Relias Dysrhythmia Basic Test
Questions and Answers 2026/2027
(Basic A Dysrhythmia)
Relias Dysrhythmia Basic Test Questions and Answers 2026/2027 (Basic A Dysrhythmia)
Examination Overview
This comprehensive examination is designed to assess competency in basic cardiac dysrhythmia
interpretation, ECG analysis, and clinical decision-making related to cardiac monitoring. The exam
covers essential topics including cardiac anatomy and conduction system, ECG fundamentals, sinus
rhythms, atrial dysrhythmias, junctional rhythms, ventricular dysrhythmias, atrioventricular blocks,
pacemaker rhythms, and emergency cardiac interventions. Questions range from foundational
knowledge to clinical application, preparing healthcare professionals for the Relias Dysrhythmia
Basic A competency assessment.
Table of Contents
1. Cardiac Anatomy, Conduction System, and ECG Fundamentals (Q1–Q30)
2. Sinus Rhythms (Q31–Q55)
3. Atrial Dysrhythmias (Q56–Q90)
4. Junctional Rhythms (Q91–Q110)
5. Ventricular Dysrhythmias (Q111–Q150)
6. Atrioventricular Blocks (Q151–Q175)
7. Pacemaker Rhythms and Artifacts (Q176–Q190)
8. Emergency Interventions and Clinical Decision-Making (Q191–Q200)
QUESTIONS 1–200
Section 1: Cardiac Anatomy, Conduction System, and ECG Fundamentals (Q1–Q30)
Q1. What is the intrinsic firing rate of the sinoatrial (SA) node under normal physiological conditions?
A. 20 to 40 beats per minute
B. 40 to 60 beats per minute
C. 60 to 100 beats per minute
D. 100 to 150 beats per minute
pg. 1
,Correct Answer: C. 60 to 100 beats per minute
Rationale: The SA node is the primary pacemaker of the heart, with an intrinsic firing rate of 60 to
100 beats per minute. Option A describes the Purkinje system rate, Option B describes the AV
junction rate, and Option D exceeds the normal SA node range.
Q2. Which sequence correctly traces the normal flow of an electrical impulse through the cardiac
conduction system?
A. AV node, SA node, Purkinje fibers, Bundle of His, bundle branches
B. SA node, Bundle of His, AV node, Purkinje fibers, bundle branches
C. SA node, AV node, Bundle of His, right and left bundle branches, Purkinje fibers
D. Purkinje fibers, bundle branches, Bundle of His, AV node, SA node
Correct Answer: C. SA node, AV node, Bundle of His, right and left bundle branches, Purkinje fibers
Rationale: The normal conduction pathway begins at the SA node, travels to the AV node (where
there is a slight delay), then to the Bundle of His, down the right and left bundle branches, and finally
to the Purkinje fibers. Option A reverses the SA and AV nodes. Option B places the Bundle of His
before the AV node. Option D traces the pathway in reverse, which is retrograde conduction.
Q3. What is the normal duration of the PR interval on an ECG?
A. 0.04 to 0.10 seconds
B. 0.12 to 0.20 seconds
C. 0.20 to 0.30 seconds
D. 0.30 to 0.40 seconds
Correct Answer: B. 0.12 to 0.20 seconds
Rationale: The PR interval represents the time from the onset of atrial depolarization to the onset of
ventricular depolarization. Normal duration is 0.12 to 0.20 seconds (3 to 5 small boxes). Values less
than 0.12 seconds may indicate pre-excitation, and values greater than 0.20 seconds indicate first-
degree AV block.
Q4. What does the QRS complex represent on an ECG tracing?
A. Atrial depolarization
B. Ventricular depolarization
C. Ventricular repolarization
D. Atrial repolarization
Correct Answer: B. Ventricular depolarization
Rationale: The QRS complex represents ventricular depolarization. The P wave represents atrial
depolarization. The T wave represents ventricular repolarization. Atrial repolarization is typically
hidden within the QRS complex.
pg. 2
,Q5. A normal QRS duration should be less than how many seconds?
