Relias Advanced Dysrhythmia Exam B Actual Exam
2026/2027 | 52 Questions with Verified Answers |
100% Correct | Pass Guaranteed
SECTION 1: Complex Atrial & Junctional Dysrhythmias (12 Questions)
Q1: EKG Description: Rhythm: Irregularly irregular with no pattern. Rate: 110-130 bpm. P waves:
Present but at least 3 different morphologies. PR interval: Varies. QRS: Narrow (0.08s). ST/T: Normal.
A. Atrial fibrillation
B. Multifocal atrial tachycardia (MAT)
C. Sinus arrhythmia
D. Atrial flutter with variable conduction
Correct Answer: B
Rationale: Step-by-Step Analysis:
Rhythm: Irregularly irregular (but MAT can be irregular).
Rate: 110-130 bpm (>100 bpm is key for MAT vs WAP).
P waves: At least 3 different morphologies - hallmark of MAT or WAP.
PR interval: Varies - expected with changing pacemaker site.
QRS: Normal.
Interpretation: Multifocal Atrial Tachycardia - criteria met: irregular, rate >100, ≥3 P morphologies.
Clinical Significance: Often seen in COPD patients. Treat underlying cause, not the rhythm itself.
Differentiation from WAP: Wandering Atrial Pacemaker has same features but rate <100 bpm.
Q2: EKG Description: Rhythm: Regular. Rate: 50 bpm. P waves: Absent. QRS: Narrow (0.08s). ST/T:
Normal.
A. Sinus bradycardia
B. Junctional rhythm
C. 2:1 AV block
D. Idioventricular rhythm
Correct Answer: B
Rationale: Step-by-Step Analysis:
Rhythm: Regular.
Rate: 50 bpm (40-60 = junctional escape range).
P waves: Absent (or may be retrograde, hidden in QRS).
PR interval: Not measurable.
QRS: Narrow (0.08s) - key differentiator from ventricular rhythm.
Interpretation: Junctional rhythm - regular, narrow QRS, rate 40-60, no visible P waves.
Clinical Action: Assess perfusion, consider atropine if symptomatic.
Q3: EKG Description: Rhythm: Irregular with progressive RR shortening then pause. Rate: 60-80 bpm
(overall). P waves: Present, constant morphology. PR interval: Progressive lengthening until QRS
dropped. QRS: Narrow (0.08s). ST/T: Normal.
,A. 2nd degree AV block, Type II
B. 2nd degree AV block, Type I (Wenckebach)
C. Sinus arrhythmia
D. 1st degree AV block
Correct Answer: B
Rationale: Step-by-Step Analysis:
Rhythm: Irregular with grouped beating and pause.
Rate: 60-80 bpm overall.
P waves: Present, constant morphology.
PR interval: Progressive lengthening until QRS dropped - hallmark of Wenckebach.
QRS: Narrow.
Interpretation: 2nd degree AV block Type I - progressive PR prolongation until dropped QRS.
Clinical Significance: Usually benign, monitor if asymptomatic.
Q4: EKG Description: Rhythm: Regular. Rate: 140 bpm. P waves: Inverted before QRS. PR interval:
0.10s (short). QRS: Narrow (0.08s). ST/T: Normal.
A. Sinus tachycardia
B. Junctional tachycardia
C. Atrial tachycardia
D. AVNRT
Correct Answer: B
Rationale: Step-by-Step Analysis:
Rhythm: Regular.
Rate: 140 bpm (>100 = tachycardia).
P waves: Inverted and short PR (0.10s) - suggests retrograde conduction.
PR interval: Short.
QRS: Narrow.
Interpretation: Junctional tachycardia - regular narrow complex tachycardia with retrograde P waves.
Clinical Action: Vagal maneuvers, adenosine if stable.
Q5: EKG Description: Rhythm: Irregular. Rate: 90-110 bpm. P waves: Present with 3 different
morphologies. PR interval: Varies. QRS: Narrow (0.08s). ST/T: Normal.
A. Multifocal atrial tachycardia
B. Wandering atrial pacemaker (WAP)
C. Atrial fibrillation
D. Sinus arrhythmia
Correct Answer: B
Rationale: Step-by-Step Analysis:
Rhythm: Irregular.
Rate: 90-110 bpm (<100 bpm key differentiator from MAT).
P waves: ≥3 different morphologies - hallmark of WAP or MAT.
PR interval: Varies.
QRS: Narrow.
