HCA Healthcare Telemetry ECG/EKG Interpretation
Guide (NEW 2026/2027 Update) Questions and
Answers | (Solutions)
Questions 1–200 with detailed rationales |
Comprehensive Telemetry Certification Review |
100% Pass Guaranteed | Graded A+
1. A nurse is analyzing a telemetry strip and notes the following: irregular
rhythm, no discernible P waves, and a ventricular rate of 120 beats per
minute. Which of the following rhythms is most likely?
A. Sinus tachycardia
B. Atrial fibrillation
C. Atrial flutter
D. Ventricular tachycardia
Correct Answer: B
Explanation: Atrial fibrillation is characterized by an irregularly irregular rhythm,
absence of discernible P waves (fibrillatory waves may be present), and a
variable ventricular rate. Sinus tachycardia (A) has regular P waves. Atrial
flutter (C) typically has sawtooth flutter waves. Ventricular tachycardia (D) is a
wide-complex tachycardia with a regular rhythm.
2. A nurse is interpreting an ECG strip and notes a regular rhythm with a rate
of 45 beats per minute. The P waves are present and upright, and each P
wave is followed by a QRS complex. The PR interval is 0.16 seconds.
Which of the following rhythms is this?
A. Sinus bradycardia
B. Junctional rhythm
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,C. First-degree heart block
D. Sinus arrhythmia
Correct Answer: A
Explanation: Sinus bradycardia is a regular rhythm with a rate below 60 beats
per minute, with normal P waves, PR interval, and QRS complexes. Junctional
rhythm (B) would have absent or inverted P waves. First-degree heart block (C)
would have a prolonged PR interval >0.20 seconds. Sinus arrhythmia (D) would
have an irregular rhythm.
3. A nurse is analyzing a telemetry strip and identifies a sawtooth pattern
between QRS complexes. The atrial rate is approximately 300 beats per
minute, and the ventricular rate is 150 beats per minute. Which of the
following rhythms is this?
A. Atrial fibrillation
B. Atrial flutter
C. Supraventricular tachycardia
D. Sinus tachycardia with artifact
Correct Answer: B
Explanation: Atrial flutter is characterized by a sawtooth pattern (flutter waves)
at an atrial rate of 250-350 beats per minute, often with a 2:1 conduction ratio
resulting in a ventricular rate of approximately 150 beats per minute. Atrial
fibrillation (A) has fibrillatory waves, not sawtooth. SVT (C) typically has a rate
>150 with no discernible P waves. Sinus tachycardia (D) would have normal P
waves.
4. A nurse is interpreting an ECG strip and notes a prolonged PR interval of
0.28 seconds with a regular rhythm and a rate of 72 beats per minute. All
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, P waves are followed by QRS complexes. Which of the following is the
correct interpretation?
A. First-degree AV block
B. Second-degree AV block, Type I
C. Second-degree AV block, Type II
D. Third-degree AV block
Correct Answer: A
Explanation: First-degree AV block is characterized by a PR interval greater
than 0.20 seconds with all P waves conducted to the ventricles. Second-degree
AV block Type I (B) would show progressive lengthening of the PR interval until a
QRS is dropped. Second-degree AV block Type II (C) would show constant PR
intervals with intermittent dropped QRS complexes. Third-degree AV block (D)
would show no relationship between P waves and QRS complexes.
5. A nurse is analyzing a telemetry strip and notes a progressive lengthening
of the PR interval until a QRS complex is dropped. This pattern repeats
itself. Which of the following rhythms is this?
A. First-degree AV block
B. Second-degree AV block, Type I (Mobitz I)
C. Second-degree AV block, Type II (Mobitz II)
D. Third-degree AV block
Correct Answer: B
Explanation: Second-degree AV block, Type I (Mobitz I or Wenckebach) is
characterized by progressive lengthening of the PR interval until a QRS complex
is dropped, after which the cycle repeats. First-degree AV block (A) has a
prolonged but constant PR interval. Second-degree AV block, Type II (C) has
constant PR intervals with sudden dropped beats. Third-degree AV block (D)
has complete dissociation between atria and ventricles.
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, 6. A nurse is interpreting an ECG strip and notes constant PR intervals with
intermittent dropped QRS complexes. There is no progressive lengthening
of the PR interval. Which of the following rhythms is this?
A. First-degree AV block
B. Second-degree AV block, Type I
C. Second-degree AV block, Type II (Mobitz II)
D. Third-degree AV block
Correct Answer: C
Explanation: Second-degree AV block, Type II (Mobitz II) is characterized by
constant PR intervals with intermittent dropped QRS complexes. This is a more
serious condition than Type I and often requires a pacemaker. First-degree AV
block (A) has a prolonged PR interval with no dropped beats. Type I (B) has
progressive PR lengthening. Third-degree AV block (D) has complete
dissociation.
7. A nurse is analyzing a telemetry strip and notes that the P waves and QRS
complexes are completely dissociated. The atrial rate is 80 beats per
minute, and the ventricular rate is 40 beats per minute. Which of the
following rhythms is this?
