RELIAS DYSRHYTHMIA BASIC A EXAM 2026: 35 QUESTIONS & VERIFIED ANSWERS | EKG RHYTHM
IDENTIFICATION, ECG INTERPRETATION (GRADED A+ SOLUTION] – QUESTIONS AND ANSWERS |
VERIFIED AND WELL DETAILED ANSWERS | PLUS RATIONALES | GUARANTEED PASS | LATEST EXAM
UPDATE
CORE DOMAINS
1. Electrophysiology and Conduction Pathways
2. Sinus Node Rhythms and Arrhythmias
3. Atrial Dysrhythmias
4. Junctional Rhythms
5. Ventricular Dysrhythmias
6. Atrioventricular (AV) Blocks
7. Pacemaker Rhythms and Artifacts
8. 12-Lead ECG Interpretation and Ischemia
9. Pharmacology and Clinical Management
10. Safety, Legal, and Ethical Standards in ECG Monitoring
INTRODUCTION
The purpose of this comprehensive assessment is to evaluate the candidate's proficiency in identifying
and interpreting cardiac dysrhythmias. It assesses foundational electrophysiology knowledge, technical
rhythm strip analysis, and the application of clinical judgment in patient scenarios. The exam structure
utilizes multiple-choice and scenario-based questions to simulate real-world professional decision-
making. Emphasis is placed on accurate identification, appropriate clinical interventions, and adherence
to safety and regulatory standards. This tool is designed to measure readiness for professional practice in
telemetry and acute care settings.
SECTION ONE – QUESTIONS 1–100
Question 1
What is the normal duration of the PR interval on an ECG?
A. Less than 0.12 seconds
B. 0.12 to 0.20 seconds
C. 0.20 to 0.24 seconds
D. Greater than 0.24 seconds
🟢 Correct answer: B
🔴 Explanation: The normal PR interval represents the time from the onset of atrial depolarization to
the onset of ventricular depolarization, which is typically between 0.12 and 0.20 seconds (3 to 5 small
boxes).
Question 2
A patient presents with a heart rate of 130 bpm, regular rhythm, and a normal P wave preceding every
,QRS complex. What is the most likely rhythm?
A. Atrial fibrillation
B. Sinus tachycardia
C. Ventricular tachycardia
D. Junctional tachycardia
🟢 Correct answer: B
🔴 Explanation: A regular rhythm with a rate over 100 bpm, where every QRS is preceded by a normal
P wave, indicates sinus tachycardia.
Question 3
Which of the following rhythms is characterized by a chaotic, irregular baseline with no discernible P
waves?
A. Atrial flutter
B. Sinus arrhythmia
C. Atrial fibrillation
D. Premature atrial complex
🟢 Correct answer: C
🔴 Explanation: Atrial fibrillation is defined by disorganized electrical activity in the atria, resulting in
an irregularly irregular ventricular response and the absence of distinct P waves.
Question 4
A patient is in ventricular tachycardia. They are unresponsive and pulseless. What is the priority
intervention?
A. Administer amiodarone
B. Synchronized cardioversion
C. Defibrillation
D. Perform a 12-lead ECG
🟢 Correct answer: C
🔴 Explanation: Pulseless ventricular tachycardia is a shockable rhythm. The immediate intervention is
unsynchronized defibrillation to restore a perfusing rhythm.
Question 5
What does a prolonged QT interval indicate?
A. Delayed atrial repolarization
B. Delayed ventricular repolarization
C. Enhanced conduction through the AV node
D. A faster heart rate
🟢 Correct answer: B
🔴 Explanation: The QT interval represents the total duration of ventricular depolarization and
repolarization. A prolonged QT interval indicates delayed ventricular repolarization, increasing the risk
for torsades de pointes.
Question 6
Identify the rhythm: The ventricular rate is 40 bpm, the atrial rate is 90 bpm, and there is no
relationship between the P waves and QRS complexes.
A. First-degree AV block
B. Second-degree AV block, Type I
,C. Third-degree AV block
D. Sinus bradycardia
🟢 Correct answer: C
🔴 Explanation: A complete lack of communication between the atria and ventricles, evidenced by
independent atrial and ventricular rates, is characteristic of a third-degree (complete) AV block.
Question 7
A patient's ECG shows a sawtooth pattern of atrial activity at a rate of 300 bpm. What is the rhythm?
A. Atrial fibrillation
B. Atrial flutter
C. Sinus tachycardia
D. Supraventricular tachycardia
🟢 Correct answer: B
🔴 Explanation: The classic "sawtooth" or F-wave pattern at an atrial rate of 250-350 bpm is the
hallmark of atrial flutter.
Question 8
What is the first step in interpreting any ECG rhythm strip?
