1 | Page
PROPHECY EKG INTERPRETATION EXAM 2026/2027 | 200 QUESTIONS
+ ANSWERS & RATIONALES | UPDATED & VERIFIED
Q1.
A patient’s EKG shows a regular rhythm with a ventricular rate of 80 bpm, upright
P waves before each QRS, and a PR interval of 0.16 seconds.
How should this rhythm be interpreted?
A. Normal sinus rhythm
B. Sinus tachycardia
C. First-degree AV block
D. Atrial flutter
Answer: A. Normal sinus rhythm
Rationale: Rate 60–100, regular, P before each QRS, and normal PR (0.12–0.20
sec) = normal sinus rhythm.
Q2.
The EKG reveals a heart rate of 150 bpm, regular rhythm, narrow QRS complexes,
and P waves hidden within T waves.
What rhythm is this most consistent with?
A. Supraventricular tachycardia (SVT)
B. Ventricular tachycardia
C. Atrial flutter
D. Sinus tachycardia
Answer: A. Supraventricular tachycardia (SVT)
Rationale: Rapid rate >150, narrow QRS, and obscured P waves are hallmark
findings of SVT.
Q3.
An EKG shows irregularly irregular rhythm with absence of distinct P waves and
variable ventricular response.
Which rhythm is most likely?
,2 | Page
A. Atrial fibrillation
B. Atrial flutter
C. Ventricular fibrillation
D. Sinus arrhythmia
Answer: A. Atrial fibrillation
Rationale: A-fib is characterized by chaotic atrial activity with no visible P
waves and an irregularly irregular rhythm.
Q4.
A patient’s EKG shows saw-tooth flutter waves at a rate of 300/min with a
ventricular rate of 75 bpm and a 4:1 conduction ratio.
What is this rhythm?
A. Atrial flutter with variable block
B. Sinus tachycardia
C. Atrial fibrillation
D. First-degree AV block
Answer: A. Atrial flutter with variable block
Rationale: Flutter waves (F waves) are saw-tooth shaped, with conduction ratio
determining ventricular response.
Q5.
The EKG reveals a regular rhythm with a PR interval prolonged to 0.24 seconds
but all P waves are conducted to QRS complexes.
Which rhythm is shown?
A. First-degree AV block
B. Second-degree AV block type I
C. Sinus rhythm with PACs
D. Sinus bradycardia
Answer: A. First-degree AV block
Rationale: PR >0.20 sec but all P waves conduct = first-degree AV block.
,3 | Page
Q6.
A rhythm strip shows progressive prolongation of the PR interval until one P wave
is not followed by a QRS complex.
What is the correct interpretation?
A. Second-degree AV block type I (Wenckebach)
B. Second-degree AV block type II
C. Third-degree AV block
D. Sinus pause
Answer: A. Second-degree AV block type I (Wenckebach)
Rationale: The “longer, longer, longer, drop” pattern is classic for Mobitz type I.
Q7.
The EKG shows constant PR intervals with intermittent non-conducted P waves
and dropped QRS complexes.
What rhythm does this represent?
A. Second-degree AV block type II (Mobitz II)
B. First-degree AV block
C. Sinus arrhythmia
D. Premature atrial contractions
Answer: A. Second-degree AV block type II (Mobitz II)
Rationale: Fixed PR with sudden dropped QRS is Mobitz II, more dangerous
than type I.
Q8.
The rhythm strip demonstrates complete dissociation between atrial and ventricular
activity. P waves and QRS complexes are present but unrelated.
What is the rhythm?
A. Third-degree AV block (complete heart block)
B. First-degree AV block
C. Atrial flutter
D. Junctional rhythm
Answer: A. Third-degree AV block (complete heart block)
Rationale: Complete AV dissociation = atria and ventricles beat independently.
, 4 | Page
Q9.
A rhythm shows wide QRS complexes at a rate of 160 bpm with no visible P
waves.
What is the most likely rhythm?
A. Ventricular tachycardia
B. Supraventricular tachycardia
C. Sinus tachycardia
D. Atrial fibrillation
Answer: A. Ventricular tachycardia
Rationale: Wide QRS >0.12 sec at high rate without P waves = VTach.
Q10.
The EKG shows a chaotic baseline with no identifiable P waves or QRS
complexes. The patient is unresponsive and pulseless.
What rhythm is this?
A. Ventricular fibrillation
B. Asystole
C. Torsades de pointes
D. Atrial fibrillation
Answer: A. Ventricular fibrillation
Rationale: VFib shows chaotic electrical activity with no organized complexes, a
lethal rhythm.
Q11.
The EKG strip shows polymorphic ventricular tachycardia with twisting of QRS
complexes around the baseline.
What rhythm does this represent?
