RELIAS DYSRHYTHMIA BASIC A TEST |
(LATEST 2026/2027 UPDATE), | 100%
CORRECT-GALEN COLLEGE OF NURSING
RELIAS DYSRHYTHMIA BASIC A TEST
Relias Dysrhythmia Basic A Test – 2026/2027 – Complete Questions
and Answers with Explanations
Question 1:
An ECG strip shows a regular rhythm with a heart rate of 48 bpm, P waves before each
QRS, and a PR interval of 0.16 seconds. What is the rhythm?
A. Sinus tachycardia
B. Sinus bradycardia
C. Atrial fibrillation
D. First-degree AV block
Answer: B. Sinus bradycardia
Rationale: A heart rate below 60 bpm with a regular rhythm, normal PR interval
(0.12–0.20 seconds), and P waves preceding each QRS indicates sinus bradycardia.
This rhythm originates from the SA node but fires slower than normal. It can be normal
in athletes or during sleep. Symptomatic bradycardia requires intervention, but
asymptomatic patients may only need monitoring.
Question 2:
A client’s ECG shows a heart rate of 120 bpm, regular rhythm, and P waves before
each QRS. What is the rhythm?
A. Sinus tachycardia
B. Supraventricular tachycardia
C. Atrial flutter
D. Ventricular tachycardia
Answer: A. Sinus tachycardia
Rationale: Sinus tachycardia is identified by a regular rhythm over 100 bpm with P
waves preceding each QRS and a normal PR interval. This rhythm is generated by the
SA node firing faster than usual, often due to stress, fever, pain, or hypovolemia.
,Management focuses on addressing the underlying cause rather than suppressing the
heart rate. Persistent tachycardia may increase myocardial oxygen demand.
Question 3:
An ECG strip shows no discernible P waves, irregular QRS complexes, and a heart rate
of 100 bpm. What is the rhythm?
A. Sinus arrhythmia
B. Atrial fibrillation
C. Atrial flutter
D. Junctional rhythm
Answer: B. Atrial fibrillation
Rationale: Atrial fibrillation is characterized by absent P waves, an irregularly
irregular rhythm, and variable ventricular response. The atria fire chaotically, causing
inefficient atrial contraction and increasing the risk for thrombus formation. Ventricular
rate may remain normal or rapid. Treatment includes rate control, rhythm
management, and anticoagulation when indicated.
Question 4:
A client with sinus bradycardia (HR 45 bpm) is asymptomatic. What is the nurse’s
priority action?
A. Administer atropine
B. Monitor the client
C. Prepare for pacing
D. Notify the provider immediately
Answer: B. Monitor the client
Rationale: Asymptomatic sinus bradycardia often does not require immediate
intervention. Continuous monitoring is appropriate to ensure the heart rate remains
stable and no symptoms develop. Atropine or pacing is reserved for symptomatic
bradycardia (e.g., hypotension, dizziness, syncope). Nurses should also assess for
reversible causes, such as medications or electrolyte imbalances.
Question 5:
An ECG shows a regular rhythm with a rate of 75 bpm, P waves before each QRS, and
a PR interval of 0.24 seconds. What is the rhythm?
A. Sinus bradycardia
B. First-degree AV block
,C. Second-degree AV block Type I
D. Sinus tachycardia
Answer: B. First-degree AV block
Rationale: First-degree AV block is identified by a consistently prolonged PR interval
(>0.20 seconds) with a normal QRS and P waves preceding each QRS. The rhythm
remains regular, and every impulse is conducted from atria to ventricles. Usually, it is
asymptomatic and may be seen in patients on beta-blockers or with increased vagal
tone. Treatment often focuses on monitoring and addressing underlying causes.
Question 6:
An ECG strip shows grouped beating with progressively lengthening PR intervals until
a QRS is dropped. What is the rhythm?
A. Second-degree AV block Type I (Wenckebach)
B. Second-degree AV block Type II
C. Third-degree AV block
D. Junctional rhythm
Answer: A. Second-degree AV block Type I (Wenckebach)
Rationale: Type I second-degree AV block (Wenckebach) is identified by
progressively longer PR intervals until a QRS complex is skipped. The ventricular
rhythm appears irregular due to the dropped beat. It is often transient and may result
from increased vagal tone or medications. Monitoring is needed, and intervention is
required only if the patient is symptomatic.
Question 7:
An ECG shows regular P waves and QRS complexes, with some QRS complexes
unexpectedly absent without PR interval prolongation. What is the rhythm?
