PROPHECY EKG FINAL PAPER 2025/2026 ANSWERS AND
QUESTIONS GRADED A+
✔✔Atrially Paced - ✔✔Spike comes before P
✔✔Ventricularly Paced - ✔✔Spike comes before QRS and QRS will be wide
✔✔AV Paced - ✔✔Spike before P and before QR
✔✔Failure to Capture - ✔✔Spikes with no QRS
✔✔Failure to Sense - ✔✔Spikes happen regardless of QRS on their own
✔✔How to determine the rhythm - ✔✔Regular or irregular?
Rate?
P before every QRS? QRS for every P?
QRS wide or narrow?
✔✔QT Interval - ✔✔0.34-0.43
✔✔P Wave - ✔✔0.06-0.12 sec
✔✔PR Interval - ✔✔0.12-0.20 sec
✔✔SA Node Firing Rhythms - ✔✔*Fires normally @ 60-100*
-SR 60-100
-SB <60
-ST 100-150
-SVT 150-350
✔✔AV Node Firing, SA Node Failed Rhythms - ✔✔*Fires normally @ 40-60*
-Junctional rhythm 40-60
-Accelerated junctional rhythm 60-100
-Junctional tachycardia 100-150
✔✔Only Purkinje Fibers Firing Rhythms (Everything else has failed) - ✔✔*Fires
normally @ 20-50*
-Idioventricular 20-50
-Accelerated idioventricular 50-100
✔✔ Normal sinus rhythm - ✔✔Regular
Rate: 60-100
P Wave: Present, upright
PR Interval: 0.12-0.20 sec
, QRS: <0.12 sec
✔✔Sinus Bradycardia - ✔✔Regular
Rate: <60
P Wave: Present, upright
PR Interval: 0.12-0.20 sec
QRS: <0.12 sec
✔✔Sinus Tachycardia - ✔✔Regular
Rate: 100-150
P Wave: Present, upright
PR Interval: 0.12-0.20 sec
QRS: <0.12 sec
✔✔Premature Atrial Contraction - ✔✔IRREGULAR
Rate: depends on underlying rhythm
P wave: Present or hidden in T wave
PR Interval: 0.12-0.20 sec
QRS: <0.12 sec
✔✔Atrial Fibrillation - ✔✔IRREGULAR
Atrial rate: UNMEASURABLE
Ventricular rate: variable
P wave: unable to see
PR Interval: N/A
QRS: <0.12 sec
✔✔A fib RVR - ✔✔IRREGULAR
Ventricular rate: 100-175
P wave: unable to see
PR Interval: N/A
QRS <0.12 sec
✔✔Atrial Flutter - ✔✔Usually REGULAR can be irregular
Atrial rate: 250-350
Ventricular rate: variable BUT < atrial rate
P Wave: Flutter
PR Interval: N/A
QRS: <0.12 sec
✔✔Supraventricular Tachycardia - ✔✔Regular
Rate: 150-350
P wave: Hidden in QRS or T wave
PR: unable to determine
QRS: <0.12 sec
QUESTIONS GRADED A+
✔✔Atrially Paced - ✔✔Spike comes before P
✔✔Ventricularly Paced - ✔✔Spike comes before QRS and QRS will be wide
✔✔AV Paced - ✔✔Spike before P and before QR
✔✔Failure to Capture - ✔✔Spikes with no QRS
✔✔Failure to Sense - ✔✔Spikes happen regardless of QRS on their own
✔✔How to determine the rhythm - ✔✔Regular or irregular?
Rate?
P before every QRS? QRS for every P?
QRS wide or narrow?
✔✔QT Interval - ✔✔0.34-0.43
✔✔P Wave - ✔✔0.06-0.12 sec
✔✔PR Interval - ✔✔0.12-0.20 sec
✔✔SA Node Firing Rhythms - ✔✔*Fires normally @ 60-100*
-SR 60-100
-SB <60
-ST 100-150
-SVT 150-350
✔✔AV Node Firing, SA Node Failed Rhythms - ✔✔*Fires normally @ 40-60*
-Junctional rhythm 40-60
-Accelerated junctional rhythm 60-100
-Junctional tachycardia 100-150
✔✔Only Purkinje Fibers Firing Rhythms (Everything else has failed) - ✔✔*Fires
normally @ 20-50*
-Idioventricular 20-50
-Accelerated idioventricular 50-100
✔✔ Normal sinus rhythm - ✔✔Regular
Rate: 60-100
P Wave: Present, upright
PR Interval: 0.12-0.20 sec
, QRS: <0.12 sec
✔✔Sinus Bradycardia - ✔✔Regular
Rate: <60
P Wave: Present, upright
PR Interval: 0.12-0.20 sec
QRS: <0.12 sec
✔✔Sinus Tachycardia - ✔✔Regular
Rate: 100-150
P Wave: Present, upright
PR Interval: 0.12-0.20 sec
QRS: <0.12 sec
✔✔Premature Atrial Contraction - ✔✔IRREGULAR
Rate: depends on underlying rhythm
P wave: Present or hidden in T wave
PR Interval: 0.12-0.20 sec
QRS: <0.12 sec
✔✔Atrial Fibrillation - ✔✔IRREGULAR
Atrial rate: UNMEASURABLE
Ventricular rate: variable
P wave: unable to see
PR Interval: N/A
QRS: <0.12 sec
✔✔A fib RVR - ✔✔IRREGULAR
Ventricular rate: 100-175
P wave: unable to see
PR Interval: N/A
QRS <0.12 sec
✔✔Atrial Flutter - ✔✔Usually REGULAR can be irregular
Atrial rate: 250-350
Ventricular rate: variable BUT < atrial rate
P Wave: Flutter
PR Interval: N/A
QRS: <0.12 sec
✔✔Supraventricular Tachycardia - ✔✔Regular
Rate: 150-350
P wave: Hidden in QRS or T wave
PR: unable to determine
QRS: <0.12 sec
