,Table of Contents: Basic Rhythms, Sinus Rhythms, and ECG
Fundamentals
1. Chapter 1: Ventricular Fibrillation - Page 4
2. Chapter 2: Ventricular Fibrillation - Page 8
3. Chapter 3: Ventricular Fibrillation - Page 12
4. Chapter 4: SVT - Page 16
5. Chapter 5: 12-Lead ECG - Page 20
6. Chapter 6: Atrial Flutter - Page 24
7. Chapter 7: Electrolyte Effects - Page 28
8. Chapter 8: SVT - Page 32
9. Chapter 9: Atrial Flutter - Page 36
10. Chapter 10: Ventricular Tachycardia - Page 40
11. Chapter 11: Bradycardia - Page 44
12. Chapter 12: Electrolyte Effects - Page 48
13. Chapter 13: Tachycardia - Page 52
14. Chapter 14: ACLS Protocols - Page 56
15. Chapter 15: Sinus Rhythm - Page 60
16. Chapter 16: Bradycardia - Page 64
17. Chapter 17: ACLS Protocols - Page 68
18. Chapter 18: Atrial Fibrillation - Page 72
19. Chapter 19: Tachycardia - Page 76
20. Chapter 20: Atrial Fibrillation - Page 80
21. Chapter 21: Ventricular Tachycardia - Page 84
22. Chapter 22: Atrial Flutter - Page 88
23. Chapter 23: ACLS Protocols - Page 92
24. Chapter 24: Ventricular Tachycardia - Page 96
25. Chapter 25: Sinus Rhythm - Page 100
,1. Which intervention is priority for a patient with sinus bradycardia at 38 bpm who is
symptomatic with The patient is on cardiac monitor, vital signs stable/unstable. What is the
most appropriate nursing identification and intervention per Relias and AHA guidelines?
A. Ignore lethal rhythm
B. Give adenosine for complete heart block
C. Identify asystole incorrectly
D. Ventricular fibrillation - initiate CPR and defibrillation per ACLS
Answer: D
Rationale: Correct because it accurately identifies the dysrhythmia based on rate, regularity, P wave
morphology, PR interval, and QRS width per Relias and AHA ECG criteria. Understanding atrial vs ventricular
origin and conduction blocks is essential. Incorrect options misinterpret key measurements or confuse similar
rhythms. Mastery of 5-step ECG interpretation ensures accurate identification and timely intervention, which is
high-yield for Relias Dysrhythmia Basic Test success. Focus: QRS width.
2. The ECG monitor shows a regular rhythm at 78 bpm, P wave before each QRS, PR interval
0.16 sec. This rhythm is The patient is on cardiac monitor, vital signs stable/unstable. What
is the most appropriate nursing identification and intervention per Relias and AHA
guidelines?
A. Normal sinus rhythm - continue monitoring
B. Fail to activate emergency response
C. Give adenosine for complete heart block
D. Identify asystole incorrectly
Answer: A
Rationale: This option reflects evidence-based ACLS and Relias competency standards for safe dysrhythmia
management. It prioritizes assessment, recognizes lethal rhythms, and implements correct emergency
response including oxygen, monitoring, medications, defibrillation, and provider notification. Distractors delay
care, use contraindicated drugs, or fail to recognize instability. Knowledge of causes, treatments, and
documentation is critical for passing and for patient safety in clinical practice. Focus: P wave analysis.
3. The ECG monitor shows a regular rhythm at 78 bpm, P wave before each QRS, PR interval
0.16 sec. This rhythm is The patient is on cardiac monitor, vital signs stable/unstable. What
is the most appropriate nursing identification and intervention per Relias and AHA
guidelines?
A. Third-degree AV block - prepare for transcutaneous pacing
B. Ignore lethal rhythm
C. Administer atropine for ventricular fibrillation
D. Sinus tachycardia with incorrect rate
Answer: A
Rationale: Correct because it accurately identifies the dysrhythmia based on rate, regularity, P wave
morphology, PR interval, and QRS width per Relias and AHA ECG criteria. Understanding atrial vs ventricular
origin and conduction blocks is essential. Incorrect options misinterpret key measurements or confuse similar
rhythms. Mastery of 5-step ECG interpretation ensures accurate identification and timely intervention, which is
high-yield for Relias Dysrhythmia Basic Test success. Focus: QRS width.
4. Which intervention is priority for a patient with sinus bradycardia at 38 bpm who is
symptomatic with The patient is on cardiac monitor, vital signs stable/unstable. What is the
, most appropriate nursing identification and intervention per Relias and AHA guidelines?
A. Fail to activate emergency response
B. Give adenosine for complete heart block
C. Ventricular fibrillation - initiate CPR and defibrillation per ACLS
D. Identify asystole incorrectly
Answer: C
Rationale: Selected answer aligns with current ECG interpretation guidelines, electrolyte effects on
myocardium, and 12-lead analysis. It considers ischemia, injury, infarction patterns, and electrolyte-induced
changes while integrating vital signs and patient symptoms. Alternatives demonstrate common errors like
confusing atrial flutter with SVT or missing heart block progression. This concept is frequently tested on Relias
and is vital for competent cardiac monitoring and emergency response. Focus: emergency response.