Interpretation: Wandering atrial pacemaker - same as MAT but rate <100 bpm.
Clinical Significance: Usually benign, common in athletes.
, Q6: EKG Description: Rhythm: Regular. Rate: 160 bpm. P waves: Hidden in T waves. PR interval: Not
measurable. QRS: Narrow (0.08s). ST/T: T waves distorted.
A. Ventricular tachycardia
B. Atrial tachycardia
C. Junctional rhythm
D. Sinus tachycardia
Correct Answer: B
Rationale: Step-by-Step Analysis:
Rhythm: Regular.
Rate: 160 bpm.
P waves: Hidden in T waves - characteristic of atrial tachycardia.
PR interval: Not measurable.
QRS: Narrow.
Interpretation: Atrial tachycardia - regular narrow complex tachycardia with hidden P waves.
Clinical Action: Vagal maneuvers, adenosine, rate control.
Q7: EKG Description: Rhythm: Irregular. Rate: 70-90 bpm. P waves: Present but morphology changes
every 3-4 beats. PR interval: Varies with P wave changes. QRS: Narrow (0.08s). ST/T: Normal.
A. Sinus arrhythmia
B. Wandering atrial pacemaker
C. Atrial fibrillation
D. Multifocal atrial tachycardia
Correct Answer: B
Rationale: Step-by-Step Analysis:
Rhythm: Irregular.
Rate: 70-90 bpm (<100 bpm).
P waves: Morphology changes every 3-4 beats - classic WAP pattern.
PR interval: Varies appropriately.
QRS: Narrow.
Interpretation: Wandering atrial pacemaker - benign rhythm with shifting pacemaker site.
Clinical Action: No treatment needed.
Q8: EKG Description: Rhythm: Regular. Rate: 120 bpm. P waves: Absent. QRS: Narrow (0.08s). ST/T:
Normal.
A. Sinus tachycardia
B. Junctional tachycardia
C. Atrial flutter
D. Ventricular tachycardia
Correct Answer: B
Rationale: Step-by-Step Analysis:
Rhythm: Regular.
Rate: 120 bpm (>100 = tachycardia).
P waves: Absent - suggests junctional origin.
PR interval: Not measurable.
QRS: Narrow.
Interpretation: Junctional tachycardia - narrow complex tachycardia without P waves.
2026/2027 | 52 Questions with Verified Answers |
100% Correct | Pass Guaranteed
SECTION 1: Complex Atrial & Junctional Dysrhythmias (12 Questions)
Q1: EKG Description: Rhythm: Irregularly irregular with no pattern. Rate: 110-130 bpm. P waves:
Present but at least 3 different morphologies. PR interval: Varies. QRS: Narrow (0.08s). ST/T: Normal.
A. Atrial fibrillation
B. Multifocal atrial tachycardia (MAT)
C. Sinus arrhythmia
D. Atrial flutter with variable conduction
Correct Answer: B
Rationale: Step-by-Step Analysis:
Rhythm: Irregularly irregular (but MAT can be irregular).
Rate: 110-130 bpm (>100 bpm is key for MAT vs WAP).
P waves: At least 3 different morphologies - hallmark of MAT or WAP.
PR interval: Varies - expected with changing pacemaker site.
QRS: Normal.
Interpretation: Multifocal Atrial Tachycardia - criteria met: irregular, rate >100, ≥3 P morphologies.
Clinical Significance: Often seen in COPD patients. Treat underlying cause, not the rhythm itself.
Differentiation from WAP: Wandering Atrial Pacemaker has same features but rate <100 bpm.
Q2: EKG Description: Rhythm: Regular. Rate: 50 bpm. P waves: Absent. QRS: Narrow (0.08s). ST/T:
Normal.
A. Sinus bradycardia
B. Junctional rhythm
C. 2:1 AV block
D. Idioventricular rhythm
Correct Answer: B
Rationale: Step-by-Step Analysis:
Rhythm: Regular.
Rate: 50 bpm (40-60 = junctional escape range).
P waves: Absent (or may be retrograde, hidden in QRS).
PR interval: Not measurable.
QRS: Narrow (0.08s) - key differentiator from ventricular rhythm.
Interpretation: Junctional rhythm - regular, narrow QRS, rate 40-60, no visible P waves.
Clinical Action: Assess perfusion, consider atropine if symptomatic.
Q3: EKG Description: Rhythm: Irregular with progressive RR shortening then pause. Rate: 60-80 bpm
(overall). P waves: Present, constant morphology. PR interval: Progressive lengthening until QRS
dropped. QRS: Narrow (0.08s). ST/T: Normal.