A. 0.06 seconds
B. 0.10 seconds
C. 0.12 seconds
D. 0.16 seconds
Correct Answer: C. 0.12 seconds
Rationale: A normal QRS duration is less than 0.12 seconds (less than 3 small boxes). QRS durations
of 0.12 seconds or greater indicate a conduction delay, such as a bundle branch block or ventricular
origin of the rhythm.
Q6. Which waveform on an ECG represents ventricular repolarization?
A. P wave
B. QRS complex
C. T wave
D. U wave
Correct Answer: C. T wave
Rationale: The T wave represents ventricular repolarization, the recovery phase of the ventricles.
The P wave is atrial depolarization, the QRS is ventricular depolarization, and the U wave (when
present) may represent repolarization of the Purkinje fibers.
Q7. What is the intrinsic rate of the AV junction if it becomes the primary pacemaker?
A. 20 to 40 beats per minute
B. 40 to 60 beats per minute
C. 60 to 100 beats per minute
D. 100 to 150 beats per minute
Correct Answer: B. 40 to 60 beats per minute
Rationale: The AV junction has an intrinsic rate of 40 to 60 beats per minute and serves as a backup
pacemaker if the SA node fails. The Purkinje system has a rate of 20 to 40 beats per minute. The SA
node normally fires at 60 to 100 beats per minute.
Q8. How many large boxes on ECG paper equal one second?
A. 1 large box
B. 3 large boxes
C. 5 large boxes
D. 10 large boxes
Correct Answer: C. 5 large boxes
pg. 3
, Rationale: Each large box on standard ECG paper represents 0.20 seconds. Therefore, 5 large boxes
equal 1 second (5 × 0.20 = 1.0 second). This is the basis for the 6-second method of heart rate
calculation.
Q9. What is the correct method for calculating a regular heart rate using the large box method?
A. Multiply the number of large boxes by 1500
B. Divide 1500 by the number of large boxes between R waves
C. Divide 300 by the number of large boxes between R waves
D. Multiply the number of R waves in 6 seconds by 10
Correct Answer: C. Divide 300 by the number of large boxes between R waves
Rationale: For regular rhythms, the heart rate can be calculated by dividing 300 by the number of
large boxes between consecutive R waves. Option B (1500 divided by small boxes) is the small box
method. Option D describes the 6-second method for irregular rhythms.
Q10. Which lead placement is correct for a 5-lead ECG monitoring system?
A. White right arm, black left arm, red right leg, green left leg, brown chest
B. White right arm, black left arm, red left leg, green right leg, brown chest
C. Black right arm, white left arm, green right leg, red left leg, brown chest
D. Red right arm, white left arm, green right leg, black left leg, brown chest
Correct Answer: B. White right arm, black left arm, red left leg, green right leg, brown chest
Rationale: Standard 5-lead ECG placement uses white (RA), black (LA), red (LL), green (RL), and
brown (chest) electrodes. The mnemonic "white on right, smoke (black) over fire (red)" helps
remember arm and leg lead placement.
Q11. What does the ST segment represent on an ECG?
A. The time between atrial and ventricular depolarization
B. The time between ventricular depolarization and repolarization
C. The time between atrial repolarization and ventricular depolarization
D. The time between ventricular repolarization and the next atrial depolarization
Correct Answer: B. The time between ventricular depolarization and repolarization
Rationale: The ST segment represents the isoelectric period between the end of ventricular
depolarization (end of QRS) and the beginning of ventricular repolarization (start of T wave). ST
segment changes are clinically significant for detecting myocardial ischemia or injury.
Q12. A patient's ECG shows a PR interval of 0.26 seconds. How should the nurse interpret this
finding?