A. Calculate the heart rate
B. Assess the QRS width
C. Determine the regularity
D. Check for a pulse
🟢 Correct answer: D
🔴 Explanation: Before any rhythm interpretation is used to guide treatment, the patient must be
assessed. The first step is always to check the patient's pulse and clinical status to correlate the rhythm
with their condition.
Question 9
Which medication is used to treat symptomatic bradycardia that is unresponsive to atropine?
A. Adenosine
B. Amiodarone
C. Epinephrine infusion
D. Diltiazem
🟢 Correct answer: C
🔴 Explanation: For symptomatic bradycardia unresponsive to atropine, an epinephrine or dopamine
infusion is indicated to increase heart rate and improve perfusion.
Question 10
A premature ventricular complex (PVC) that has a different shape than a previous PVC is called:
A. Unifocal
B. Multifocal
C. Couplet
D. Bigeminy
🟢 Correct answer: B
🔴 Explanation: Multifocal PVCs originate from different ectopic foci in the ventricles, resulting in QRS
complexes with different morphologies.
, Question 11
A patient's rhythm shows a QRS complex that occurs after a P wave, but the PR interval is 0.28 seconds
and constant. What is this rhythm?
A. First-degree AV block
B. Second-degree AV block, Type I
C. Second-degree AV block, Type II
D. Normal sinus rhythm
🟢 Correct answer: A
🔴 Explanation: A PR interval that is consistently longer than 0.20 seconds indicates a first-degree AV
block, which is a delay in conduction through the AV node.
Question 12
What is the term for a PVC that occurs every other beat?
A. Bigeminy
B. Trigeminy
C. Couplet
D. Quadrigeminy
🟢 Correct answer: A
🔴 Explanation: Ventricular bigeminy describes a pattern where every other beat is a premature
ventricular complex.
Question 13
A patient with atrial fibrillation is at high risk for which complication?
A. Pulmonary embolism
B. Stroke
C. Myocardial infarction
D. Pneumonia
🟢 Correct answer: B
🔴 Explanation: The chaotic atrial activity in atrial fibrillation can lead to blood stasis and clot
formation in the atria. If a clot embolizes to the brain, it can cause a stroke.
Question 14
On an ECG, the P wave represents:
A. Ventricular depolarization
B. Atrial repolarization
C. Atrial depolarization
D. Ventricular repolarization
🟢 Correct answer: C
🔴 Explanation: The P wave is the first waveform on an ECG and represents the electrical
depolarization of the atria.
Question 15
A patient is experiencing symptomatic bradycardia with a heart rate of 40 bpm. What is the first-line
medication?
A. Atropine
B. Adenosine
C. Amiodarone
IDENTIFICATION, ECG INTERPRETATION (GRADED A+ SOLUTION] – QUESTIONS AND ANSWERS |
VERIFIED AND WELL DETAILED ANSWERS | PLUS RATIONALES | GUARANTEED PASS | LATEST EXAM
UPDATE
CORE DOMAINS
1. Electrophysiology and Conduction Pathways
2. Sinus Node Rhythms and Arrhythmias
3. Atrial Dysrhythmias
4. Junctional Rhythms
5. Ventricular Dysrhythmias
6. Atrioventricular (AV) Blocks
7. Pacemaker Rhythms and Artifacts
8. 12-Lead ECG Interpretation and Ischemia
9. Pharmacology and Clinical Management
10. Safety, Legal, and Ethical Standards in ECG Monitoring
INTRODUCTION
The purpose of this comprehensive assessment is to evaluate the candidate's proficiency in identifying
and interpreting cardiac dysrhythmias. It assesses foundational electrophysiology knowledge, technical
rhythm strip analysis, and the application of clinical judgment in patient scenarios. The exam structure
utilizes multiple-choice and scenario-based questions to simulate real-world professional decision-
making. Emphasis is placed on accurate identification, appropriate clinical interventions, and adherence
to safety and regulatory standards. This tool is designed to measure readiness for professional practice in
telemetry and acute care settings.
SECTION ONE – QUESTIONS 1–100
Question 1
What is the normal duration of the PR interval on an ECG?
A. Less than 0.12 seconds
B. 0.12 to 0.20 seconds
C. 0.20 to 0.24 seconds
D. Greater than 0.24 seconds
🟢 Correct answer: B
🔴 Explanation: The normal PR interval represents the time from the onset of atrial depolarization to
the onset of ventricular depolarization, which is typically between 0.12 and 0.20 seconds (3 to 5 small
boxes).
Question 2
A patient presents with a heart rate of 130 bpm, regular rhythm, and a normal P wave preceding every
,QRS complex. What is the most likely rhythm?
A. Atrial fibrillation
B. Sinus tachycardia
C. Ventricular tachycardia
D. Junctional tachycardia
🟢 Correct answer: B
🔴 Explanation: A regular rhythm with a rate over 100 bpm, where every QRS is preceded by a normal
P wave, indicates sinus tachycardia.
