Relias | Dysrhythmia Basic A
OBJECTIVE ASSESSMENT - EXAM
Relias Dysrhythmia Basic A
Test 55 Questions and Answers
(Basic A Dysrhythmia) || A+
GRADED
Certification Exam
55 100% 2026/2027
QUESTIONS VERIFIED ANSWERS EDITION
TOPICS COVERED
Cardiac Conduction System & Electrophysiology
ECG Waveform Interpretation & Measurement
Sinus, Atrial & Junctional Rhythm Identification
Ventricular Dysrhythmias & Lethal Arrhythmias
Heart Blocks & AV Conduction Disorders Pacemaker Function, Troubleshooting & ACLS Protocols
COVER PAGE - 1
Relias Dysrhythmia Basic A Test 55 Questions and Answers (Basic A Dysrhythmia) || A+ GRADED -- 2026/2027 | Passing Score: 80% | Page 1 of 46
, SECTION 1 | Cardiac Anatomy & Basic ECG Principles | Q1-Q11 | Relias Dysrhythmia Basic A Test 55 Questions and A
Q1 Question 1 of 55
Normal ECG Segment
P PR QRS T
Time (ms)
Q1. A 62-year-old patient is being monitored on a telemetry unit after an
uncomplicated myocardial infarction. The nurse is reviewing the ECG tracing and
notes that the PR interval measures 0.18 seconds.
A. The PR interval is prolonged and indicates first-degree AV block.
B. The PR interval is within normal limits and reflects normal atrioventricular conduction.
C. The PR interval is shortened and suggests pre-excitation syndrome.
D. The PR interval is variable and indicates an underlying junctional rhythm.
Correct Answer: B
Rationale:
A normal PR interval ranges from 0.12 to 0.20 seconds. A measurement of 0.18 seconds falls squarely
within this normal range, indicating intact AV nodal conduction. First-degree AV block would present with
a PR interval greater than 0.20 seconds, while pre-excitation syndromes typically demonstrate PR
intervals shorter than 0.12 seconds.
Relias Dysrhythmia Basic A Test 55 Questions and Answers (Basic A Dysrhythmia) || A+ GRADED -- 2026/2027 | Passing Score: 80% | Page 2 of 46
, SECTION 1 | Cardiac Anatomy & Basic ECG Principles | Q1-Q11 | Relias Dysrhythmia Basic A Test 55 Questions and A
Q2 Question 2 of 55
Q2. During a routine physical examination, a nurse practitioner explains to a
45-year-old patient how the electrical impulse travels through the heart. The patient
asks which structure acts as the natural pacemaker that initiates each heartbeat.
A. The atrioventricular node generates the primary electrical impulse for the ventricles.
B. The bundle of His serves as the dominant pacemaker by initiating atrial depolarization.
C. The sinoatrial node spontaneously depolarizes and sets the intrinsic heart rate at 60 to 100
beats per minute.
D. The Purkinje fibers regulate the heart rate by overriding slower pacemaker sites in the atria.
Correct Answer: C
Rationale:
The sinoatrial (SA) node is the heart's primary pacemaker, located in the right atrium near the superior
vena cava. It spontaneously depolarizes at an intrinsic rate of 60 to 100 beats per minute, establishing
the normal sinus rhythm. The AV node, bundle of His, and Purkinje fibers are secondary pacemakers
with slower intrinsic rates that serve as backup mechanisms.
Q3 Question 3 of 55
Q3. A telemetry technician is calibrating the ECG monitor for a 78-year-old patient
admitted with chest pain. The technician must ensure that each small square on the
standard ECG graph paper represents the correct time interval.
A. Each small square represents 0.04 seconds, and each large square represents 0.20 seconds.
B. Each small square represents 0.10 seconds, and each large square represents 0.50 seconds.
C. Each small square represents 0.02 seconds, and each large square represents 0.10 seconds.
D. Each small square represents 0.08 seconds, and each large square represents 0.40 seconds.
Correct Answer: A
Rationale:
Standard ECG graph paper runs at 25 millimeters per second. Each small square is 1 mm wide,
representing 0.04 seconds (40 milliseconds). Each large square, composed of five small squares,
represents 0.20 seconds (200 milliseconds). These standard measurements are essential for accurately
calculating heart rate and interval durations.