A. Normal PR interval
B. First-degree AV block
pg. 4
Questions and Answers 2026/2027
(Basic A Dysrhythmia)
Relias Dysrhythmia Basic Test Questions and Answers 2026/2027 (Basic A Dysrhythmia)
Examination Overview
This comprehensive examination is designed to assess competency in basic cardiac dysrhythmia
interpretation, ECG analysis, and clinical decision-making related to cardiac monitoring. The exam
covers essential topics including cardiac anatomy and conduction system, ECG fundamentals, sinus
rhythms, atrial dysrhythmias, junctional rhythms, ventricular dysrhythmias, atrioventricular blocks,
pacemaker rhythms, and emergency cardiac interventions. Questions range from foundational
knowledge to clinical application, preparing healthcare professionals for the Relias Dysrhythmia
Basic A competency assessment.
Table of Contents
1. Cardiac Anatomy, Conduction System, and ECG Fundamentals (Q1–Q30)
2. Sinus Rhythms (Q31–Q55)
3. Atrial Dysrhythmias (Q56–Q90)
4. Junctional Rhythms (Q91–Q110)
5. Ventricular Dysrhythmias (Q111–Q150)
6. Atrioventricular Blocks (Q151–Q175)
7. Pacemaker Rhythms and Artifacts (Q176–Q190)
8. Emergency Interventions and Clinical Decision-Making (Q191–Q200)
QUESTIONS 1–200
Section 1: Cardiac Anatomy, Conduction System, and ECG Fundamentals (Q1–Q30)
Q1. What is the intrinsic firing rate of the sinoatrial (SA) node under normal physiological conditions?
A. 20 to 40 beats per minute
B. 40 to 60 beats per minute
C. 60 to 100 beats per minute
D. 100 to 150 beats per minute
pg. 1
,Correct Answer: C. 60 to 100 beats per minute
Rationale: The SA node is the primary pacemaker of the heart, with an intrinsic firing rate of 60 to
100 beats per minute. Option A describes the Purkinje system rate, Option B describes the AV
junction rate, and Option D exceeds the normal SA node range.
Q2. Which sequence correctly traces the normal flow of an electrical impulse through the cardiac
conduction system?
A. AV node, SA node, Purkinje fibers, Bundle of His, bundle branches
B. SA node, Bundle of His, AV node, Purkinje fibers, bundle branches
C. SA node, AV node, Bundle of His, right and left bundle branches, Purkinje fibers
D. Purkinje fibers, bundle branches, Bundle of His, AV node, SA node
Correct Answer: C. SA node, AV node, Bundle of His, right and left bundle branches, Purkinje fibers
Rationale: The normal conduction pathway begins at the SA node, travels to the AV node (where
there is a slight delay), then to the Bundle of His, down the right and left bundle branches, and finally
to the Purkinje fibers. Option A reverses the SA and AV nodes. Option B places the Bundle of His
before the AV node. Option D traces the pathway in reverse, which is retrograde conduction.
Q3. What is the normal duration of the PR interval on an ECG?
A. 0.04 to 0.10 seconds
B. 0.12 to 0.20 seconds
C. 0.20 to 0.30 seconds
D. 0.30 to 0.40 seconds
Correct Answer: B. 0.12 to 0.20 seconds
Rationale: The PR interval represents the time from the onset of atrial depolarization to the onset of
ventricular depolarization. Normal duration is 0.12 to 0.20 seconds (3 to 5 small boxes). Values less
than 0.12 seconds may indicate pre-excitation, and values greater than 0.20 seconds indicate first-
degree AV block.
Q4. What does the QRS complex represent on an ECG tracing?
A. Atrial depolarization
B. Ventricular depolarization
C. Ventricular repolarization
D. Atrial repolarization
Correct Answer: B. Ventricular depolarization
Rationale: The QRS complex represents ventricular depolarization. The P wave represents atrial
depolarization. The T wave represents ventricular repolarization. Atrial repolarization is typically
hidden within the QRS complex.
pg. 2
,Q5. A normal QRS duration should be less than how many seconds?
