CARDIOVASCULAR CREDENTIALING
CRAT EXAM AND PRACTICE EXAM 2026/2027
Complete Blueprint Coverage — Certified Rhythm Analysis Technician A+
A+ 5 100%
QUESTIONS VERIFIED CORE DOMAINS COVERED RATIONALES INCLUDED
CATEGORIES
ECG Fundamentals, Waveforms, and Measurements
Sinus, Atrial, and Junctional Rhythms
Ventricular Rhythms and Ectopy
Atrioventricular Blocks and Bundle-Branch Blocks
Pacemakers, Artifacts, Technical Issues, and Clinical Response
STUVIAACTUALEXAM
,CRAT EXAM AND PRACTICE EXAM 2026/2027 Page 2
ECG FUNDAMENTALS, WAVEFORMS, AND MEASUREMENTS
Q1
A technician is reviewing a 12-lead ECG recorded at standard calibration. The QRS complex measures 3 small boxes in
height in lead II. The technician must determine the amplitude of this QRS complex in millivolts.
A. 0.03 mV
B. 3.0 mV
C. 0.3 mV
D. 30 mV
Correct Answer: C
At standard calibration, 10 mm (10 small boxes) equals 1 mV. Therefore 3 small boxes equal 0.3 mV. The other values misapply the
calibration factor.
Q2
On a rhythm strip recorded at 25 mm/s, the R-R interval measures 20 small boxes. The technician calculates the heart rate
using the small-box method.
A. 100 beats per minute
B. 60 beats per minute
C. 75 beats per minute
D. 150 beats per minute
Correct Answer: C
Heart rate = 1500 / number of small boxes between consecutive R waves. = 75 bpm. The other rates correspond to different
interval lengths.
Q3
A patient’s ECG shows a PR interval of 0.28 seconds. The technician recognizes this finding as:
A. Normal PR interval
B. First-degree atrioventricular block
C. Wolff-Parkinson-White pattern
D. Complete heart block
Correct Answer: B
A PR interval greater than 0.20 seconds defines first-degree AV block. WPW shortens the PR interval; complete heart block shows
dissociation rather than a prolonged but consistent PR.
Q4
While measuring the QT interval on a rhythm strip, the technician notes that the heart rate is 100 bpm. To obtain a
rate-corrected QT (QTc) the technician should:
A. Simply multiply the measured QT by the heart rate
B. Apply a correction formula such as Bazett’s (QTc = QT / √RR) using the RR interval in seconds
C. Use the uncorrected QT because rate correction is unnecessary above 60 bpm
D. Measure only the QRS duration and ignore the T wave
Correct Answer: B
Rate correction is required because the QT interval shortens at higher heart rates. Bazett’s formula is the most commonly applied method; the
other approaches do not produce a valid QTc.
Q5
A lead II rhythm strip shows a consistent P wave that is upright and smoothly rounded, followed by a QRS complex of normal
duration. The PR interval is 0.16 s. The technician identifies the rhythm as:
A. Ventricular escape rhythm
B. Junctional rhythm
C. Normal sinus rhythm
D. Atrial flutter
Correct Answer: C
Upright P waves in lead II, normal PR interval, and normal QRS duration with a regular rate between 60–100 bpm define normal sinus rhythm.
STUVIAACTUALEXAM
, CRAT EXAM AND PRACTICE EXAM 2026/2027 Page 3
Q6
The technician observes that the T wave is inverted in leads V1–V4 on a previously normal ECG. This change most strongly
suggests:
A. Hyperkalemia
B. A normal variant in young adults
C. Myocardial ischemia in the anterior wall
D. Lead-wire reversal
Correct Answer: C
New T-wave inversion in the precordial leads is a classic marker of anterior ischemia. Hyperkalemia typically produces peaked T waves; lead
reversal creates other characteristic patterns.
Q7
A rhythm strip is recorded at double standard speed (50 mm/s). The technician must adjust the rate calculation method
accordingly. The correct approach is:
A. Use 3000 divided by the number of small boxes between R waves
B. Continue using 1500 divided by small boxes without adjustment
C. Double the calculated rate obtained with the standard formula
D. Halve the calculated rate obtained with the standard formula
Correct Answer: A
At 50 mm/s each small box represents 0.02 s, so the constant becomes 3000 instead of 1500. Failing to adjust the constant produces an
incorrect rate.
Q8
The technician measures a QRS duration of 0.14 seconds in a regular wide-complex rhythm. This duration indicates:
A. Normal ventricular conduction
B. Abnormal ventricular conduction or ventricular origin
C. Atrial enlargement
D. A normal PR interval
Correct Answer: B
A QRS duration ≥0.12 s is considered wide and implies either ventricular ectopy/escape or aberrant conduction (bundle-branch block).
Normal QRS is <0.12 s.
Q9
On a standard 12-lead ECG the technician notes that lead aVR shows a deep negative QRS deflection while lead II shows a
tall positive R wave. This axis pattern is consistent with:
A. Normal QRS axis
B. Right-axis deviation
C. Extreme right-axis deviation
D. Indeterminate axis
Correct Answer: A
A positive QRS in lead II and a negative QRS in aVR is the expected finding for a normal frontal-plane axis (approximately –30° to +90°).
Q10
A patient’s ECG demonstrates ST-segment elevation of 3 mm in leads II, III, and aVF. The technician should recognize this
pattern as most consistent with:
A. Pericarditis limited to the lateral wall
B. Normal early repolarization
C. Anterior-wall ischemia
D. Acute inferior-wall ST-elevation myocardial infarction
Correct Answer: D
Leads II, III, and aVF view the inferior wall of the left ventricle. ST elevation in these leads is the hallmark of acute inferior STEMI.
