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:
1. Rhythm: Irregularly irregular (no repeating pattern).
2. Rate: 110–130 bpm (tachycardic; MAT requires >100).
3. P waves: ≥3 discrete morphologies—pathognomonic for MAT/WAP.
4. PR interval: Varies with shifting atrial focus.
5. QRS: Narrow (supraventricular origin).
6. Interpretation: Multifocal atrial tachycardia.
7. Clinical Significance: COPD exacerbation common trigger; treat underlying
disease, not rhythm.
Differentiation: Wandering atrial pacemaker identical 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:
1. Rhythm: Regular.
2. Rate: 50 bpm (40–60 = junctional escape).
3. P waves: Absent (retrograde P may hide within QRS).
4. PR interval: Not measurable.
5. QRS: Narrow (origin above ventricles).
6. Interpretation: Junctional escape rhythm.
7. Clinical Action: Evaluate perfusion; atropine 0.5 mg IV if symptomatic.
Q3: EKG Description: Rhythm: Irregular, grouped beating. Rate: 80–100 bpm. P waves:
Upright, 1:1 until dropped; no QRS after every 3rd P. PR interval: Lengthens
0.20→0.36→drop. QRS: Narrow (0.08s).
A. 2nd-degree AV block Type II
B. 2nd-degree AV block Type I (Wenckebach)
C. Sinus arrhythmia
D. Non-conducted PACs
,Correct Answer: B
Rationale: Step-by-Step Analysis:
1. Rhythm: Irregular due to grouped beating.
2. Rate: 80–100 bpm (atrial); ventricular slightly less.
3. P waves: Normal morphology; periodic non-conduction.
4. PR interval: Progressive prolongation before dropped beat.
5. QRS: Narrow (supraventricular).
6. Interpretation: Mobitz I (Wenckebach).
7. Clinical Significance: Usually benign; observe unless symptomatic.
Q4: EKG Description: Rhythm: Regular. Rate: 150 bpm. P waves: Saw-tooth flutter waves
300/min; 2:1 conduction. PR interval: Not applicable. QRS: Narrow (0.08s). ST/T: Flutter
waves distort baseline.
A. Sinus tachycardia
B. Atrial fibrillation
C. Atrial flutter 2:1
D. SVT with aberrancy
Correct Answer: C
Rationale: Step-by-Step Analysis:
1. Rhythm: Regular.
2. Rate: 150 bpm (typical 2:1 flutter rate).
3. P waves: Classic saw-tooth flutter waves 300/min.
4. Conduction: 2:1 (every second flutter conducts).
5. QRS: Narrow.
6. Interpretation: Typical atrial flutter 2:1.
7. Clinical Action: Vagal maneuvers or adenosine to unmask flutter waves;
rate/rhythm control per protocol.
, Q5: EKG Description: Rhythm: Regular. Rate: 70 bpm. P waves: Inverted before QRS. PR
interval: 0.10 s (short). QRS: Narrow (0.08s). ST/T: Normal.
A. Normal sinus rhythm
B. Low-atrial/junctional rhythm
C. WPW pre-excitation
D. 1st-degree AV block
Correct Answer: B
Rationale: Step-by-Step Analysis:
1. Rhythm: Regular.
2. Rate: 70 bpm (normal junctional).
3. P waves: Inverted in II, aVR upright—low atrial or junctional origin.
4. PR interval: 0.10 s (short).
5. QRS: Narrow.
6. Interpretation: Low-atrial/junctional rhythm with retrograde conduction.
7. Clinical Significance: Benign if stable; rule out digitalis toxicity if on digoxin.
Q6: EKG Description: Rhythm: Irregularly irregular. Rate: 90–110 bpm. P waves: ≥3
morphologies. PR interval: Varies. QRS: Narrow (0.08s). ST/T: Normal.
