RELIAS DYSRHYTHMIA EXAM
QUESTIONS WITH CORRECT
ANSWERS
Q1.
A patient’s ECG shows an irregularly irregular rhythm, absence of P waves,
and a ventricular rate of 118 bpm. What is the most likely rhythm?
A. Atrial flutter
B. Atrial fibrillation
C. Supraventricular tachycardia
D. Junctional tachycardia
Correct Answer: B
Rationale: Atrial fibrillation is identified by an irregularly irregular rhythm
and lack of distinct P waves. The ventricular rate may be slow, controlled, or
rapid depending on AV node conduction. This rhythm increases the risk for
thromboembolism, making anticoagulation assessment critical.
Q2.
Which dysrhythmia requires immediate defibrillation if the patient is
unresponsive and pulseless?
A. Ventricular tachycardia with a pulse
,B. Asystole
C. Ventricular fibrillation
D. Sinus bradycardia
Correct Answer: C
Rationale: Ventricular fibrillation produces chaotic electrical activity with no
effective cardiac output. Immediate defibrillation is the priority intervention
to restore organized rhythm. CPR should be initiated while preparing the
defibrillator.
Q3.
An ECG shows a regular rhythm with sawtooth flutter waves and a
ventricular rate of 75 bpm. What rhythm is present?
A. Atrial fibrillation
B. Atrial flutter with controlled ventricular response
C. SVT
D. First-degree AV block
Correct Answer: B
Rationale: Atrial flutter is characterized by uniform flutter (F) waves that
resemble a sawtooth pattern. A controlled ventricular response occurs when
AV conduction limits ventricular rate. Management focuses on rate control,
rhythm control, and anticoagulation.
Q4.
Which medication is first-line for symptomatic sinus bradycardia?
A. Adenosine
B. Atropine
,C. Amiodarone
D. Lidocaine
Correct Answer: B
Rationale: Atropine blocks parasympathetic influence on the SA node,
increasing heart rate. It is the first-line treatment for symptomatic
bradycardia according to ACLS guidelines. If ineffective, pacing may be
required.
Q5.
A rhythm strip shows progressive PR interval prolongation followed by a
dropped QRS complex. What is the rhythm?
A. Second-degree AV block Type II
B. Third-degree AV block
C. Second-degree AV block Type I
D. First-degree AV block
Correct Answer: C
Rationale: Wenckebach (Mobitz I) demonstrates gradual PR lengthening
until a beat is dropped. It is often benign and related to AV nodal conduction
delay. Treatment is usually unnecessary unless symptomatic.
Q6.
Which rhythm is most commonly associated with digoxin toxicity?
A. Sinus tachycardia
B. Junctional rhythm
C. Atrial flutter
D. Ventricular fibrillation
, Correct Answer: B
Rationale: Digoxin suppresses SA node activity and enhances AV nodal
conduction delay, often resulting in junctional rhythms. Patients may present
with nausea, visual changes, and arrhythmias. Monitoring serum digoxin
levels is essential.
Q7.
A wide-complex tachycardia should be assumed to be which rhythm until
proven otherwise?
A. SVT with aberrancy
B. Ventricular tachycardia
C. Atrial fibrillation
D. Junctional tachycardia
Correct Answer: B
Rationale: Ventricular tachycardia is life-threatening and must be treated
aggressively. Misdiagnosing VT as SVT can delay life-saving interventions.
Clinically, VT is more common in patients with structural heart disease.
Q8.
What is the defining ECG feature of first-degree AV block?
A. Dropped QRS complexes
B. Shortened PR interval
C. Prolonged PR interval
D. Absent P waves
Correct Answer: C
QUESTIONS WITH CORRECT
ANSWERS
Q1.
A patient’s ECG shows an irregularly irregular rhythm, absence of P waves,
and a ventricular rate of 118 bpm. What is the most likely rhythm?
A. Atrial flutter
B. Atrial fibrillation
C. Supraventricular tachycardia
D. Junctional tachycardia
Correct Answer: B
Rationale: Atrial fibrillation is identified by an irregularly irregular rhythm
and lack of distinct P waves. The ventricular rate may be slow, controlled, or
rapid depending on AV node conduction. This rhythm increases the risk for
thromboembolism, making anticoagulation assessment critical.
Q2.
Which dysrhythmia requires immediate defibrillation if the patient is
unresponsive and pulseless?
A. Ventricular tachycardia with a pulse
,B. Asystole
C. Ventricular fibrillation
D. Sinus bradycardia
Correct Answer: C
Rationale: Ventricular fibrillation produces chaotic electrical activity with no
effective cardiac output. Immediate defibrillation is the priority intervention
to restore organized rhythm. CPR should be initiated while preparing the
defibrillator.
Q3.
An ECG shows a regular rhythm with sawtooth flutter waves and a
ventricular rate of 75 bpm. What rhythm is present?
A. Atrial fibrillation
B. Atrial flutter with controlled ventricular response
C. SVT
D. First-degree AV block
Correct Answer: B
Rationale: Atrial flutter is characterized by uniform flutter (F) waves that
resemble a sawtooth pattern. A controlled ventricular response occurs when
AV conduction limits ventricular rate. Management focuses on rate control,
rhythm control, and anticoagulation.
Q4.
Which medication is first-line for symptomatic sinus bradycardia?
A. Adenosine
B. Atropine
,C. Amiodarone
D. Lidocaine
Correct Answer: B
Rationale: Atropine blocks parasympathetic influence on the SA node,
increasing heart rate. It is the first-line treatment for symptomatic
bradycardia according to ACLS guidelines. If ineffective, pacing may be
required.
Q5.
A rhythm strip shows progressive PR interval prolongation followed by a
dropped QRS complex. What is the rhythm?
A. Second-degree AV block Type II
B. Third-degree AV block
C. Second-degree AV block Type I
D. First-degree AV block
Correct Answer: C
Rationale: Wenckebach (Mobitz I) demonstrates gradual PR lengthening
until a beat is dropped. It is often benign and related to AV nodal conduction
delay. Treatment is usually unnecessary unless symptomatic.
Q6.
Which rhythm is most commonly associated with digoxin toxicity?
A. Sinus tachycardia
B. Junctional rhythm
C. Atrial flutter
D. Ventricular fibrillation
, Correct Answer: B
Rationale: Digoxin suppresses SA node activity and enhances AV nodal
conduction delay, often resulting in junctional rhythms. Patients may present
with nausea, visual changes, and arrhythmias. Monitoring serum digoxin
levels is essential.
Q7.
A wide-complex tachycardia should be assumed to be which rhythm until
proven otherwise?
A. SVT with aberrancy
B. Ventricular tachycardia
C. Atrial fibrillation
D. Junctional tachycardia
Correct Answer: B
Rationale: Ventricular tachycardia is life-threatening and must be treated
aggressively. Misdiagnosing VT as SVT can delay life-saving interventions.
Clinically, VT is more common in patients with structural heart disease.
Q8.
What is the defining ECG feature of first-degree AV block?
A. Dropped QRS complexes
B. Shortened PR interval
C. Prolonged PR interval
D. Absent P waves
Correct Answer: C
