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Section 1 – Rhythm Identification & Analysis (Questions 1-25)
1. ECG Description: The rhythm strip shows a regular rhythm at a rate of 68 bpm.
Each QRS complex (0.08 s) is preceded by a normal, upright P wave with a
consistent PR interval of 0.16 s. No ectopic beats are present.
What is the correct rhythm interpretation?
A. Sinus bradycardia
B. Normal sinus rhythm
C. First-degree AV block
D. Sinus tachycardia
Correct Answer: B
Rationale: All criteria for normal sinus rhythm are met: regularity, rate 60-100,
normal P-QRS relationship, and consistent PR interval.
2. ECG Description: Regular rhythm at 48 bpm. P waves upright and consistent, PR
0.18 s, QRS 0.08 s.
Correct rhythm?
A. Normal sinus rhythm
B. Sinus bradycardia
C. Sinus arrest
D. First-degree block
Correct Answer: B
Rationale: Rate <60 with otherwise normal sinus characteristics indicates sinus
bradycardia.
3. ECG Description: Regular rhythm at 110 bpm. Normal P waves, PR 0.14 s, QRS
narrow.
Correct rhythm?
A. Sinus tachycardia
B. Atrial flutter
C. Ventricular tachycardia
, D. SVT
Correct Answer: A
Rationale: Gradual onset, rate 100-150, normal P-QRS morphology, and regularity
define sinus tachycardia.
4. ECG Description: Irregularly irregular rhythm, no distinct P waves, baseline fine
wavy, ventricular rate 88 bpm, narrow QRS.
Correct rhythm?
A. Atrial fibrillation
B. Sinus arrhythmia
C. Atrial flutter
D. Third-degree block
Correct Answer: A
Rationale: Irregularly irregular with absent P waves and narrow QRS is classic for
atrial fibrillation.
5. ECG Description: Regular at 150 bpm. Saw-tooth flutter waves best seen in lead
II; QRS narrow; 2:1 conduction.
Correct rhythm?
A. Atrial flutter
B. Sinus tachycardia
C. SVT
D. VT
Correct Answer: A
Rationale: Saw-tooth baseline with 2:1 conduction producing 150 bpm is typical
atrial flutter.
6. ECG Description: Regular sinus at 70 bpm. One premature wide bizarre QRS
(>0.12 s) occurs without preceding P wave; compensatory pause follows.
Correct interpretation?
A. PAC
B. PVC
C. Aberrancy
D. Junctional beat
Correct Answer: B
Rationale: Wide premature QRS without P wave and compensatory pause defines
a PVC.
7. ECG Description: Wide-complex tachycardia at 180 bpm; no P waves visible; QRS
0.16 s, regular.
Correct rhythm?
A. SVT with aberrancy
B. Ventricular tachycardia