rationale: Through overdrive suppression, the fastest pacemaker controls the heart, and the SA node's
intrinsic rate of 60 to 100 per minute exceeds that of the AV junction (40 to 60) and the Purkinje system (20
to 40). Size has no bearing on pacemaker dominance, so option B is a distractor. Option C reverses the logic,
because the slowest site is Purkinje tissue, and option D is false because all conduction tissue requires
coronary perfusion.
Q4. A preceptor asks a new nurse to trace the normal electrical impulse from its initiation to
ventricular contraction. Which sequence is correct?
A. SA node, AV node, Purkinje fibers, Bundle of His, bundle branches
B. AV node, SA node, Bundle of His, bundle branches, Purkinje fibers
C. SA node, Bundle of His, AV node, bundle branches, Purkinje fibers
D. SA node, AV node, Bundle of His, bundle branches, Purkinje fibers [CORRECT]
Correct Answer: D
Rationale: The impulse normally begins in the SA node, traverses the atria to the AV node, passes through
the Bundle of His, divides into the right and left bundle branches, and finally spreads through the Purkinje
fibers to depolarize the ventricular myocardium. Option A incorrectly places the Purkinje fibers ahead of the
His bundle and branches, option B starts at the wrong pacemaker, and option C skips the AV node until after
2
, Relias Dysrhythmia Basic Test - Dysrhythmia Basic A 2026/2027 Edition
the His bundle. Sequential order questions appear frequently on Relias testing because conduction delays
anywhere along this pathway produce predictable ECG changes.
Q5. A nurse educator is explaining the physiologic purpose of the normal conduction delay at the AV
node. The best explanation is that the delay:
A. Accelerates conduction toward the ventricles during exercise
B. Allows the atria to contract and complete ventricular filling before ventricular systole begins
[CORRECT]
C. Generates the P wave visible on the ECG tracing
D. Completely prevents any retrograde conduction to the atria
Correct Answer: B
Rationale: The approximately 0.1-second AV nodal delay lets atrial contraction contribute the final volume
to ventricular filling, often called the atrial kick, before the ventricles depolarize and contract. The P wave is
produced by atrial depolarization initiated by the SA node, not by the AV node itself, so option C
misattributes the waveform. Option A is the opposite of the delay's effect, and option D overstates the
function because retrograde conduction can and does occur in some junctional rhythms.
Q6. If the SA node fails to fire, which intrinsic rate is characteristic of a junctional (AV junctional)
escape rhythm?
A. 20 to 40 beats per minute
B. 60 to 100 beats per minute
C. 40 to 60 beats per minute [CORRECT]
D. 100 to 150 beats per minute
Correct Answer: C
Rationale: Escape pacemakers fire at rates reflecting their intrinsic automaticity, and the AV junction takes
over at 40 to 60 beats per minute, usually producing a narrow QRS with absent or inverted P waves. The 20
to 40 range describes a ventricular (idioventricular) escape rhythm with a wide QRS, which is the next
backup if the junction also fails. Option D is not an intrinsic escape rate at all, and option B is the SA node's
own range, making both common Relias answer traps.
Q7. Phase 0 of the fast-response ventricular cardiac action potential is best characterized by:
A. Rapid depolarization produced by a sudden influx of sodium ions [CORRECT]
B. A plateau produced by slow calcium influx
C. Repolarization produced by potassium efflux returning the cell toward resting potential
D. A stable resting membrane potential maintained until the next impulse arrives
Correct Answer: A
3
CARDIAC RHYTHM INTERPRETATION - NURSING EDUCATION COMPETENCY PREPARATION SERIES
Relias Dysrhythmia Basic Test Answers
Dysrhythmia - Basic A
2026/2027 Edition - 65-Question Competency Assessment (A+ GRADED 100% VERIFIED)
Aligned with the Relias learning platform dysrhythmia competency format and current 2026-2027 ACLS-aligned
dysrhythmia guidelines
65 8 A-D 70%
Multiple-Choice Questions Rhythm Domains Four Options, One Correct Scenario Strip-Style Items
ASSESSMENT INSTRUCTIONS
1. Select the ONE best answer (A-D) for each of the 65 questions. Each question is followed by the correct answer and a
dysrhythmia-specific rationale for study review.
2. Rhythm strips are presented as written strip descriptions, such as (The monitor shows...), consistent with the Relias
text-based format. Rate methods: the 300 method counts large boxes between R waves, and the 1500 method counts small
boxes for regular rhythms.
3. Cognitive level distribution: approximately 25% recall, 55% application, 20% analysis. Approximately 70% of items are
scenario or rhythm-strip based; 30% are direct recall or measurement questions.
4. Content reflects current 2026/2027 guideline practice: atropine 1 mg IV for symptomatic bradycardia, synchronized
cardioversion for unstable tachydysrhythmias, and unsynchronized defibrillation for pulseless ventricular dysrhythmias.
SECTION 1: CARDIAC ANATOMY AND PHYSIOLOGY (HEART
STRUCTURES, CONDUCTION SYSTEM, AND ELECTROPHYSIOLOGY)
Questions 1-10 | 10 items
Q1. Which chamber of the heart receives oxygenated blood returning from the lungs through the four
pulmonary veins?
