BSMH Advanced Arrhythmia Course Exam And Practice Exam Newest 2026/2027 Test
Bank| Bon Secours Mercy Health Advanced Arrhythmia Nursing Course Exam Prep With
Complete 300 Real Exam Questions And Correct Verified Answers/ Already Graded A+
(Most Recent!!)
300 QUESTIONS - BSMH ADVANCED ARRHYTHMIA - UNIQUE - ZERO REPEATS - REAL EXAM
FORMAT - LARGE FONT - VERIFIED ANSWERS + RATIONALES
DOMAIN 1: BASIC ELECTROPHYSIOLOGY AND EKG FUNDAMENTALS
Question 1
What does the P wave represent on ECG?
A. Contraindicated management for this rhythm
B. Atrial depolarization
C. Incorrect option: Atrial depolarization is wrong mechanism
D. Wrong answer: different arrhythmia interpretation
Answer: B
Rationale: P wave represents atrial depolarization. QRS is ventricular depolarization. T wave is ventricular
repolarization. PR interval is AV conduction time. Atrial repolarization is hidden in QRS.
DOMAIN 1: BASIC ELECTROPHYSIOLOGY AND EKG FUNDAMENTALS
Question 2
Normal PR interval duration?
A. Contraindicated management for this rhythm
B. Incorrect option: 0.12-0.20 seconds (3-5 small s is wrong mechanism
C. 0.12-0.20 seconds (3-5 small squares)
D. Wrong answer: different arrhythmia interpretation
Answer: C
Rationale: PR interval measures AV node conduction. Prolonged >0.20s indicates first-degree AV block. Short
PR <0.12s suggests accessory pathway like WPW.
DOMAIN 1: BASIC ELECTROPHYSIOLOGY AND EKG FUNDAMENTALS
Question 3
Normal QRS duration?
A. Incorrect option: <0.12 seconds (<120ms) or <3 s is wrong mechanism
B. Contraindicated management for this rhythm
C. Wrong answer: different arrhythmia interpretation
, D. <0.12 seconds (<120ms) or <3 small squares
Answer: D
Rationale: Narrow QRS indicates supraventricular origin. Wide QRS >=0.12s indicates ventricular origin or
aberrant conduction like BBB, WPW, hyperkalemia.
DOMAIN 1: BASIC ELECTROPHYSIOLOGY AND EKG FUNDAMENTALS
Question 4
What is the absolute refractory period?
A. Period during cardiac cycle when myocyte cannot be depolarized regardless of stimulus strength
B. Wrong answer: different arrhythmia interpretation
C. Incorrect option: Period during cardiac cycle wh is wrong mechanism
D. Contraindicated management for this rhythm
Answer: A
Rationale: Cardiac cells have effective refractory (no stimulus works) and relative refractory (strong stimulus
can). Prevents tetany. Important for understanding why early PVCs can cause R-on-T and Vfib.
DOMAIN 2: SINUS AND ATRIAL RHYTHMS
Question 5
Sinus tachycardia is characterized by?
A. Sinus rhythm with P wave before each QRS, rate 100-150 bpm, regular
B. Contraindicated management for this rhythm
C. Incorrect option: Sinus rhythm with P wave befor is wrong mechanism
D. Wrong answer: different arrhythmia interpretation
Answer: A
Rationale: Sinus tach is physiologic response to fever, pain, hypovolemia, anxiety, HF. Treat underlying cause,
not just rate. Distinguish from SVT which is usually >150 and sudden onset.
DOMAIN 2: SINUS AND ATRIAL RHYTHMS
Question 6
Premature atrial contraction (PAC) ECG finding?
A. Incorrect option: Early P wave with different mo is wrong mechanism
B. Contraindicated management for this rhythm
C. Wrong answer: different arrhythmia interpretation
, D. Early P wave with different morphology, often non-conducted or with narrow QRS, compensatory
pause incomplete
Answer: D
Rationale: PAC originates in atria, P wave morphology different from sinus. Non-conducted PAC can cause
pause. Frequent PACs can trigger atrial fibrillation. Usually benign.
DOMAIN 2: SINUS AND ATRIAL RHYTHMS
Question 7
Atrial flutter sawtooth pattern best seen in?
A. Leads II, III, aVF with atrial rate 250-350 bpm, typically 300 bpm
B. Contraindicated management for this rhythm
C. Wrong answer: different arrhythmia interpretation
D. Incorrect option: Leads II, III, aVF with atrial is wrong mechanism
Answer: A
Rationale: Atrial flutter macro-reentrant circuit in right atrium. Sawtooth flutter waves. 2:1 conduction gives
ventricular rate 150 bpm. Consider flutter with regular narrow QRS at 150 bpm.
DOMAIN 2: SINUS AND ATRIAL RHYTHMS
Question 8
Atrial fibrillation ECG criteria?