A. Second-degree AV block Type I
B. Second-degree AV block Type II
C. Third-degree AV block
D. Sinus arrest
Answer: B. Second-degree AV block Type II
Rationale: Type II second-degree AV block is characterized by intermittent non-
conducted P waves without PR prolongation. The QRS may be widened if the block
occurs below the bundle of His. This rhythm is more likely to progress to complete
heart block and often requires pacing. It can be life-threatening, so early recognition is
critical.
, Question 8:
An ECG strip shows no relationship between P waves and QRS complexes, with regular
ventricular rate. What is the rhythm?
A. Second-degree AV block Type II
B. Third-degree AV block (complete heart block)
C. Junctional rhythm
D. Atrial fibrillation
Answer: B. Third-degree AV block (complete heart block)
Rationale: Complete heart block occurs when atrial impulses do not conduct to the
ventricles, resulting in independent atrial and ventricular rhythms. P waves and QRS
complexes are regular but unrelated. This rhythm can cause bradycardia,
hypotension, and syncope. Management typically includes urgent pacing and
treatment of reversible causes.
Question 9:
A client’s ECG shows a heart rate of 180 bpm, regular rhythm, P waves not visible, and
narrow QRS complexes. What is the rhythm?
A. Sinus tachycardia
B. Supraventricular tachycardia (SVT)
C. Atrial fibrillation
D. Ventricular tachycardia
Answer: B. Supraventricular tachycardia (SVT)
Rationale: SVT is a rapid, regular rhythm originating above the ventricles, often with
a rate between 150–250 bpm. P waves may be hidden in preceding T waves due to the
rapid rate. QRS complexes are usually narrow (<0.12 seconds). It can cause
palpitations, dizziness, or hypotension. Management may include vagal maneuvers,
adenosine, or synchronized cardioversion if unstable.
Question 10:
An ECG shows sawtooth atrial waves at a rate of 300 bpm and a ventricular rate of 75
bpm. What is the rhythm?
A. Atrial fibrillation
B. Atrial flutter with 4:1 block
C. Supraventricular tachycardia
D. Ventricular tachycardia
Answer: B. Atrial flutter with 4:1 block
Rationale: Atrial flutter is characterized by rapid, regular atrial depolarizations
(LATEST 2026/2027 UPDATE), | 100%
CORRECT-GALEN COLLEGE OF NURSING
RELIAS DYSRHYTHMIA BASIC A TEST
Relias Dysrhythmia Basic A Test – 2026/2027 – Complete Questions
and Answers with Explanations
Question 1:
An ECG strip shows a regular rhythm with a heart rate of 48 bpm, P waves before each
QRS, and a PR interval of 0.16 seconds. What is the rhythm?
A. Sinus tachycardia
B. Sinus bradycardia
C. Atrial fibrillation
D. First-degree AV block
Answer: B. Sinus bradycardia
Rationale: A heart rate below 60 bpm with a regular rhythm, normal PR interval
(0.12–0.20 seconds), and P waves preceding each QRS indicates sinus bradycardia.
This rhythm originates from the SA node but fires slower than normal. It can be normal
in athletes or during sleep. Symptomatic bradycardia requires intervention, but
asymptomatic patients may only need monitoring.
Question 2:
A client’s ECG shows a heart rate of 120 bpm, regular rhythm, and P waves before
each QRS. What is the rhythm?
A. Sinus tachycardia
B. Supraventricular tachycardia
C. Atrial flutter
D. Ventricular tachycardia
Answer: A. Sinus tachycardia
Rationale: Sinus tachycardia is identified by a regular rhythm over 100 bpm with P
waves preceding each QRS and a normal PR interval. This rhythm is generated by the
SA node firing faster than usual, often due to stress, fever, pain, or hypovolemia.
,Management focuses on addressing the underlying cause rather than suppressing the
heart rate. Persistent tachycardia may increase myocardial oxygen demand.
Question 3:
An ECG strip shows no discernible P waves, irregular QRS complexes, and a heart rate
of 100 bpm. What is the rhythm?
A. Sinus arrhythmia
B. Atrial fibrillation
C. Atrial flutter
D. Junctional rhythm
Answer: B. Atrial fibrillation
Rationale: Atrial fibrillation is characterized by absent P waves, an irregularly
irregular rhythm, and variable ventricular response. The atria fire chaotically, causing
inefficient atrial contraction and increasing the risk for thrombus formation. Ventricular
rate may remain normal or rapid. Treatment includes rate control, rhythm
management, and anticoagulation when indicated.