5. Which intervention is priority for a patient with sinus bradycardia at 38 bpm who is
symptomatic with The patient is on cardiac monitor, vital signs stable/unstable. What is the
most appropriate nursing identification and intervention per Relias and AHA guidelines?
A. Ventricular fibrillation - initiate CPR and defibrillation per ACLS
B. Ignore lethal rhythm
C. Defibrillate a stable sinus rhythm
D. Sinus tachycardia with incorrect rate
Answer: A
Rationale: Correct because it accurately identifies the dysrhythmia based on rate, regularity, P wave
morphology, PR interval, and QRS width per Relias and AHA ECG criteria. Understanding atrial vs ventricular
origin and conduction blocks is essential. Incorrect options misinterpret key measurements or confuse similar
rhythms. Mastery of 5-step ECG interpretation ensures accurate identification and timely intervention, which is
high-yield for Relias Dysrhythmia Basic Test success. Focus: rate regularity.
6. Which intervention is priority for a patient with sinus bradycardia at 38 bpm who is
symptomatic with The patient is on cardiac monitor, vital signs stable/unstable. What is the
most appropriate nursing identification and intervention per Relias and AHA guidelines?
A. Ignore lethal rhythm
B. Administer atropine for ventricular fibrillation
C. Atrial fibrillation with RVR - assess, notify provider, consider rate control
D. Confuse SVT with atrial flutter
Answer: C
Rationale: Correct because it accurately identifies the dysrhythmia based on rate, regularity, P wave
morphology, PR interval, and QRS width per Relias and AHA ECG criteria. Understanding atrial vs ventricular
origin and conduction blocks is essential. Incorrect options misinterpret key measurements or confuse similar
rhythms. Mastery of 5-step ECG interpretation ensures accurate identification and timely intervention, which is
high-yield for Relias Dysrhythmia Basic Test success. Focus: QRS width.
7. Which intervention is priority for a patient with sinus bradycardia at 38 bpm who is
symptomatic with The patient is on cardiac monitor, vital signs stable/unstable. What is the
most appropriate nursing identification and intervention per Relias and AHA guidelines?
A. Fail to activate emergency response
B. Atrial fibrillation with RVR - assess, notify provider, consider rate control
C. Give adenosine for complete heart block
Fundamentals
1. Chapter 1: Ventricular Fibrillation - Page 4
2. Chapter 2: Ventricular Fibrillation - Page 8
3. Chapter 3: Ventricular Fibrillation - Page 12
4. Chapter 4: SVT - Page 16
5. Chapter 5: 12-Lead ECG - Page 20
6. Chapter 6: Atrial Flutter - Page 24
7. Chapter 7: Electrolyte Effects - Page 28
8. Chapter 8: SVT - Page 32
9. Chapter 9: Atrial Flutter - Page 36
10. Chapter 10: Ventricular Tachycardia - Page 40
11. Chapter 11: Bradycardia - Page 44
12. Chapter 12: Electrolyte Effects - Page 48
13. Chapter 13: Tachycardia - Page 52
14. Chapter 14: ACLS Protocols - Page 56
15. Chapter 15: Sinus Rhythm - Page 60
16. Chapter 16: Bradycardia - Page 64
17. Chapter 17: ACLS Protocols - Page 68
18. Chapter 18: Atrial Fibrillation - Page 72
19. Chapter 19: Tachycardia - Page 76
20. Chapter 20: Atrial Fibrillation - Page 80
21. Chapter 21: Ventricular Tachycardia - Page 84
22. Chapter 22: Atrial Flutter - Page 88
23. Chapter 23: ACLS Protocols - Page 92
24. Chapter 24: Ventricular Tachycardia - Page 96
25. Chapter 25: Sinus Rhythm - Page 100
,1. Which intervention is priority for a patient with sinus bradycardia at 38 bpm who is
symptomatic with The patient is on cardiac monitor, vital signs stable/unstable. What is the
most appropriate nursing identification and intervention per Relias and AHA guidelines?
A. Ignore lethal rhythm
B. Give adenosine for complete heart block
C. Identify asystole incorrectly
D. Ventricular fibrillation - initiate CPR and defibrillation per ACLS
Answer: D
Rationale: Correct because it accurately identifies the dysrhythmia based on rate, regularity, P wave
morphology, PR interval, and QRS width per Relias and AHA ECG criteria. Understanding atrial vs ventricular
origin and conduction blocks is essential. Incorrect options misinterpret key measurements or confuse similar
rhythms. Mastery of 5-step ECG interpretation ensures accurate identification and timely intervention, which is
high-yield for Relias Dysrhythmia Basic Test success. Focus: QRS width.