A. Torsades de pointes
B. Ventricular fibrillation
C. Monomorphic VTach
D. Atrial flutter
PROPHECY EKG INTERPRETATION EXAM 2026/2027 | 200 QUESTIONS
+ ANSWERS & RATIONALES | UPDATED & VERIFIED
Q1.
A patient’s EKG shows a regular rhythm with a ventricular rate of 80 bpm, upright
P waves before each QRS, and a PR interval of 0.16 seconds.
How should this rhythm be interpreted?
A. Normal sinus rhythm
B. Sinus tachycardia
C. First-degree AV block
D. Atrial flutter
Answer: A. Normal sinus rhythm
Rationale: Rate 60–100, regular, P before each QRS, and normal PR (0.12–0.20
sec) = normal sinus rhythm.
Q2.
The EKG reveals a heart rate of 150 bpm, regular rhythm, narrow QRS complexes,
and P waves hidden within T waves.
What rhythm is this most consistent with?
A. Supraventricular tachycardia (SVT)
B. Ventricular tachycardia
C. Atrial flutter
D. Sinus tachycardia
Answer: A. Supraventricular tachycardia (SVT)
Rationale: Rapid rate >150, narrow QRS, and obscured P waves are hallmark
findings of SVT.
Q3.
An EKG shows irregularly irregular rhythm with absence of distinct P waves and
variable ventricular response.
Which rhythm is most likely?
,2 | Page
A. Atrial fibrillation
B. Atrial flutter
C. Ventricular fibrillation
D. Sinus arrhythmia
Answer: A. Atrial fibrillation
Rationale: A-fib is characterized by chaotic atrial activity with no visible P
waves and an irregularly irregular rhythm.
Q4.
A patient’s EKG shows saw-tooth flutter waves at a rate of 300/min with a
ventricular rate of 75 bpm and a 4:1 conduction ratio.
What is this rhythm?
A. Atrial flutter with variable block
B. Sinus tachycardia
C. Atrial fibrillation
D. First-degree AV block
Answer: A. Atrial flutter with variable block
Rationale: Flutter waves (F waves) are saw-tooth shaped, with conduction ratio
determining ventricular response.
Q5.
The EKG reveals a regular rhythm with a PR interval prolonged to 0.24 seconds
but all P waves are conducted to QRS complexes.
Which rhythm is shown?
A. First-degree AV block
B. Second-degree AV block type I
C. Sinus rhythm with PACs
D. Sinus bradycardia
Answer: A. First-degree AV block
Rationale: PR >0.20 sec but all P waves conduct = first-degree AV block.
,3 | Page
Q6.
A rhythm strip shows progressive prolongation of the PR interval until one P wave
is not followed by a QRS complex.
What is the correct interpretation?
A. Second-degree AV block type I (Wenckebach)
B. Second-degree AV block type II
C. Third-degree AV block
D. Sinus pause
Answer: A. Second-degree AV block type I (Wenckebach)
Rationale: The “longer, longer, longer, drop” pattern is classic for Mobitz type I.
Q7.
The EKG shows constant PR intervals with intermittent non-conducted P waves
and dropped QRS complexes.
What rhythm does this represent?
A. Second-degree AV block type II (Mobitz II)
B. First-degree AV block
C. Sinus arrhythmia
D. Premature atrial contractions
Answer: A. Second-degree AV block type II (Mobitz II)
Rationale: Fixed PR with sudden dropped QRS is Mobitz II, more dangerous
than type I.
Q8.
The rhythm strip demonstrates complete dissociation between atrial and ventricular
activity. P waves and QRS complexes are present but unrelated.
What is the rhythm?
A. Third-degree AV block (complete heart block)
B. First-degree AV block
C. Atrial flutter
D. Junctional rhythm
Answer: A. Third-degree AV block (complete heart block)
Rationale: Complete AV dissociation = atria and ventricles beat independently.
, 4 | Page
Q9.
A rhythm shows wide QRS complexes at a rate of 160 bpm with no visible P
waves.
What is the most likely rhythm?
A. Ventricular tachycardia
B. Supraventricular tachycardia
C. Sinus tachycardia
D. Atrial fibrillation
Answer: A. Ventricular tachycardia
Rationale: Wide QRS >0.12 sec at high rate without P waves = VTach.
Q10.
The EKG shows a chaotic baseline with no identifiable P waves or QRS
complexes. The patient is unresponsive and pulseless.
What rhythm is this?
A. Ventricular fibrillation
B. Asystole
C. Torsades de pointes
D. Atrial fibrillation
Answer: A. Ventricular fibrillation
Rationale: VFib shows chaotic electrical activity with no organized complexes, a
lethal rhythm.
Q11.
The EKG strip shows polymorphic ventricular tachycardia with twisting of QRS
complexes around the baseline.
What rhythm does this represent?
A. Torsades de pointes
B. Ventricular fibrillation
C. Monomorphic VTach
D. Atrial flutter