A. Contraindicated management for this rhythm
B. Irregularly irregular rhythm with no distinct P waves, irregular QRS, atrial rate 350-600 bpm
C. Wrong answer: different arrhythmia interpretation
D. Incorrect option: Irregularly irregular rhythm w is wrong mechanism
Answer: B
Rationale: AFib chaotic atrial activity. Irregularly irregular ventricular response. Risk of stroke due to clot in left
atrial appendage. Requires anticoagulation based on CHA2DS2-VASc.
DOMAIN 2: SINUS AND ATRIAL RHYTHMS
Question 9
Multifocal atrial tachycardia (MAT) criteria?
A. Incorrect option: Irregular rhythm with at least is wrong mechanism
B. Irregular rhythm with at least 3 different P wave morphologies, rate >100, variable PR and PP
C. Contraindicated management for this rhythm
, D. Wrong answer: different arrhythmia interpretation
Answer: B
Rationale: MAT seen in COPD, hypoxia, theophylline toxicity. Treat underlying lung disease, correct hypoxia,
magnesium. Not responsive to cardioversion. Verapamil may help but treat cause.
DOMAIN 3: JUNCTIONAL AND SUPRAVENTRICULAR ARRHYTHMIAS
Question 10
Junctional rhythm ECG?
A. Narrow QRS, rate 40-60 bpm, absent or inverted P waves, retrograde P may occur before, during,
or after QRS
B. Incorrect option: Narrow QRS, rate 40-60 bpm, ab is wrong mechanism
C. Wrong answer: different arrhythmia interpretation
D. Contraindicated management for this rhythm
Answer: A
Rationale: Junctional escape when SA node fails. Junctional tachycardia rate 60-100+ from AV node
automaticity, seen in digoxin toxicity. Accelerated junctional 60-100.
DOMAIN 3: JUNCTIONAL AND SUPRAVENTRICULAR ARRHYTHMIAS
Question 11
Paroxysmal supraventricular tachycardia (PSVT) treatment first-line stable?
A. Contraindicated management for this rhythm
B. Vagal maneuvers then adenosine 6mg rapid IV push followed by 12mg if needed
C. Wrong answer: different arrhythmia interpretation
D. Incorrect option: Vagal maneuvers then adenosine is wrong mechanism
Answer: B
Rationale: PSVT reentrant circuit involving AV node. Adenosine blocks AV node temporarily. Must give rapid IV
push with flush and elevate arm. Warn patient chest pressure, flushing. Contraindicated in asthma can cause
bronchospasm.
DOMAIN 3: JUNCTIONAL AND SUPRAVENTRICULAR ARRHYTHMIAS
Question 12
WPW pattern ECG?
A. Contraindicated management for this rhythm
B. Wrong answer: different arrhythmia interpretation
Bank| Bon Secours Mercy Health Advanced Arrhythmia Nursing Course Exam Prep With
Complete 300 Real Exam Questions And Correct Verified Answers/ Already Graded A+
(Most Recent!!)
300 QUESTIONS - BSMH ADVANCED ARRHYTHMIA - UNIQUE - ZERO REPEATS - REAL EXAM
FORMAT - LARGE FONT - VERIFIED ANSWERS + RATIONALES
DOMAIN 1: BASIC ELECTROPHYSIOLOGY AND EKG FUNDAMENTALS
Question 1
What does the P wave represent on ECG?
A. Contraindicated management for this rhythm
B. Atrial depolarization
C. Incorrect option: Atrial depolarization is wrong mechanism
D. Wrong answer: different arrhythmia interpretation
Answer: B
Rationale: P wave represents atrial depolarization. QRS is ventricular depolarization. T wave is ventricular
repolarization. PR interval is AV conduction time. Atrial repolarization is hidden in QRS.
DOMAIN 1: BASIC ELECTROPHYSIOLOGY AND EKG FUNDAMENTALS
Question 2
Normal PR interval duration?
A. Contraindicated management for this rhythm
B. Incorrect option: 0.12-0.20 seconds (3-5 small s is wrong mechanism
C. 0.12-0.20 seconds (3-5 small squares)
D. Wrong answer: different arrhythmia interpretation
Answer: C
Rationale: PR interval measures AV node conduction. Prolonged >0.20s indicates first-degree AV block. Short
PR <0.12s suggests accessory pathway like WPW.
DOMAIN 1: BASIC ELECTROPHYSIOLOGY AND EKG FUNDAMENTALS
Question 3
Normal QRS duration?
A. Incorrect option: <0.12 seconds (<120ms) or <3 s is wrong mechanism
B. Contraindicated management for this rhythm
C. Wrong answer: different arrhythmia interpretation
, D. <0.12 seconds (<120ms) or <3 small squares
Answer: D
Rationale: Narrow QRS indicates supraventricular origin. Wide QRS >=0.12s indicates ventricular origin or
aberrant conduction like BBB, WPW, hyperkalemia.
DOMAIN 1: BASIC ELECTROPHYSIOLOGY AND EKG FUNDAMENTALS
Question 4
What is the absolute refractory period?
