Page 1 of 43
RELIAS DYSRHYTHMIAS ADVANCED & BASIC A
AND B NEWEST 2025 ACTUAL EXAM| COMPLETE
REAL EXAM QUESTIONS AND CORRECT DETAILED
ANSWERS (VERIFIED ANSWERS) ALREADY GRADED
A+ (MOST RECENT!!)
A group of nursing students are discussing atrial flutter. These students
recognize that which of the following are seen with atrial flutter? Select
all that apply:
A) Ventricular rate of 220-300 bpm.
B) Regular rhythm
C) Saw-tooth pattern
D) Measurable PR interval
E) Long QRS interval - Correct Answer(s) - B, C
The ATRIAL rate is 250-400 bpm. Ventricular is about 75-150. The
rhythm is regular, with the P wave appearing as little flutter or a "saw
tooth pattern". The PR interval is not measurable r/t this saw-tooth P
wave. The QRS is normal.
A nursing student is aware that which of the following is the treatment
for unstable atrial flutter?
A) Adenosine (Adenocard) 6 mg rapid IVP.
B) Cardioversion with adjacent Heparin therapy
C) Defibrillation STAT followed by CPR.
D) Altemose 3 mg IVP over 1-2 seconds. - Correct Answer - B.
pg. 1
,Page 2 of 43
Cardioversion is used if the patient is unstable. Anticoagulants are used
if the arrhythmia has stuck around for 48 hr +. Adenosine may be used
with a narrow QRS and regular RR interval
A nurse on a CVT unit views the monitor and sees the patient in room
452 has just begun having occasional PVCs. Which action should the
nurse take first?
A) Check on the patient
B) Check last magnesium and potassium levels
C) Document the occurrence and watch for further PVCs
D) Contact the physician - Correct Answer - A
Although electrolytes are likely the culprit, the nurse first needs to first
assess the patient. Then, the nurse should look in the patient's chart and
evaluate or request an order for electrolyte levels. This may eventually
need to be documented, but the nurse can be held liable for neglect if
he/she does not assess the patient first. The physician may or may not
need to be contacted.
Which of the following does the nursing student realize is the treatment
for a stable patient presenting with QRS intervals above 0.12 seconds
with a regular rhythm and a rate of 100-250 bpm?
A) Atropine
B) Defibrillation
C) Amiodarone
D) Adenosine - Correct Answer - C
pg. 2
,Page 3 of 43
This is describing ventricular tachycardia (QRS is a giveaway), and the
treatment for a stable patient is Amiodarone or cardioversion. If the
patient were unstable, we'd go ahead and defibrillate.
The nurse in the intensive care unit (ICU) hears an alarm sound in the
patient's room. Arriving in the room, the patient is unresponsive, without
a pulse, and a flat line on the monitor. What is the first action by the
nurse?
A) Administer atropine 0.5 mg
B) Administer epinephrine
C) Defibrillate with 360 joules
D) Begin cardiopulmonary resuscitation (CPR) - Correct Answer – D.
We cannot defibrillate asystole
The nurse is caring for a client with acute coronary syndrome (ACS) and
atrial fibrillation who has a new prescription for metoprolol (Lopressor).
Which monitoring is essential when administering the medication?
A) ST segment
B) Heart rate
C) Troponin
D) Myoglobin - Correct Answer – B.
The effects of metoprolol are to decrease heart rate, blood pressure, and
myocardial oxygen demand. ST segment elevation is consistent with MI;
it does not address monitoring of metoprolol. Elevation in troponin is
consistent with a diagnosis of MI but does not address needed
monitoring for metoprolol. Elevation in myoglobin is consistent with
pg. 3
, Page 4 of 43
myocardial injury in ACS but does not address needed monitoring
related to metoprolol.
The nurse is caring for a client with atrial fibrillation. In addition to an
antidysrhythmic, what medication does the nurse plan to administer?
A) Heparin
B) Atropine
C) Dobutamine
D) Magnesium sulfate - Correct Answer – A.
Clients with atrial fibrillation are prone to blood pooling in the atrium,
clotting, then embolizing. Heparin is used to prevent thrombus
development in the atrium and the consequence of embolization (i.e.,
stroke).
The nurse is caring for a client on a telemetry unit with a regular heart
rhythm and rate of 60; a P wave precedes each QRS complex, and the
PR interval is 0.24 second. Additional vital signs are as follows: blood
pressure 118/68, respiratory rate 16, and temperature 98.8° F. The
following medications are available on the medication record. What
action should the nurse take?
A) Administer atropine.
B) Administer digoxin.
C) Administer clonidine.
D) Continue to monitor. - Correct Answer – D.
The client is displaying sinus rhythm with first-degree atrioventicular
heart block; this is usually asymptomatic and does not require treatment.