2. The ECG monitor shows a regular rhythm at 78 bpm, P wave before each QRS, PR interval
0.16 sec. This rhythm is The patient is on cardiac monitor, vital signs stable/unstable. What
is the most appropriate nursing identification and intervention per Relias and AHA
guidelines?
A. Normal sinus rhythm - continue monitoring
B. Fail to activate emergency response
C. Give adenosine for complete heart block
D. Identify asystole incorrectly
Answer: A
Rationale: This option reflects evidence-based ACLS and Relias competency standards for safe dysrhythmia
management. It prioritizes assessment, recognizes lethal rhythms, and implements correct emergency
response including oxygen, monitoring, medications, defibrillation, and provider notification. Distractors delay
care, use contraindicated drugs, or fail to recognize instability. Knowledge of causes, treatments, and
documentation is critical for passing and for patient safety in clinical practice. Focus: P wave analysis.
3. The ECG monitor shows a regular rhythm at 78 bpm, P wave before each QRS, PR interval
0.16 sec. This rhythm is The patient is on cardiac monitor, vital signs stable/unstable. What
is the most appropriate nursing identification and intervention per Relias and AHA
guidelines?
A. Third-degree AV block - prepare for transcutaneous pacing
B. Ignore lethal rhythm
C. Administer atropine for ventricular fibrillation
D. Sinus tachycardia with incorrect rate
Answer: A
Rationale: Correct because it accurately identifies the dysrhythmia based on rate, regularity, P wave
morphology, PR interval, and QRS width per Relias and AHA ECG criteria. Understanding atrial vs ventricular
origin and conduction blocks is essential. Incorrect options misinterpret key measurements or confuse similar
rhythms. Mastery of 5-step ECG interpretation ensures accurate identification and timely intervention, which is
high-yield for Relias Dysrhythmia Basic Test success. Focus: QRS width.
4. Which intervention is priority for a patient with sinus bradycardia at 38 bpm who is
symptomatic with The patient is on cardiac monitor, vital signs stable/unstable. What is the
, most appropriate nursing identification and intervention per Relias and AHA guidelines?
A. Fail to activate emergency response
B. Give adenosine for complete heart block
C. Ventricular fibrillation - initiate CPR and defibrillation per ACLS
D. Identify asystole incorrectly
Answer: C
Rationale: Selected answer aligns with current ECG interpretation guidelines, electrolyte effects on
myocardium, and 12-lead analysis. It considers ischemia, injury, infarction patterns, and electrolyte-induced
changes while integrating vital signs and patient symptoms. Alternatives demonstrate common errors like
confusing atrial flutter with SVT or missing heart block progression. This concept is frequently tested on Relias
and is vital for competent cardiac monitoring and emergency response. Focus: emergency response.
5. Which intervention is priority for a patient with sinus bradycardia at 38 bpm who is
symptomatic with The patient is on cardiac monitor, vital signs stable/unstable. What is the
most appropriate nursing identification and intervention per Relias and AHA guidelines?
A. Ventricular fibrillation - initiate CPR and defibrillation per ACLS
B. Ignore lethal rhythm
C. Defibrillate a stable sinus rhythm
D. Sinus tachycardia with incorrect rate
Answer: A
Rationale: Correct because it accurately identifies the dysrhythmia based on rate, regularity, P wave
morphology, PR interval, and QRS width per Relias and AHA ECG criteria. Understanding atrial vs ventricular
origin and conduction blocks is essential. Incorrect options misinterpret key measurements or confuse similar
rhythms. Mastery of 5-step ECG interpretation ensures accurate identification and timely intervention, which is
high-yield for Relias Dysrhythmia Basic Test success. Focus: rate regularity.
6. Which intervention is priority for a patient with sinus bradycardia at 38 bpm who is
symptomatic with The patient is on cardiac monitor, vital signs stable/unstable. What is the
most appropriate nursing identification and intervention per Relias and AHA guidelines?
A. Ignore lethal rhythm
B. Administer atropine for ventricular fibrillation
C. Atrial fibrillation with RVR - assess, notify provider, consider rate control
D. Confuse SVT with atrial flutter
Answer: C
Rationale: Correct because it accurately identifies the dysrhythmia based on rate, regularity, P wave
morphology, PR interval, and QRS width per Relias and AHA ECG criteria. Understanding atrial vs ventricular
origin and conduction blocks is essential. Incorrect options misinterpret key measurements or confuse similar
rhythms. Mastery of 5-step ECG interpretation ensures accurate identification and timely intervention, which is
high-yield for Relias Dysrhythmia Basic Test success. Focus: QRS width.
7. Which intervention is priority for a patient with sinus bradycardia at 38 bpm who is
symptomatic with The patient is on cardiac monitor, vital signs stable/unstable. What is the
most appropriate nursing identification and intervention per Relias and AHA guidelines?
A. Fail to activate emergency response
B. Atrial fibrillation with RVR - assess, notify provider, consider rate control
C. Give adenosine for complete heart block