A. Period during cardiac cycle when myocyte cannot be depolarized regardless of stimulus strength
B. Wrong answer: different arrhythmia interpretation
C. Incorrect option: Period during cardiac cycle wh is wrong mechanism
D. Contraindicated management for this rhythm
Answer: A
Rationale: Cardiac cells have effective refractory (no stimulus works) and relative refractory (strong stimulus
can). Prevents tetany. Important for understanding why early PVCs can cause R-on-T and Vfib.
DOMAIN 2: SINUS AND ATRIAL RHYTHMS
Question 5
Sinus tachycardia is characterized by?
A. Sinus rhythm with P wave before each QRS, rate 100-150 bpm, regular
B. Contraindicated management for this rhythm
C. Incorrect option: Sinus rhythm with P wave befor is wrong mechanism
D. Wrong answer: different arrhythmia interpretation
Answer: A
Rationale: Sinus tach is physiologic response to fever, pain, hypovolemia, anxiety, HF. Treat underlying cause,
not just rate. Distinguish from SVT which is usually >150 and sudden onset.
DOMAIN 2: SINUS AND ATRIAL RHYTHMS
Question 6
Premature atrial contraction (PAC) ECG finding?
A. Incorrect option: Early P wave with different mo is wrong mechanism
B. Contraindicated management for this rhythm
C. Wrong answer: different arrhythmia interpretation
, D. Early P wave with different morphology, often non-conducted or with narrow QRS, compensatory
pause incomplete
Answer: D
Rationale: PAC originates in atria, P wave morphology different from sinus. Non-conducted PAC can cause
pause. Frequent PACs can trigger atrial fibrillation. Usually benign.
DOMAIN 2: SINUS AND ATRIAL RHYTHMS
Question 7
Atrial flutter sawtooth pattern best seen in?
A. Leads II, III, aVF with atrial rate 250-350 bpm, typically 300 bpm
B. Contraindicated management for this rhythm
C. Wrong answer: different arrhythmia interpretation
D. Incorrect option: Leads II, III, aVF with atrial is wrong mechanism
Answer: A
Rationale: Atrial flutter macro-reentrant circuit in right atrium. Sawtooth flutter waves. 2:1 conduction gives
ventricular rate 150 bpm. Consider flutter with regular narrow QRS at 150 bpm.
DOMAIN 2: SINUS AND ATRIAL RHYTHMS
Question 8
Atrial fibrillation ECG criteria?
A. Contraindicated management for this rhythm
B. Irregularly irregular rhythm with no distinct P waves, irregular QRS, atrial rate 350-600 bpm
C. Wrong answer: different arrhythmia interpretation
D. Incorrect option: Irregularly irregular rhythm w is wrong mechanism
Answer: B
Rationale: AFib chaotic atrial activity. Irregularly irregular ventricular response. Risk of stroke due to clot in left
atrial appendage. Requires anticoagulation based on CHA2DS2-VASc.
DOMAIN 2: SINUS AND ATRIAL RHYTHMS
Question 9
Multifocal atrial tachycardia (MAT) criteria?
A. Incorrect option: Irregular rhythm with at least is wrong mechanism
B. Irregular rhythm with at least 3 different P wave morphologies, rate >100, variable PR and PP
C. Contraindicated management for this rhythm
, D. Wrong answer: different arrhythmia interpretation
Answer: B
Rationale: MAT seen in COPD, hypoxia, theophylline toxicity. Treat underlying lung disease, correct hypoxia,
magnesium. Not responsive to cardioversion. Verapamil may help but treat cause.
DOMAIN 3: JUNCTIONAL AND SUPRAVENTRICULAR ARRHYTHMIAS
Question 10
Junctional rhythm ECG?
A. Narrow QRS, rate 40-60 bpm, absent or inverted P waves, retrograde P may occur before, during,
or after QRS
B. Incorrect option: Narrow QRS, rate 40-60 bpm, ab is wrong mechanism
C. Wrong answer: different arrhythmia interpretation
D. Contraindicated management for this rhythm
Answer: A
Rationale: Junctional escape when SA node fails. Junctional tachycardia rate 60-100+ from AV node
automaticity, seen in digoxin toxicity. Accelerated junctional 60-100.
DOMAIN 3: JUNCTIONAL AND SUPRAVENTRICULAR ARRHYTHMIAS
Question 11
Paroxysmal supraventricular tachycardia (PSVT) treatment first-line stable?
A. Contraindicated management for this rhythm
B. Vagal maneuvers then adenosine 6mg rapid IV push followed by 12mg if needed
C. Wrong answer: different arrhythmia interpretation
D. Incorrect option: Vagal maneuvers then adenosine is wrong mechanism
Answer: B
Rationale: PSVT reentrant circuit involving AV node. Adenosine blocks AV node temporarily. Must give rapid IV
push with flush and elevate arm. Warn patient chest pressure, flushing. Contraindicated in asthma can cause
bronchospasm.
DOMAIN 3: JUNCTIONAL AND SUPRAVENTRICULAR ARRHYTHMIAS
Question 12
WPW pattern ECG?
A. Contraindicated management for this rhythm
B. Wrong answer: different arrhythmia interpretation