Question 3
Which of the following rhythms is characterized by a chaotic, irregular baseline with no discernible P
waves?
A. Atrial flutter
B. Sinus arrhythmia
C. Atrial fibrillation
D. Premature atrial complex
🟢 Correct answer: C
🔴 Explanation: Atrial fibrillation is defined by disorganized electrical activity in the atria, resulting in
an irregularly irregular ventricular response and the absence of distinct P waves.
Question 4
A patient is in ventricular tachycardia. They are unresponsive and pulseless. What is the priority
intervention?
A. Administer amiodarone
B. Synchronized cardioversion
C. Defibrillation
D. Perform a 12-lead ECG
🟢 Correct answer: C
🔴 Explanation: Pulseless ventricular tachycardia is a shockable rhythm. The immediate intervention is
unsynchronized defibrillation to restore a perfusing rhythm.
Question 5
What does a prolonged QT interval indicate?
A. Delayed atrial repolarization
B. Delayed ventricular repolarization
C. Enhanced conduction through the AV node
D. A faster heart rate
🟢 Correct answer: B
🔴 Explanation: The QT interval represents the total duration of ventricular depolarization and
repolarization. A prolonged QT interval indicates delayed ventricular repolarization, increasing the risk
for torsades de pointes.
Question 6
Identify the rhythm: The ventricular rate is 40 bpm, the atrial rate is 90 bpm, and there is no
relationship between the P waves and QRS complexes.
A. First-degree AV block
B. Second-degree AV block, Type I
,C. Third-degree AV block
D. Sinus bradycardia
🟢 Correct answer: C
🔴 Explanation: A complete lack of communication between the atria and ventricles, evidenced by
independent atrial and ventricular rates, is characteristic of a third-degree (complete) AV block.
Question 7
A patient's ECG shows a sawtooth pattern of atrial activity at a rate of 300 bpm. What is the rhythm?
A. Atrial fibrillation
B. Atrial flutter
C. Sinus tachycardia
D. Supraventricular tachycardia
🟢 Correct answer: B
🔴 Explanation: The classic "sawtooth" or F-wave pattern at an atrial rate of 250-350 bpm is the
hallmark of atrial flutter.
Question 8
What is the first step in interpreting any ECG rhythm strip?
A. Calculate the heart rate
B. Assess the QRS width
C. Determine the regularity
D. Check for a pulse
🟢 Correct answer: D
🔴 Explanation: Before any rhythm interpretation is used to guide treatment, the patient must be
assessed. The first step is always to check the patient's pulse and clinical status to correlate the rhythm
with their condition.
Question 9
Which medication is used to treat symptomatic bradycardia that is unresponsive to atropine?
A. Adenosine
B. Amiodarone
C. Epinephrine infusion
D. Diltiazem
🟢 Correct answer: C
🔴 Explanation: For symptomatic bradycardia unresponsive to atropine, an epinephrine or dopamine
infusion is indicated to increase heart rate and improve perfusion.
Question 10
A premature ventricular complex (PVC) that has a different shape than a previous PVC is called:
A. Unifocal
B. Multifocal
C. Couplet
D. Bigeminy
🟢 Correct answer: B
🔴 Explanation: Multifocal PVCs originate from different ectopic foci in the ventricles, resulting in QRS
complexes with different morphologies.
, Question 11
A patient's rhythm shows a QRS complex that occurs after a P wave, but the PR interval is 0.28 seconds
and constant. What is this rhythm?
A. First-degree AV block
B. Second-degree AV block, Type I
C. Second-degree AV block, Type II
D. Normal sinus rhythm
🟢 Correct answer: A
🔴 Explanation: A PR interval that is consistently longer than 0.20 seconds indicates a first-degree AV
block, which is a delay in conduction through the AV node.
Question 12
What is the term for a PVC that occurs every other beat?
A. Bigeminy
B. Trigeminy
C. Couplet
D. Quadrigeminy
🟢 Correct answer: A
🔴 Explanation: Ventricular bigeminy describes a pattern where every other beat is a premature
ventricular complex.
Question 13
A patient with atrial fibrillation is at high risk for which complication?
A. Pulmonary embolism
B. Stroke
C. Myocardial infarction
D. Pneumonia
🟢 Correct answer: B
🔴 Explanation: The chaotic atrial activity in atrial fibrillation can lead to blood stasis and clot
formation in the atria. If a clot embolizes to the brain, it can cause a stroke.
Question 14
On an ECG, the P wave represents:
A. Ventricular depolarization
B. Atrial repolarization
C. Atrial depolarization
D. Ventricular repolarization
🟢 Correct answer: C
🔴 Explanation: The P wave is the first waveform on an ECG and represents the electrical
depolarization of the atria.
Question 15
A patient is experiencing symptomatic bradycardia with a heart rate of 40 bpm. What is the first-line
medication?
A. Atropine
B. Adenosine
C. Amiodarone