A. Right atrium
B. Left atrium [CORRECT]
C. Right ventricle
D. Left ventricle
Correct Answer: B
Rationale: The left atrium receives freshly oxygenated blood from the pulmonary veins and passes it
through the mitral valve into the left ventricle for delivery to the systemic circulation. The right atrium
instead receives deoxygenated blood from the superior and inferior vena cavae, and the right ventricle pumps
that blood toward the lungs. The left ventricle receives blood from the left atrium, not directly from the
pulmonary veins, making the other three options anatomically incorrect.
1
,Relias Dysrhythmia Basic Test - Dysrhythmia Basic A 2026/2027 Edition
Q2. Which cardiac valve lies between the left atrium and the left ventricle and closes during
ventricular systole to prevent retrograde flow?
A. Tricuspid valve
B. Aortic valve
C. Mitral (bicuspid) valve [CORRECT]
D. Pulmonic valve
Correct Answer: C
Rationale: The mitral (bicuspid) valve guards the left atrioventricular junction; when the left ventricle
contracts, it snaps shut to keep blood from regurgitating back into the left atrium. The tricuspid valve
occupies the same position on the right side of the heart, while the aortic and pulmonic valves guard the
ventricular outflow tracts. Confusing atrioventricular valves with semilunar valves is a classic Relias exam
trap, so anchor each valve to the chamber pair it separates.
Q3. The sinoatrial (SA) node serves as the dominant pacemaker of the heart primarily because it:
A. Has the fastest intrinsic firing rate of 60 to 100 impulses per minute [CORRECT]
B. Is the largest structure within the conduction system
C. Has the slowest intrinsic rate, which allows complete ventricular filling
D. Is the only conduction tissue supplied by the coronary arteries
Correct Answer: A
Rationale: Through overdrive suppression, the fastest pacemaker controls the heart, and the SA node's
intrinsic rate of 60 to 100 per minute exceeds that of the AV junction (40 to 60) and the Purkinje system (20
to 40). Size has no bearing on pacemaker dominance, so option B is a distractor. Option C reverses the logic,
because the slowest site is Purkinje tissue, and option D is false because all conduction tissue requires
coronary perfusion.
Q4. A preceptor asks a new nurse to trace the normal electrical impulse from its initiation to
ventricular contraction. Which sequence is correct?
A. SA node, AV node, Purkinje fibers, Bundle of His, bundle branches
B. AV node, SA node, Bundle of His, bundle branches, Purkinje fibers
C. SA node, Bundle of His, AV node, bundle branches, Purkinje fibers
D. SA node, AV node, Bundle of His, bundle branches, Purkinje fibers [CORRECT]
Correct Answer: D
Rationale: The impulse normally begins in the SA node, traverses the atria to the AV node, passes through
the Bundle of His, divides into the right and left bundle branches, and finally spreads through the Purkinje
fibers to depolarize the ventricular myocardium. Option A incorrectly places the Purkinje fibers ahead of the
His bundle and branches, option B starts at the wrong pacemaker, and option C skips the AV node until after
2
, Relias Dysrhythmia Basic Test - Dysrhythmia Basic A 2026/2027 Edition
the His bundle. Sequential order questions appear frequently on Relias testing because conduction delays
anywhere along this pathway produce predictable ECG changes.
Q5. A nurse educator is explaining the physiologic purpose of the normal conduction delay at the AV
node. The best explanation is that the delay:
A. Accelerates conduction toward the ventricles during exercise
B. Allows the atria to contract and complete ventricular filling before ventricular systole begins
[CORRECT]
C. Generates the P wave visible on the ECG tracing
D. Completely prevents any retrograde conduction to the atria
Correct Answer: B
Rationale: The approximately 0.1-second AV nodal delay lets atrial contraction contribute the final volume
to ventricular filling, often called the atrial kick, before the ventricles depolarize and contract. The P wave is
produced by atrial depolarization initiated by the SA node, not by the AV node itself, so option C
misattributes the waveform. Option A is the opposite of the delay's effect, and option D overstates the
function because retrograde conduction can and does occur in some junctional rhythms.
Q6. If the SA node fails to fire, which intrinsic rate is characteristic of a junctional (AV junctional)
escape rhythm?
A. 20 to 40 beats per minute
B. 60 to 100 beats per minute
C. 40 to 60 beats per minute [CORRECT]
D. 100 to 150 beats per minute
Correct Answer: C
Rationale: Escape pacemakers fire at rates reflecting their intrinsic automaticity, and the AV junction takes
over at 40 to 60 beats per minute, usually producing a narrow QRS with absent or inverted P waves. The 20
to 40 range describes a ventricular (idioventricular) escape rhythm with a wide QRS, which is the next
backup if the junction also fails. Option D is not an intrinsic escape rate at all, and option B is the SA node's
own range, making both common Relias answer traps.
Q7. Phase 0 of the fast-response ventricular cardiac action potential is best characterized by:
A. Rapid depolarization produced by a sudden influx of sodium ions [CORRECT]
B. A plateau produced by slow calcium influx
C. Repolarization produced by potassium efflux returning the cell toward resting potential
D. A stable resting membrane potential maintained until the next impulse arrives
Correct Answer: A
3