STUVIAACTUALEXAM
CRAT EXAM AND PRACTICE EXAM 2026/2027
Complete Blueprint Coverage — Certified Rhythm Analysis Technician A+
A+ 5 100%
QUESTIONS VERIFIED CORE DOMAINS COVERED RATIONALES INCLUDED
CATEGORIES
ECG Fundamentals, Waveforms, and Measurements
Sinus, Atrial, and Junctional Rhythms
Ventricular Rhythms and Ectopy
Atrioventricular Blocks and Bundle-Branch Blocks
Pacemakers, Artifacts, Technical Issues, and Clinical Response
STUVIAACTUALEXAM
,CRAT EXAM AND PRACTICE EXAM 2026/2027 Page 2
ECG FUNDAMENTALS, WAVEFORMS, AND MEASUREMENTS
Q1
A technician is reviewing a 12-lead ECG recorded at standard calibration. The QRS complex measures 3 small boxes in
height in lead II. The technician must determine the amplitude of this QRS complex in millivolts.
A. 0.03 mV
B. 3.0 mV
C. 0.3 mV
D. 30 mV
Correct Answer: C
At standard calibration, 10 mm (10 small boxes) equals 1 mV. Therefore 3 small boxes equal 0.3 mV. The other values misapply the
calibration factor.
Q2
On a rhythm strip recorded at 25 mm/s, the R-R interval measures 20 small boxes. The technician calculates the heart rate
using the small-box method.
A. 100 beats per minute
B. 60 beats per minute
C. 75 beats per minute
D. 150 beats per minute
Correct Answer: C
Heart rate = 1500 / number of small boxes between consecutive R waves. = 75 bpm. The other rates correspond to different
interval lengths.
Q3
A patient’s ECG shows a PR interval of 0.28 seconds. The technician recognizes this finding as:
A. Normal PR interval
B. First-degree atrioventricular block
C. Wolff-Parkinson-White pattern
D. Complete heart block
Correct Answer: B
A PR interval greater than 0.20 seconds defines first-degree AV block. WPW shortens the PR interval; complete heart block shows
dissociation rather than a prolonged but consistent PR.
Q4
While measuring the QT interval on a rhythm strip, the technician notes that the heart rate is 100 bpm. To obtain a
rate-corrected QT (QTc) the technician should:
A. Simply multiply the measured QT by the heart rate
B. Apply a correction formula such as Bazett’s (QTc = QT / √RR) using the RR interval in seconds
C. Use the uncorrected QT because rate correction is unnecessary above 60 bpm
D. Measure only the QRS duration and ignore the T wave
Correct Answer: B
Rate correction is required because the QT interval shortens at higher heart rates. Bazett’s formula is the most commonly applied method; the
other approaches do not produce a valid QTc.
Q5
A lead II rhythm strip shows a consistent P wave that is upright and smoothly rounded, followed by a QRS complex of normal
duration. The PR interval is 0.16 s. The technician identifies the rhythm as:
A. Ventricular escape rhythm
B. Junctional rhythm
C. Normal sinus rhythm
D. Atrial flutter
Correct Answer: C
Upright P waves in lead II, normal PR interval, and normal QRS duration with a regular rate between 60–100 bpm define normal sinus rhythm.
STUVIAACTUALEXAM
, CRAT EXAM AND PRACTICE EXAM 2026/2027 Page 3
Q6
The technician observes that the T wave is inverted in leads V1–V4 on a previously normal ECG. This change most strongly
suggests:
A. Hyperkalemia
B. A normal variant in young adults
C. Myocardial ischemia in the anterior wall
D. Lead-wire reversal
Correct Answer: C
New T-wave inversion in the precordial leads is a classic marker of anterior ischemia. Hyperkalemia typically produces peaked T waves; lead
reversal creates other characteristic patterns.
Q7
A rhythm strip is recorded at double standard speed (50 mm/s). The technician must adjust the rate calculation method
accordingly. The correct approach is:
A. Use 3000 divided by the number of small boxes between R waves
B. Continue using 1500 divided by small boxes without adjustment
C. Double the calculated rate obtained with the standard formula
D. Halve the calculated rate obtained with the standard formula
Correct Answer: A
At 50 mm/s each small box represents 0.02 s, so the constant becomes 3000 instead of 1500. Failing to adjust the constant produces an
incorrect rate.
Q8
The technician measures a QRS duration of 0.14 seconds in a regular wide-complex rhythm. This duration indicates:
A. Normal ventricular conduction
B. Abnormal ventricular conduction or ventricular origin
C. Atrial enlargement
D. A normal PR interval
Correct Answer: B
A QRS duration ≥0.12 s is considered wide and implies either ventricular ectopy/escape or aberrant conduction (bundle-branch block).
Normal QRS is <0.12 s.
Q9
On a standard 12-lead ECG the technician notes that lead aVR shows a deep negative QRS deflection while lead II shows a
tall positive R wave. This axis pattern is consistent with:
A. Normal QRS axis
B. Right-axis deviation
C. Extreme right-axis deviation
D. Indeterminate axis
Correct Answer: A
A positive QRS in lead II and a negative QRS in aVR is the expected finding for a normal frontal-plane axis (approximately –30° to +90°).
Q10
A patient’s ECG demonstrates ST-segment elevation of 3 mm in leads II, III, and aVF. The technician should recognize this
pattern as most consistent with:
A. Pericarditis limited to the lateral wall
B. Normal early repolarization
C. Anterior-wall ischemia
D. Acute inferior-wall ST-elevation myocardial infarction
Correct Answer: D
Leads II, III, and aVF view the inferior wall of the left ventricle. ST elevation in these leads is the hallmark of acute inferior STEMI.
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