BSMH ADVANCED ARRHYTHMIA
COURSE EXAM 2026/2027 | BON
SECOURS MERCY HEALTH NURSING
EDUCATION | 300 REAL EXAM
QUESTIONS WITH CORRECT VERIFIED
ANSWERS & DETAILED RATIONALES |
ALREADY GRADED A+ | INSTANT
DOWNLOAD PDF
1. What does one small box on standard ECG paper represent?
A. 0.02 sec
B. 0.04 sec
C. 0.10 sec
D. 0.20 sec
Answer: B. 0.04 seconds. Rationale: At standard 25 mm/sec, each small box equals 0.04
seconds.
2. What does one large box on ECG paper represent?
A. 0.04 sec
B. 0.10 sec
C. 0.20 sec
D. 0.40 sec
Answer: C. 0.20 seconds. Rationale: One large box contains 5 small boxes, so 5 × 0.04
= 0.20 seconds.
3. Which waveform represents atrial depolarization?
A. P wave
B. PR segment
C. QRS complex
D. T wave
Answer: A. P wave. Rationale: The P wave reflects atrial depolarization.
4. What does the QRS complex represent?
A. Atrial repolarization
B. Ventricular depolarization
,C. Ventricular repolarization
D. AV nodal delay
Answer: B. Ventricular depolarization. Rationale: The QRS represents ventricular
depolarization; atrial repolarization is hidden within it.
5. What does the T wave represent?
A. Atrial depolarization
B. Ventricular depolarization
C. Ventricular repolarization
D. Bundle branch conduction
Answer: C. Ventricular repolarization. Rationale: The T wave reflects ventricular
repolarization.
6. What is the normal PR interval?
A. 0.04–0.10 sec
B. 0.12–0.20 sec
C. 0.20–0.36 sec
D. 0.36–0.44 sec
Answer: B. 0.12–0.20 seconds. Rationale: The PR interval measures conduction from the
SA node through the AV node to the ventricles.
7. What is the normal QRS duration?
A. Less than 0.12 sec
B. 0.12–0.20 sec
C. 0.20–0.36 sec
D. Greater than 0.20 sec
Answer: A. Less than 0.12 seconds. Rationale: A QRS wider than 0.12 seconds suggests
bundle branch block or ventricular origin.
8. Which structure is the primary pacemaker of the heart?
A. AV node
B. SA node
C. Bundle of His
D. Purkinje fibers
Answer: B. SA node. Rationale: The SA node fires at 60–100 bpm, the fastest intrinsic
rate, so it normally dominates.
9. What is the intrinsic rate of the AV junction?
A. 20–40 bpm
B. 40–60 bpm
C. 60–100 bpm
D. 100–150 bpm
Answer: B. 40–60 bpm. Rationale: The AV junction acts as a secondary pacemaker.
,10. What is the intrinsic rate of Purkinje fibers?
A. 20–40 bpm
B. 40–60 bpm
C. 60–100 bpm
D. 100–120 bpm
Answer: A. 20–40 bpm. Rationale: Purkinje fibers are a last-resort pacemaker.
11. Which findings describe normal sinus rhythm?
A. P wave before every QRS, rate 60–100 bpm
B. No P waves, irregularly irregular
C. Sawtooth waves
D. Wide QRS, rate 150 bpm
Answer: A. P wave before every QRS, rate 60–100 bpm. Rationale: This is the definition
of normal sinus rhythm.
12. Which rhythm has a normal P-QRS relationship but a rate below 60 bpm?
A. Sinus bradycardia
B. Sinus tachycardia
C. Atrial fibrillation
D. Ventricular tachycardia
Answer: A. Sinus bradycardia. Rationale: Sinus bradycardia is sinus rhythm with a rate
under 60 bpm.
13. Which rhythm has a normal P-QRS relationship but a rate above 100 bpm?
A. Sinus bradycardia
B. Sinus tachycardia
C. Junctional rhythm
D. Idioventricular rhythm
Answer: B. Sinus tachycardia. Rationale: Sinus tachycardia is sinus rhythm with a rate
over 100 bpm.
14. What is sinus arrhythmia?
A. Irregularly irregular rhythm with no P waves
B. Phasic variation in heart rate with breathing
C. Sawtooth atrial activity
D. Absent P waves
Answer: B. Phasic variation in heart rate with breathing. Rationale: Respiratory sinus
arrhythmia is a normal variation.