A. MAT
B. Wandering atrial pacemaker (WAP)
C. Atrial fibrillation
D. Sinus arrhythmia
Correct Answer: B
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:
1. Rhythm: Irregularly irregular (no repeating pattern).
2. Rate: 110–130 bpm (tachycardic; MAT requires >100).
3. P waves: ≥3 discrete morphologies—pathognomonic for MAT/WAP.
4. PR interval: Varies with shifting atrial focus.
5. QRS: Narrow (supraventricular origin).
6. Interpretation: Multifocal atrial tachycardia.
7. Clinical Significance: COPD exacerbation common trigger; treat underlying
disease, not rhythm.
Differentiation: Wandering atrial pacemaker identical 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:
1. Rhythm: Regular.
2. Rate: 50 bpm (40–60 = junctional escape).
3. P waves: Absent (retrograde P may hide within QRS).
4. PR interval: Not measurable.
5. QRS: Narrow (origin above ventricles).
6. Interpretation: Junctional escape rhythm.
7. Clinical Action: Evaluate perfusion; atropine 0.5 mg IV if symptomatic.
Q3: EKG Description: Rhythm: Irregular, grouped beating. Rate: 80–100 bpm. P waves:
Upright, 1:1 until dropped; no QRS after every 3rd P. PR interval: Lengthens
0.20→0.36→drop. QRS: Narrow (0.08s).
A. 2nd-degree AV block Type II
B. 2nd-degree AV block Type I (Wenckebach)
C. Sinus arrhythmia
D. Non-conducted PACs
,Correct Answer: B
Rationale: Step-by-Step Analysis:
1. Rhythm: Irregular due to grouped beating.
2. Rate: 80–100 bpm (atrial); ventricular slightly less.
3. P waves: Normal morphology; periodic non-conduction.
4. PR interval: Progressive prolongation before dropped beat.
5. QRS: Narrow (supraventricular).
6. Interpretation: Mobitz I (Wenckebach).
7. Clinical Significance: Usually benign; observe unless symptomatic.
Q4: EKG Description: Rhythm: Regular. Rate: 150 bpm. P waves: Saw-tooth flutter waves
300/min; 2:1 conduction. PR interval: Not applicable. QRS: Narrow (0.08s). ST/T: Flutter
waves distort baseline.
A. Sinus tachycardia
B. Atrial fibrillation
C. Atrial flutter 2:1
D. SVT with aberrancy
Correct Answer: C
Rationale: Step-by-Step Analysis:
1. Rhythm: Regular.
2. Rate: 150 bpm (typical 2:1 flutter rate).
3. P waves: Classic saw-tooth flutter waves 300/min.
4. Conduction: 2:1 (every second flutter conducts).
5. QRS: Narrow.
6. Interpretation: Typical atrial flutter 2:1.
7. Clinical Action: Vagal maneuvers or adenosine to unmask flutter waves;
rate/rhythm control per protocol.
, Q5: EKG Description: Rhythm: Regular. Rate: 70 bpm. P waves: Inverted before QRS. PR
interval: 0.10 s (short). QRS: Narrow (0.08s). ST/T: Normal.
A. Normal sinus rhythm
B. Low-atrial/junctional rhythm
C. WPW pre-excitation
D. 1st-degree AV block
Correct Answer: B
Rationale: Step-by-Step Analysis:
1. Rhythm: Regular.
2. Rate: 70 bpm (normal junctional).
3. P waves: Inverted in II, aVR upright—low atrial or junctional origin.
4. PR interval: 0.10 s (short).
5. QRS: Narrow.
6. Interpretation: Low-atrial/junctional rhythm with retrograde conduction.
7. Clinical Significance: Benign if stable; rule out digitalis toxicity if on digoxin.
Q6: EKG Description: Rhythm: Irregularly irregular. Rate: 90–110 bpm. P waves: ≥3
morphologies. PR interval: Varies. QRS: Narrow (0.08s). ST/T: Normal.
A. MAT
B. Wandering atrial pacemaker (WAP)
C. Atrial fibrillation
D. Sinus arrhythmia
Correct Answer: B