Atropine is used in emergency treatment of symptomatic bradycardia.
pg. 4
RELIAS DYSRHYTHMIAS ADVANCED & BASIC A
AND B NEWEST 2025 ACTUAL EXAM| COMPLETE
REAL EXAM QUESTIONS AND CORRECT DETAILED
ANSWERS (VERIFIED ANSWERS) ALREADY GRADED
A+ (MOST RECENT!!)
A group of nursing students are discussing atrial flutter. These students
recognize that which of the following are seen with atrial flutter? Select
all that apply:
A) Ventricular rate of 220-300 bpm.
B) Regular rhythm
C) Saw-tooth pattern
D) Measurable PR interval
E) Long QRS interval - Correct Answer(s) - B, C
The ATRIAL rate is 250-400 bpm. Ventricular is about 75-150. The
rhythm is regular, with the P wave appearing as little flutter or a "saw
tooth pattern". The PR interval is not measurable r/t this saw-tooth P
wave. The QRS is normal.
A nursing student is aware that which of the following is the treatment
for unstable atrial flutter?
A) Adenosine (Adenocard) 6 mg rapid IVP.
B) Cardioversion with adjacent Heparin therapy
C) Defibrillation STAT followed by CPR.
D) Altemose 3 mg IVP over 1-2 seconds. - Correct Answer - B.
pg. 1
,Page 2 of 43
Cardioversion is used if the patient is unstable. Anticoagulants are used
if the arrhythmia has stuck around for 48 hr +. Adenosine may be used
with a narrow QRS and regular RR interval
A nurse on a CVT unit views the monitor and sees the patient in room
452 has just begun having occasional PVCs. Which action should the
nurse take first?
A) Check on the patient
B) Check last magnesium and potassium levels
C) Document the occurrence and watch for further PVCs
D) Contact the physician - Correct Answer - A
Although electrolytes are likely the culprit, the nurse first needs to first
assess the patient. Then, the nurse should look in the patient's chart and
evaluate or request an order for electrolyte levels. This may eventually
need to be documented, but the nurse can be held liable for neglect if
he/she does not assess the patient first. The physician may or may not
need to be contacted.
Which of the following does the nursing student realize is the treatment
for a stable patient presenting with QRS intervals above 0.12 seconds
with a regular rhythm and a rate of 100-250 bpm?
A) Atropine
B) Defibrillation
C) Amiodarone
D) Adenosine - Correct Answer - C
pg. 2
,Page 3 of 43
This is describing ventricular tachycardia (QRS is a giveaway), and the
treatment for a stable patient is Amiodarone or cardioversion. If the
patient were unstable, we'd go ahead and defibrillate.
The nurse in the intensive care unit (ICU) hears an alarm sound in the
patient's room. Arriving in the room, the patient is unresponsive, without
a pulse, and a flat line on the monitor. What is the first action by the
nurse?
A) Administer atropine 0.5 mg
B) Administer epinephrine
C) Defibrillate with 360 joules
D) Begin cardiopulmonary resuscitation (CPR) - Correct Answer – D.
We cannot defibrillate asystole
The nurse is caring for a client with acute coronary syndrome (ACS) and
atrial fibrillation who has a new prescription for metoprolol (Lopressor).
Which monitoring is essential when administering the medication?
A) ST segment
B) Heart rate
C) Troponin
D) Myoglobin - Correct Answer – B.
The effects of metoprolol are to decrease heart rate, blood pressure, and
myocardial oxygen demand. ST segment elevation is consistent with MI;
it does not address monitoring of metoprolol. Elevation in troponin is
consistent with a diagnosis of MI but does not address needed
monitoring for metoprolol. Elevation in myoglobin is consistent with
pg. 3
, Page 4 of 43
myocardial injury in ACS but does not address needed monitoring
related to metoprolol.
The nurse is caring for a client with atrial fibrillation. In addition to an
antidysrhythmic, what medication does the nurse plan to administer?
A) Heparin
B) Atropine
C) Dobutamine
D) Magnesium sulfate - Correct Answer – A.
Clients with atrial fibrillation are prone to blood pooling in the atrium,
clotting, then embolizing. Heparin is used to prevent thrombus
development in the atrium and the consequence of embolization (i.e.,
stroke).
The nurse is caring for a client on a telemetry unit with a regular heart
rhythm and rate of 60; a P wave precedes each QRS complex, and the
PR interval is 0.24 second. Additional vital signs are as follows: blood
pressure 118/68, respiratory rate 16, and temperature 98.8° F. The
following medications are available on the medication record. What
action should the nurse take?
A) Administer atropine.
B) Administer digoxin.
C) Administer clonidine.
D) Continue to monitor. - Correct Answer – D.
The client is displaying sinus rhythm with first-degree atrioventicular
heart block; this is usually asymptomatic and does not require treatment.
Atropine is used in emergency treatment of symptomatic bradycardia.
pg. 4