15. What is the hallmark of atrial fibrillation?
A. Sawtooth waves
B. Irregularly irregular ventricular response with no P waves
C. Regular narrow-complex tachycardia
D. Wide QRS complexes
, Answer: B. Irregularly irregular ventricular response with no P waves. Rationale: AF has
chaotic atrial activity and an irregularly irregular ventricular response.
16. What is the hallmark of atrial flutter?
A. Sawtooth flutter waves
B. No P waves
C. Delta wave
D. Epsilon wave
Answer: A. Sawtooth flutter waves. Rationale: Atrial flutter typically has an atrial rate of
250–350 bpm with sawtooth F waves.
17. Which rhythm is typically regular, narrow-complex, and faster than 150
bpm with hidden P waves?
A. Supraventricular tachycardia
B. Ventricular tachycardia
C. Atrial fibrillation
D. Sinus bradycardia
Answer: A. Supraventricular tachycardia. Rationale: SVT is a regular narrow-complex
tachycardia, often with hidden P waves.
18. What is required to diagnose multifocal atrial tachycardia?
A. At least three different P-wave morphologies with irregular rhythm
B. Sawtooth waves
C. No P waves
D. Wide QRS complexes
Answer: A. At least three different P-wave morphologies with irregular rhythm.
Rationale: MAT is diagnosed by multiple P-wave morphologies and irregularity.
19. What is the typical rate of a junctional escape rhythm?
A. 20–40 bpm
B. 40–60 bpm
C. 60–100 bpm
D. Greater than 100 bpm
Answer: B. 40–60 bpm. Rationale: The AV junction has an intrinsic rate of 40–60 bpm.
20. What is the rate of junctional tachycardia?
A. Less than 40 bpm
B. 40–60 bpm
C. 60–100 bpm
D. Greater than 100 bpm
Answer: D. Greater than 100 bpm. Rationale: Junctional tachycardia originates from
the AV junction at over 100 bpm.
21. Which finding is characteristic of a PVC?
A. Early wide QRS with no preceding P wave
COURSE EXAM 2026/2027 | BON
SECOURS MERCY HEALTH NURSING
EDUCATION | 300 REAL EXAM
QUESTIONS WITH CORRECT VERIFIED
ANSWERS & DETAILED RATIONALES |
ALREADY GRADED A+ | INSTANT
DOWNLOAD PDF
1. What does one small box on standard ECG paper represent?
A. 0.02 sec
B. 0.04 sec
C. 0.10 sec
D. 0.20 sec
Answer: B. 0.04 seconds. Rationale: At standard 25 mm/sec, each small box equals 0.04
seconds.
2. What does one large box on ECG paper represent?
A. 0.04 sec
B. 0.10 sec
C. 0.20 sec
D. 0.40 sec
Answer: C. 0.20 seconds. Rationale: One large box contains 5 small boxes, so 5 × 0.04
= 0.20 seconds.
3. Which waveform represents atrial depolarization?
A. P wave
B. PR segment
C. QRS complex
D. T wave
Answer: A. P wave. Rationale: The P wave reflects atrial depolarization.
4. What does the QRS complex represent?
A. Atrial repolarization
B. Ventricular depolarization
,C. Ventricular repolarization
D. AV nodal delay
Answer: B. Ventricular depolarization. Rationale: The QRS represents ventricular
depolarization; atrial repolarization is hidden within it.
5. What does the T wave represent?
A. Atrial depolarization
B. Ventricular depolarization
C. Ventricular repolarization
D. Bundle branch conduction
Answer: C. Ventricular repolarization. Rationale: The T wave reflects ventricular
repolarization.
6. What is the normal PR interval?
A. 0.04–0.10 sec
B. 0.12–0.20 sec
C. 0.20–0.36 sec
D. 0.36–0.44 sec
Answer: B. 0.12–0.20 seconds. Rationale: The PR interval measures conduction from the
SA node through the AV node to the ventricles.
7. What is the normal QRS duration?
A. Less than 0.12 sec
B. 0.12–0.20 sec
C. 0.20–0.36 sec
D. Greater than 0.20 sec
Answer: A. Less than 0.12 seconds. Rationale: A QRS wider than 0.12 seconds suggests
bundle branch block or ventricular origin.
