2026/2027
Comprehensive Study Guide for
Relias Dysrhythmias Exam B New
2026/2027: Complete Test Bank,
Practice Questions, and Detailed
Review Notes
Question 1
A patient presents with a heart rate of 45 bpm and reports dizziness. What is the most
appropriate initial nursing intervention?
A. Administer atropine immediately
B. Prepare for cardioversion
C. Assess the patient’s blood pressure
D. Encourage ambulation
Correct Answer: C. Assess the patient’s blood pressure
Rationale: The first priority is to determine hemodynamic stability. A low heart rate
with dizziness may indicate decreased cardiac output, so assessing blood pressure
helps determine whether the patient is stable or in shock. Immediate medications or
procedures are premature without full assessment. Ambulation would worsen
symptoms.
Question 2
On telemetry monitoring, a wide QRS complex most commonly indicates:
A. Normal sinus rhythm
B. Atrial flutter
C. Bundle branch block or ventricular rhythm
D. Sinus tachycardia
Correct Answer: C. Bundle branch block or ventricular rhythm
Rationale: A widened QRS complex indicates delayed ventricular conduction, often
due to bundle branch blocks or ventricular-origin rhythms. These conditions may be
serious and require close monitoring. Normal sinus rhythm and atrial rhythms
typically have narrow QRS complexes.
,2026/2027
Question 3
Which complication is most commonly associated with prolonged telemetry electrode
use?
A. Myocardial infarction
B. Skin irritation or breakdown
C. Stroke
D. Hypertension
Correct Answer: B. Skin irritation or breakdown
Rationale: Adhesive electrodes can irritate the skin, especially with prolonged use or
sensitive skin. This is a local complication and not systemic. The other options are
unrelated to electrode placement.
Question 4
A telemetry patient’s heart rate suddenly increases from 70 bpm to 150 bpm. What is
the nurse’s first action?
A. Apply oxygen
B. Start CPR
C. Notify the nurse/physician immediately
D. Remove electrodes
Correct Answer: C. Notify the nurse/physician immediately
Rationale: A sudden tachycardia may indicate an arrhythmia requiring urgent
evaluation. Immediate reporting ensures rapid assessment and intervention. Oxygen
or CPR is not indicated without confirming instability.
Question 5
ST-segment elevation on ECG most strongly indicates:
A. Electrolyte imbalance
B. Myocardial injury or infarction
C. Normal variant
D. Dehydration
Correct Answer: B. Myocardial injury or infarction
Rationale: ST elevation is a classic sign of acute myocardial injury, often indicating
STEMI. It requires urgent medical intervention. It is not a normal finding.
, 2026/2027
Question 6
Which rhythm requires immediate nursing intervention?
A. Sinus bradycardia
B. Ventricular tachycardia
C. Sinus rhythm
D. Atrial rhythm
Correct Answer: B. Ventricular tachycardia
Rationale: Ventricular tachycardia is a life-threatening arrhythmia that can rapidly
deteriorate into ventricular fibrillation and cardiac arrest, requiring immediate
treatment.
Question 7
A patient experiencing shortness of breath and tachycardia should be positioned in:
A. Supine position
B. Prone position
C. High Fowler’s position
D. Trendelenburg position
Correct Answer: C. High Fowler’s position
Rationale: High Fowler’s improves lung expansion and oxygenation, reducing
respiratory distress and cardiac workload.
Question 8
A telemetry monitor displays a flat line. The nurse’s first action should be:
A. Begin CPR immediately
B. Check leads and connections
C. Call family
D. Document death
Correct Answer: B. Check leads and connections
Rationale: A flat line may be due to equipment disconnection or artifact. The first step
is to ensure proper lead placement before assuming cardiac arrest.
Question 9
A patient with atrial fibrillation is most commonly prescribed:
Comprehensive Study Guide for
Relias Dysrhythmias Exam B New
2026/2027: Complete Test Bank,
Practice Questions, and Detailed
Review Notes
Question 1
A patient presents with a heart rate of 45 bpm and reports dizziness. What is the most
appropriate initial nursing intervention?
A. Administer atropine immediately
B. Prepare for cardioversion
C. Assess the patient’s blood pressure
D. Encourage ambulation
Correct Answer: C. Assess the patient’s blood pressure
Rationale: The first priority is to determine hemodynamic stability. A low heart rate
with dizziness may indicate decreased cardiac output, so assessing blood pressure
helps determine whether the patient is stable or in shock. Immediate medications or
procedures are premature without full assessment. Ambulation would worsen
symptoms.
Question 2
On telemetry monitoring, a wide QRS complex most commonly indicates:
A. Normal sinus rhythm
B. Atrial flutter
C. Bundle branch block or ventricular rhythm
D. Sinus tachycardia
Correct Answer: C. Bundle branch block or ventricular rhythm
Rationale: A widened QRS complex indicates delayed ventricular conduction, often
due to bundle branch blocks or ventricular-origin rhythms. These conditions may be
serious and require close monitoring. Normal sinus rhythm and atrial rhythms
typically have narrow QRS complexes.
,2026/2027
Question 3
Which complication is most commonly associated with prolonged telemetry electrode
use?
A. Myocardial infarction
B. Skin irritation or breakdown
C. Stroke
D. Hypertension
Correct Answer: B. Skin irritation or breakdown
Rationale: Adhesive electrodes can irritate the skin, especially with prolonged use or
sensitive skin. This is a local complication and not systemic. The other options are
unrelated to electrode placement.
Question 4
A telemetry patient’s heart rate suddenly increases from 70 bpm to 150 bpm. What is
the nurse’s first action?
A. Apply oxygen
B. Start CPR
C. Notify the nurse/physician immediately
D. Remove electrodes
Correct Answer: C. Notify the nurse/physician immediately
Rationale: A sudden tachycardia may indicate an arrhythmia requiring urgent
evaluation. Immediate reporting ensures rapid assessment and intervention. Oxygen
or CPR is not indicated without confirming instability.
Question 5
ST-segment elevation on ECG most strongly indicates:
A. Electrolyte imbalance
B. Myocardial injury or infarction
C. Normal variant
D. Dehydration
Correct Answer: B. Myocardial injury or infarction
Rationale: ST elevation is a classic sign of acute myocardial injury, often indicating
STEMI. It requires urgent medical intervention. It is not a normal finding.
, 2026/2027
Question 6
Which rhythm requires immediate nursing intervention?
A. Sinus bradycardia
B. Ventricular tachycardia
C. Sinus rhythm
D. Atrial rhythm
Correct Answer: B. Ventricular tachycardia
Rationale: Ventricular tachycardia is a life-threatening arrhythmia that can rapidly
deteriorate into ventricular fibrillation and cardiac arrest, requiring immediate
treatment.
Question 7
A patient experiencing shortness of breath and tachycardia should be positioned in:
A. Supine position
B. Prone position
C. High Fowler’s position
D. Trendelenburg position
Correct Answer: C. High Fowler’s position
Rationale: High Fowler’s improves lung expansion and oxygenation, reducing
respiratory distress and cardiac workload.
Question 8
A telemetry monitor displays a flat line. The nurse’s first action should be:
A. Begin CPR immediately
B. Check leads and connections
C. Call family
D. Document death
Correct Answer: B. Check leads and connections
Rationale: A flat line may be due to equipment disconnection or artifact. The first step
is to ensure proper lead placement before assuming cardiac arrest.
Question 9
A patient with atrial fibrillation is most commonly prescribed:
