RELIAS Dysrhythmia Basic A Exam | 200+ Practice Questions with Detailed Rationales | Nursing ECG Interpretation

Page 1 of 250




RELIAS DYSRHYTHMIA BASIC A
EXAM

Original Curriculum-Aligned Practice Question s — 2026–2027




PROFESSIONAL TITLE PAGE




Original Curriculum-Aligned Practice Question s**



Relias Dysrhythmia Basic A Exam



2026–2027 Edition



200+ Multiple-Choice Question s with Detailed rationales


Target Audience: Nursing Students, Healthcare Professionals, Telemetry Technicians



Difficulty Distribution: 30% Easy | 50% Moderate | 20% Difficult



Question Type: Multiple Choice Question s (MCQs) — A through D

,Page 2 of 250




TABLE OF CONTENTS


1. **Curriculum Coverage Blueprint**

2. **Section 1: ECG Foundations & Measurements** (Question s 1–35)

3. **Section 2: Sinus Rhythms** (Question s 36–70)

4. **Section 3: Atrial Dysrhythmias** (Question s 71–100)

5. **Section 4: Junctional Rhythms** (Question s 101–120)

6. **Section 5: Ventricular Dysrhythmias** (Question s 121–155)

7. **Section 6: AV Heart Blocks** (Question s 156–185)
8. **Section 7: Pacemaker Rhythms & Clinical Interventions** (Question s 186–210)



---


---



SECTION 1: ECG FOUNDATIONS & MEASUREMENTS


---



Question s 1–35


---

,Page 3 of 250



Question 1

Learning Objective: Identify the duration represented by standard ECG paper measurements

Difficulty: Easy


Question : On standard ECG paper running at 25 mm/second, how many seconds does ONE
small box (1 mm) represent on the horizontal axis?


A. 0.04 seconds
B. 0.10 seconds

C. 0.20 seconds

D. 1.00 seconds



Correct answer : A. 0.04 seconds


Detailed rationale: Standard ECG paper runs at 25 mm per second. One small box measures 1
mm horizontally. Since 25 mm equals 1 second, 1 mm equals 1/25 = 0.04 seconds. This
fundamental measurement is the basis for calculating all ECG intervals. Five small boxes (5 mm)
equal 0.20 seconds (one large box), and 15 small boxes equal 0.60 seconds.



Why the other options are incorrect
B (0.10 seconds): This is the duration of 2.5 small boxes, not a standard ECG measurement.

C (0.20 seconds):This is the duration of one large box (5 small boxes), not one small box.

(1.00 seconds): This is the duration of 25 small boxes (the entire 25 mm span), not a single
small box.



Exam tip: Remember the mnemonic "**300-150-100-75-60-50**" for the large-box method of
heart rate calculation. Each large box = 0.20 seconds; therefore, 300 large boxes = 60 seconds (1
minute).

, Page 4 of 250



---



### Question 2
**Topic:** ECG Paper Measurement

**Learning Objective:** Calculate heart rate using the large-box method

**Difficulty:** Easy



**Question :** A rhythm strip shows 4 large boxes between two consecutive R waves. What is
the approximate heart rate?



A. 60 bpm

B. 75 bpm

C. 100 bpm
D. 150 bpm



**Correct answer :** B. 75 bpm



**Detailed rationale:** The large-box method for calculating heart rate uses the formula: Rate =
300 ÷ (number of large boxes between R-R intervals). With 4 large boxes between R waves: 300
÷ 4 = 75 bpm. This method is most accurate for regular rhythms. The number 300 comes from 60
seconds ÷ 0.20 seconds per large box = 300 large boxes per minute.



**Why the other options are incorrect:**

- **A (60 bpm):** This would correspond to 5 large boxes between R waves (300 ÷ 5 = 60).

- **C (100 bpm):** This would correspond to 3 large boxes between R waves (300 ÷ 3 = 100).

- **D (150 bpm):** This would correspond to 2 large boxes between R waves (300 ÷ 2 = 150).