8. Which structure is the primary pacemaker of the heart?
A. AV node
B. SA node
C. Bundle of His
D. Purkinje fibers
Answer: B. SA node. Rationale: The SA node fires at 60–100 bpm, the fastest intrinsic
rate, so it normally dominates.
9. What is the intrinsic rate of the AV junction?
A. 20–40 bpm
B. 40–60 bpm
C. 60–100 bpm
D. 100–150 bpm
Answer: B. 40–60 bpm. Rationale: The AV junction acts as a secondary pacemaker.
,10. What is the intrinsic rate of Purkinje fibers?
A. 20–40 bpm
B. 40–60 bpm
C. 60–100 bpm
D. 100–120 bpm
Answer: A. 20–40 bpm. Rationale: Purkinje fibers are a last-resort pacemaker.
11. Which findings describe normal sinus rhythm?
A. P wave before every QRS, rate 60–100 bpm
B. No P waves, irregularly irregular
C. Sawtooth waves
D. Wide QRS, rate 150 bpm
Answer: A. P wave before every QRS, rate 60–100 bpm. Rationale: This is the definition
of normal sinus rhythm.
12. Which rhythm has a normal P-QRS relationship but a rate below 60 bpm?
A. Sinus bradycardia
B. Sinus tachycardia
C. Atrial fibrillation
D. Ventricular tachycardia
Answer: A. Sinus bradycardia. Rationale: Sinus bradycardia is sinus rhythm with a rate
under 60 bpm.
13. Which rhythm has a normal P-QRS relationship but a rate above 100 bpm?
A. Sinus bradycardia
B. Sinus tachycardia
C. Junctional rhythm
D. Idioventricular rhythm
Answer: B. Sinus tachycardia. Rationale: Sinus tachycardia is sinus rhythm with a rate
over 100 bpm.
14. What is sinus arrhythmia?
A. Irregularly irregular rhythm with no P waves
B. Phasic variation in heart rate with breathing
C. Sawtooth atrial activity
D. Absent P waves
Answer: B. Phasic variation in heart rate with breathing. Rationale: Respiratory sinus
arrhythmia is a normal variation.
15. What is the hallmark of atrial fibrillation?
A. Sawtooth waves
B. Irregularly irregular ventricular response with no P waves
C. Regular narrow-complex tachycardia
D. Wide QRS complexes
, Answer: B. Irregularly irregular ventricular response with no P waves. Rationale: AF has
chaotic atrial activity and an irregularly irregular ventricular response.
16. What is the hallmark of atrial flutter?
A. Sawtooth flutter waves
B. No P waves
C. Delta wave
D. Epsilon wave
Answer: A. Sawtooth flutter waves. Rationale: Atrial flutter typically has an atrial rate of
250–350 bpm with sawtooth F waves.
17. Which rhythm is typically regular, narrow-complex, and faster than 150
bpm with hidden P waves?
A. Supraventricular tachycardia
B. Ventricular tachycardia
C. Atrial fibrillation
D. Sinus bradycardia
Answer: A. Supraventricular tachycardia. Rationale: SVT is a regular narrow-complex
tachycardia, often with hidden P waves.
18. What is required to diagnose multifocal atrial tachycardia?
A. At least three different P-wave morphologies with irregular rhythm
B. Sawtooth waves
C. No P waves
D. Wide QRS complexes
Answer: A. At least three different P-wave morphologies with irregular rhythm.
Rationale: MAT is diagnosed by multiple P-wave morphologies and irregularity.
19. What is the typical rate of a junctional escape rhythm?
A. 20–40 bpm
B. 40–60 bpm
C. 60–100 bpm
D. Greater than 100 bpm
Answer: B. 40–60 bpm. Rationale: The AV junction has an intrinsic rate of 40–60 bpm.
20. What is the rate of junctional tachycardia?
A. Less than 40 bpm
B. 40–60 bpm
C. 60–100 bpm
D. Greater than 100 bpm
Answer: D. Greater than 100 bpm. Rationale: Junctional tachycardia originates from
the AV junction at over 100 bpm.
21. Which finding is characteristic of a PVC?
A. Early wide QRS with no preceding P wave