A. Second-degree AV block, Type I
B. Second-degree AV block, Type II
C. Third-degree AV block (Complete Heart Block)
D. Sinus bradycardia
Correct Answer: C
Explanation: Third-degree AV block (complete heart block) is characterized by
complete dissociation between P waves and QRS complexes, with the atria and
ventricles beating independently. The atrial rate is typically faster than the
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Guide (NEW 2026/2027 Update) Questions and
Answers | (Solutions)
Questions 1–200 with detailed rationales |
Comprehensive Telemetry Certification Review |
100% Pass Guaranteed | Graded A+
1. A nurse is analyzing a telemetry strip and notes the following: irregular
rhythm, no discernible P waves, and a ventricular rate of 120 beats per
minute. Which of the following rhythms is most likely?
A. Sinus tachycardia
B. Atrial fibrillation
C. Atrial flutter
D. Ventricular tachycardia
Correct Answer: B
Explanation: Atrial fibrillation is characterized by an irregularly irregular rhythm,
absence of discernible P waves (fibrillatory waves may be present), and a
variable ventricular rate. Sinus tachycardia (A) has regular P waves. Atrial
flutter (C) typically has sawtooth flutter waves. Ventricular tachycardia (D) is a
wide-complex tachycardia with a regular rhythm.
2. A nurse is interpreting an ECG strip and notes a regular rhythm with a rate
of 45 beats per minute. The P waves are present and upright, and each P
wave is followed by a QRS complex. The PR interval is 0.16 seconds.
Which of the following rhythms is this?
A. Sinus bradycardia
B. Junctional rhythm
Page 1 of 90
,C. First-degree heart block
D. Sinus arrhythmia
Correct Answer: A
Explanation: Sinus bradycardia is a regular rhythm with a rate below 60 beats
per minute, with normal P waves, PR interval, and QRS complexes. Junctional
rhythm (B) would have absent or inverted P waves. First-degree heart block (C)
would have a prolonged PR interval >0.20 seconds. Sinus arrhythmia (D) would
have an irregular rhythm.
3. A nurse is analyzing a telemetry strip and identifies a sawtooth pattern
between QRS complexes. The atrial rate is approximately 300 beats per
minute, and the ventricular rate is 150 beats per minute. Which of the
following rhythms is this?
A. Atrial fibrillation
B. Atrial flutter
C. Supraventricular tachycardia
D. Sinus tachycardia with artifact
Correct Answer: B
Explanation: Atrial flutter is characterized by a sawtooth pattern (flutter waves)
at an atrial rate of 250-350 beats per minute, often with a 2:1 conduction ratio
resulting in a ventricular rate of approximately 150 beats per minute. Atrial
fibrillation (A) has fibrillatory waves, not sawtooth. SVT (C) typically has a rate
>150 with no discernible P waves. Sinus tachycardia (D) would have normal P
waves.
4. A nurse is interpreting an ECG strip and notes a prolonged PR interval of
0.28 seconds with a regular rhythm and a rate of 72 beats per minute. All
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, P waves are followed by QRS complexes. Which of the following is the
correct interpretation?
A. First-degree AV block
B. Second-degree AV block, Type I
C. Second-degree AV block, Type II
D. Third-degree AV block
Correct Answer: A
Explanation: First-degree AV block is characterized by a PR interval greater
than 0.20 seconds with all P waves conducted to the ventricles. Second-degree
AV block Type I (B) would show progressive lengthening of the PR interval until a
QRS is dropped. Second-degree AV block Type II (C) would show constant PR
intervals with intermittent dropped QRS complexes. Third-degree AV block (D)
would show no relationship between P waves and QRS complexes.
5. A nurse is analyzing a telemetry strip and notes a progressive lengthening
of the PR interval until a QRS complex is dropped. This pattern repeats
itself. Which of the following rhythms is this?
A. First-degree AV block
B. Second-degree AV block, Type I (Mobitz I)
C. Second-degree AV block, Type II (Mobitz II)
D. Third-degree AV block
Correct Answer: B
Explanation: Second-degree AV block, Type I (Mobitz I or Wenckebach) is
characterized by progressive lengthening of the PR interval until a QRS complex
is dropped, after which the cycle repeats. First-degree AV block (A) has a
prolonged but constant PR interval. Second-degree AV block, Type II (C) has
constant PR intervals with sudden dropped beats. Third-degree AV block (D)
has complete dissociation between atria and ventricles.
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, 6. A nurse is interpreting an ECG strip and notes constant PR intervals with
intermittent dropped QRS complexes. There is no progressive lengthening
of the PR interval. Which of the following rhythms is this?
A. First-degree AV block
B. Second-degree AV block, Type I
C. Second-degree AV block, Type II (Mobitz II)
D. Third-degree AV block
Correct Answer: C
Explanation: Second-degree AV block, Type II (Mobitz II) is characterized by
constant PR intervals with intermittent dropped QRS complexes. This is a more
serious condition than Type I and often requires a pacemaker. First-degree AV
block (A) has a prolonged PR interval with no dropped beats. Type I (B) has
progressive PR lengthening. Third-degree AV block (D) has complete
dissociation.
7. A nurse is analyzing a telemetry strip and notes that the P waves and QRS
complexes are completely dissociated. The atrial rate is 80 beats per
minute, and the ventricular rate is 40 beats per minute. Which of the
following rhythms is this?
A. Second-degree AV block, Type I
B. Second-degree AV block, Type II
C. Third-degree AV block (Complete Heart Block)
D. Sinus bradycardia
Correct Answer: C
Explanation: Third-degree AV block (complete heart block) is characterized by
complete dissociation between P waves and QRS complexes, with the atria and
ventricles beating independently. The atrial rate is typically faster than the
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