Question 4:
A client with sinus bradycardia (HR 45 bpm) is asymptomatic. What is the nurse’s
priority action?
A. Administer atropine
B. Monitor the client
C. Prepare for pacing
D. Notify the provider immediately
Answer: B. Monitor the client
Rationale: Asymptomatic sinus bradycardia often does not require immediate
intervention. Continuous monitoring is appropriate to ensure the heart rate remains
stable and no symptoms develop. Atropine or pacing is reserved for symptomatic
bradycardia (e.g., hypotension, dizziness, syncope). Nurses should also assess for
reversible causes, such as medications or electrolyte imbalances.
Question 5:
An ECG shows a regular rhythm with a rate of 75 bpm, P waves before each QRS, and
a PR interval of 0.24 seconds. What is the rhythm?
A. Sinus bradycardia
B. First-degree AV block
,C. Second-degree AV block Type I
D. Sinus tachycardia
Answer: B. First-degree AV block
Rationale: First-degree AV block is identified by a consistently prolonged PR interval
(>0.20 seconds) with a normal QRS and P waves preceding each QRS. The rhythm
remains regular, and every impulse is conducted from atria to ventricles. Usually, it is
asymptomatic and may be seen in patients on beta-blockers or with increased vagal
tone. Treatment often focuses on monitoring and addressing underlying causes.
Question 6:
An ECG strip shows grouped beating with progressively lengthening PR intervals until
a QRS is dropped. What is the rhythm?
A. Second-degree AV block Type I (Wenckebach)
B. Second-degree AV block Type II
C. Third-degree AV block
D. Junctional rhythm
Answer: A. Second-degree AV block Type I (Wenckebach)
Rationale: Type I second-degree AV block (Wenckebach) is identified by
progressively longer PR intervals until a QRS complex is skipped. The ventricular
rhythm appears irregular due to the dropped beat. It is often transient and may result
from increased vagal tone or medications. Monitoring is needed, and intervention is
required only if the patient is symptomatic.
Question 7:
An ECG shows regular P waves and QRS complexes, with some QRS complexes
unexpectedly absent without PR interval prolongation. What is the rhythm?
A. Second-degree AV block Type I
B. Second-degree AV block Type II
C. Third-degree AV block
D. Sinus arrest
Answer: B. Second-degree AV block Type II
Rationale: Type II second-degree AV block is characterized by intermittent non-
conducted P waves without PR prolongation. The QRS may be widened if the block
occurs below the bundle of His. This rhythm is more likely to progress to complete
heart block and often requires pacing. It can be life-threatening, so early recognition is
critical.
, Question 8:
An ECG strip shows no relationship between P waves and QRS complexes, with regular
ventricular rate. What is the rhythm?
A. Second-degree AV block Type II
B. Third-degree AV block (complete heart block)
C. Junctional rhythm
D. Atrial fibrillation
Answer: B. Third-degree AV block (complete heart block)
Rationale: Complete heart block occurs when atrial impulses do not conduct to the
ventricles, resulting in independent atrial and ventricular rhythms. P waves and QRS
complexes are regular but unrelated. This rhythm can cause bradycardia,
hypotension, and syncope. Management typically includes urgent pacing and
treatment of reversible causes.
Question 9:
A client’s ECG shows a heart rate of 180 bpm, regular rhythm, P waves not visible, and
narrow QRS complexes. What is the rhythm?
A. Sinus tachycardia
B. Supraventricular tachycardia (SVT)
C. Atrial fibrillation
D. Ventricular tachycardia
Answer: B. Supraventricular tachycardia (SVT)
Rationale: SVT is a rapid, regular rhythm originating above the ventricles, often with
a rate between 150–250 bpm. P waves may be hidden in preceding T waves due to the
rapid rate. QRS complexes are usually narrow (<0.12 seconds). It can cause
palpitations, dizziness, or hypotension. Management may include vagal maneuvers,
adenosine, or synchronized cardioversion if unstable.
Question 10:
An ECG shows sawtooth atrial waves at a rate of 300 bpm and a ventricular rate of 75
bpm. What is the rhythm?
A. Atrial fibrillation
B. Atrial flutter with 4:1 block
C. Supraventricular tachycardia
D. Ventricular tachycardia
Answer: B. Atrial flutter with 4:1 block
Rationale: Atrial flutter is characterized by rapid, regular atrial depolarizations
