2026/2027 | Study Guide, Practice Questions
& Answers with Detailed Rationales | ECG
Rhythm Identification & Telemetry Exam
Prep
BASIC ARRHYTHMIA SENTARA TEST 2026/2027
STUDY GUIDE & PRACTICE QUESTIONS
• This comprehensive exam contains 200 practice questions with detailed rationales
to strengthen your ECG rhythm identification and telemetry monitoring skills
• Use this material by studying one section at a time, reviewing rationales carefully,
and retesting weak areas before the actual exam
QUESTION 1: What is the normal heart rate for an adult in normal sinus
rhythm?
A) 40-60 beats per minute
B) 60-100 beats per minute
C) 100-120 beats per minute
D) 120-140 beats per minute
E) 140-160 beats per minute
CORRECT ANSWER: B - 60-100 beats per minute
Rationale: Normal sinus rhythm is defined as a heart rate between 60-100 beats per
minute. Rates below 60 bpm are considered bradycardia, while rates above 100
bpm are considered tachycardia. This is the standard reference range for adult
heart rate assessment in clinical practice.
QUESTION 2: Which interval on an ECG represents ventricular depolarization?
A) PR interval
B) QT interval
,C) QRS complex
D) ST segment
E) TP segment
CORRECT ANSWER: C - QRS complex
Rationale: The QRS complex represents ventricular depolarization and typically
lasts 0.08-0.12 seconds (80-120 milliseconds). A QRS wider than 0.12 seconds
indicates a conduction delay, such as a bundle branch block or ventricular rhythm.
QUESTION 3: What does the P wave represent on an ECG?
A) Atrial depolarization
B) Ventricular depolarization
C) Atrial repolarization
D) Ventricular repolarization
E) AV node conduction
CORRECT ANSWER: A - Atrial depolarization
Rationale: The P wave represents atrial depolarization (electrical activation of the
atria). A normal P wave should be upright in most leads, with a duration of 0.08-
0.10 seconds. The absence of a P wave may indicate atrial fibrillation or a junctional
rhythm.
QUESTION 4: A patient presents with a heart rate of 48 bpm in normal sinus
rhythm. What is this rhythm called?
A) Tachycardia
B) Bradycardia
C) Atrial flutter
D) Normal sinus rhythm
,E) Sick sinus syndrome
CORRECT ANSWER: B - Bradycardia
Rationale: Bradycardia is defined as a heart rate below 60 bpm in adults. While this
patient maintains normal sinus rhythm characteristics (regular P waves before QRS
complexes), the rate falls below the normal range. Symptomatic bradycardia may
require intervention such as atropine or pacing.
QUESTION 5: What is the PR interval and what does it represent?
A) The time for atrial depolarization only
B) The time from atrial depolarization to ventricular depolarization
C) The time for ventricular repolarization
D) The time from atrial repolarization to ventricular depolarization
E) The interval between two P waves
CORRECT ANSWER: B - The time from atrial depolarization to ventricular
depolarization
Rationale: The PR interval measures from the beginning of the P wave to the
beginning of the QRS complex, representing the time for atrial depolarization plus
AV nodal and bundle conduction delay. Normal PR interval is 0.12-0.20 seconds.
Prolonged PR interval may indicate first-degree AV block.
QUESTION 6: Which of the following best describes sinus tachycardia?
A) Heart rate >100 bpm with regular rhythm and normal P waves
B) Heart rate <60 bpm with irregular rhythm
C) Heart rate >100 bpm with absent P waves
D) Heart rate >150 bpm with widened QRS complexes
E) Heart rate varying between 60-100 bpm
, CORRECT ANSWER: A - Heart rate >100 bpm with regular rhythm and normal P
waves
Rationale: Sinus tachycardia is a regular rhythm with a rate >100 bpm, originating
from the SA node. Normal P waves are present, the PR interval is normal, and the
QRS complex is narrow. Common causes include fever, pain, anxiety, exercise, and
hyperthyroidism.
QUESTION 7: What is the most common type of premature atrial contraction
(PAC) pattern?
A) Isolated PACs occurring randomly
B) Bigeminy (every other beat is a PAC)
C) Trigeminy (every third beat is a PAC)
D) Quadrigeminy (every fourth beat is a PAC)
E) Couplets of PACs
CORRECT ANSWER: A - Isolated PACs occurring randomly
Rationale: Isolated PACs occurring randomly throughout the rhythm are the most
common presentation. PACs are characterized by an early P wave (different from
sinus P wave) followed by a QRS complex. While patterns like bigeminy and
trigeminy can occur, random isolated PACs are most frequently observed in clinical
practice.
QUESTION 8: How does a PAC typically appear on an ECG?
A) Wide QRS complex with no preceding P wave
B) An early P wave with a different morphology followed by a narrow QRS
C) Completely irregular rhythm with no visible P waves
D) Regular rhythm with buried P waves
E) Wide, bizarre QRS complexes occurring every other beat