A. 0.06 seconds
B. 0.10 seconds
C. 0.12 seconds
D. 0.16 seconds
Correct Answer: C. 0.12 seconds
Rationale: A normal QRS duration is less than 0.12 seconds (less than 3 small boxes). QRS durations
of 0.12 seconds or greater indicate a conduction delay, such as a bundle branch block or ventricular
origin of the rhythm.
Q6. Which waveform on an ECG represents ventricular repolarization?
A. P wave
B. QRS complex
C. T wave
D. U wave
Correct Answer: C. T wave
Rationale: The T wave represents ventricular repolarization, the recovery phase of the ventricles.
The P wave is atrial depolarization, the QRS is ventricular depolarization, and the U wave (when
present) may represent repolarization of the Purkinje fibers.
Q7. What is the intrinsic rate of the AV junction if it becomes the primary pacemaker?
A. 20 to 40 beats per minute
B. 40 to 60 beats per minute
C. 60 to 100 beats per minute
D. 100 to 150 beats per minute
Correct Answer: B. 40 to 60 beats per minute
Rationale: The AV junction has an intrinsic rate of 40 to 60 beats per minute and serves as a backup
pacemaker if the SA node fails. The Purkinje system has a rate of 20 to 40 beats per minute. The SA
node normally fires at 60 to 100 beats per minute.
Q8. How many large boxes on ECG paper equal one second?
A. 1 large box
B. 3 large boxes
C. 5 large boxes
D. 10 large boxes
Correct Answer: C. 5 large boxes
pg. 3
, Rationale: Each large box on standard ECG paper represents 0.20 seconds. Therefore, 5 large boxes
equal 1 second (5 × 0.20 = 1.0 second). This is the basis for the 6-second method of heart rate
calculation.
Q9. What is the correct method for calculating a regular heart rate using the large box method?
A. Multiply the number of large boxes by 1500
B. Divide 1500 by the number of large boxes between R waves
C. Divide 300 by the number of large boxes between R waves
D. Multiply the number of R waves in 6 seconds by 10
Correct Answer: C. Divide 300 by the number of large boxes between R waves
Rationale: For regular rhythms, the heart rate can be calculated by dividing 300 by the number of
large boxes between consecutive R waves. Option B (1500 divided by small boxes) is the small box
method. Option D describes the 6-second method for irregular rhythms.
Q10. Which lead placement is correct for a 5-lead ECG monitoring system?
A. White right arm, black left arm, red right leg, green left leg, brown chest
B. White right arm, black left arm, red left leg, green right leg, brown chest
C. Black right arm, white left arm, green right leg, red left leg, brown chest
D. Red right arm, white left arm, green right leg, black left leg, brown chest
Correct Answer: B. White right arm, black left arm, red left leg, green right leg, brown chest
Rationale: Standard 5-lead ECG placement uses white (RA), black (LA), red (LL), green (RL), and
brown (chest) electrodes. The mnemonic "white on right, smoke (black) over fire (red)" helps
remember arm and leg lead placement.
Q11. What does the ST segment represent on an ECG?
A. The time between atrial and ventricular depolarization
B. The time between ventricular depolarization and repolarization
C. The time between atrial repolarization and ventricular depolarization
D. The time between ventricular repolarization and the next atrial depolarization
Correct Answer: B. The time between ventricular depolarization and repolarization
Rationale: The ST segment represents the isoelectric period between the end of ventricular
depolarization (end of QRS) and the beginning of ventricular repolarization (start of T wave). ST
segment changes are clinically significant for detecting myocardial ischemia or injury.
Q12. A patient's ECG shows a PR interval of 0.26 seconds. How should the nurse interpret this
finding?
A. Normal PR interval
B. First-degree AV block
pg. 4