,A. 2nd degree AV block, Type II
B. 2nd degree AV block, Type I (Wenckebach)
C. Sinus arrhythmia
D. 1st degree AV block
Correct Answer: B
Rationale: Step-by-Step Analysis:
Rhythm: Irregular with grouped beating and pause.
Rate: 60-80 bpm overall.
P waves: Present, constant morphology.
PR interval: Progressive lengthening until QRS dropped - hallmark of Wenckebach.
QRS: Narrow.
Interpretation: 2nd degree AV block Type I - progressive PR prolongation until dropped QRS.
Clinical Significance: Usually benign, monitor if asymptomatic.
Q4: EKG Description: Rhythm: Regular. Rate: 140 bpm. P waves: Inverted before QRS. PR interval:
0.10s (short). QRS: Narrow (0.08s). ST/T: Normal.
A. Sinus tachycardia
B. Junctional tachycardia
C. Atrial tachycardia
D. AVNRT
Correct Answer: B
Rationale: Step-by-Step Analysis:
Rhythm: Regular.
Rate: 140 bpm (>100 = tachycardia).
P waves: Inverted and short PR (0.10s) - suggests retrograde conduction.
PR interval: Short.
QRS: Narrow.
Interpretation: Junctional tachycardia - regular narrow complex tachycardia with retrograde P waves.
Clinical Action: Vagal maneuvers, adenosine if stable.
Q5: EKG Description: Rhythm: Irregular. Rate: 90-110 bpm. P waves: Present with 3 different
morphologies. PR interval: Varies. QRS: Narrow (0.08s). ST/T: Normal.
A. Multifocal atrial tachycardia
B. Wandering atrial pacemaker (WAP)
C. Atrial fibrillation
D. Sinus arrhythmia
Correct Answer: B
Rationale: Step-by-Step Analysis:
Rhythm: Irregular.
Rate: 90-110 bpm (<100 bpm key differentiator from MAT).
P waves: ≥3 different morphologies - hallmark of WAP or MAT.
PR interval: Varies.
QRS: Narrow.
Interpretation: Wandering atrial pacemaker - same as MAT but rate <100 bpm.
Clinical Significance: Usually benign, common in athletes.
, Q6: EKG Description: Rhythm: Regular. Rate: 160 bpm. P waves: Hidden in T waves. PR interval: Not
measurable. QRS: Narrow (0.08s). ST/T: T waves distorted.
A. Ventricular tachycardia
B. Atrial tachycardia
C. Junctional rhythm
D. Sinus tachycardia
Correct Answer: B
Rationale: Step-by-Step Analysis:
Rhythm: Regular.
Rate: 160 bpm.
P waves: Hidden in T waves - characteristic of atrial tachycardia.
PR interval: Not measurable.
QRS: Narrow.
Interpretation: Atrial tachycardia - regular narrow complex tachycardia with hidden P waves.
Clinical Action: Vagal maneuvers, adenosine, rate control.
Q7: EKG Description: Rhythm: Irregular. Rate: 70-90 bpm. P waves: Present but morphology changes
every 3-4 beats. PR interval: Varies with P wave changes. QRS: Narrow (0.08s). ST/T: Normal.
A. Sinus arrhythmia
B. Wandering atrial pacemaker
C. Atrial fibrillation
D. Multifocal atrial tachycardia
Correct Answer: B
Rationale: Step-by-Step Analysis:
Rhythm: Irregular.
Rate: 70-90 bpm (<100 bpm).
P waves: Morphology changes every 3-4 beats - classic WAP pattern.
PR interval: Varies appropriately.
QRS: Narrow.
Interpretation: Wandering atrial pacemaker - benign rhythm with shifting pacemaker site.
Clinical Action: No treatment needed.
Q8: EKG Description: Rhythm: Regular. Rate: 120 bpm. P waves: Absent. QRS: Narrow (0.08s). ST/T:
Normal.
A. Sinus tachycardia
B. Junctional tachycardia
C. Atrial flutter
D. Ventricular tachycardia
Correct Answer: B
Rationale: Step-by-Step Analysis:
Rhythm: Regular.
Rate: 120 bpm (>100 = tachycardia).
P waves: Absent - suggests junctional origin.
PR interval: Not measurable.
QRS: Narrow.
Interpretation: Junctional tachycardia - narrow complex tachycardia without P waves.