Relias Dysrhythmia Basic A Test 55 Questions and Answers (Basic A Dysrhythmia) || A+ GRADED -- 2026/2027 | Passing Score: 80% | Page 3 of 46
, SECTION 1 | Cardiac Anatomy & Basic ECG Principles | Q1-Q11 | Relias Dysrhythmia Basic A Test 55 Questions and A
Q4 Question 4 of 55
Q4. A critical care nurse is assessing the ECG of a 55-year-old patient recovering
from coronary artery bypass surgery. The nurse notes that the QRS complex duration
measures 0.14 seconds on the rhythm strip.
A. The QRS duration is normal and indicates normal ventricular depolarization through the
His-Purkinje system.
B. The QRS duration is prolonged and suggests delayed ventricular depolarization, possibly from
a bundle branch block.
C. The QRS duration is shortened and indicates accelerated conduction through accessory
pathways.
D. The QRS duration is variable and reflects normal respiratory variation in cardiac conduction.
Correct Answer: B
Rationale:
A normal QRS complex duration is 0.12 seconds or less. A measurement of 0.14 seconds indicates
prolonged ventricular depolarization, most commonly caused by a bundle branch block where one
ventricle depolarizes later than the other. This finding warrants further evaluation to determine whether a
right or left bundle branch block is present.
Q5 Question 5 of 55
Q5. An emergency department nurse is caring for a 34-year-old patient who presents
with palpitations. The physician asks the nurse to calculate the heart rate from a
six-second ECG rhythm strip that shows 11 QRS complexes.
A. Multiply 11 by 10 to estimate a heart rate of 110 beats per minute.
B. Multiply 11 by 6 to estimate a heart rate of 66 beats per minute.
C. Divide 300 by 11 to estimate a heart rate of approximately 27 beats per minute.
D. Divide 1500 by 11 to estimate a heart rate of approximately 136 beats per minute.
Correct Answer: A
Rationale:
The six-second method for estimating heart rate involves counting the number of QRS complexes within
a six-second strip and multiplying that number by 10. With 11 QRS complexes, the estimated heart rate is
110 beats per minute. This method is particularly useful for irregular rhythms where the large-box method
may be less accurate.
Relias Dysrhythmia Basic A Test 55 Questions and Answers (Basic A Dysrhythmia) || A+ GRADED -- 2026/2027 | Passing Score: 80% | Page 4 of 46
OBJECTIVE ASSESSMENT - EXAM
Relias Dysrhythmia Basic A
Test 55 Questions and Answers
(Basic A Dysrhythmia) || A+
GRADED
Certification Exam
55 100% 2026/2027
QUESTIONS VERIFIED ANSWERS EDITION
TOPICS COVERED
Cardiac Conduction System & Electrophysiology
ECG Waveform Interpretation & Measurement
Sinus, Atrial & Junctional Rhythm Identification
Ventricular Dysrhythmias & Lethal Arrhythmias
Heart Blocks & AV Conduction Disorders Pacemaker Function, Troubleshooting & ACLS Protocols
COVER PAGE - 1
Relias Dysrhythmia Basic A Test 55 Questions and Answers (Basic A Dysrhythmia) || A+ GRADED -- 2026/2027 | Passing Score: 80% | Page 1 of 46
, SECTION 1 | Cardiac Anatomy & Basic ECG Principles | Q1-Q11 | Relias Dysrhythmia Basic A Test 55 Questions and A
Q1 Question 1 of 55
Normal ECG Segment
P PR QRS T
Time (ms)
Q1. A 62-year-old patient is being monitored on a telemetry unit after an
uncomplicated myocardial infarction. The nurse is reviewing the ECG tracing and
notes that the PR interval measures 0.18 seconds.
A. The PR interval is prolonged and indicates first-degree AV block.
B. The PR interval is within normal limits and reflects normal atrioventricular conduction.
C. The PR interval is shortened and suggests pre-excitation syndrome.
D. The PR interval is variable and indicates an underlying junctional rhythm.
Correct Answer: B
Rationale:
A normal PR interval ranges from 0.12 to 0.20 seconds. A measurement of 0.18 seconds falls squarely
within this normal range, indicating intact AV nodal conduction. First-degree AV block would present with
a PR interval greater than 0.20 seconds, while pre-excitation syndromes typically demonstrate PR
intervals shorter than 0.12 seconds.
Relias Dysrhythmia Basic A Test 55 Questions and Answers (Basic A Dysrhythmia) || A+ GRADED -- 2026/2027 | Passing Score: 80% | Page 2 of 46
, SECTION 1 | Cardiac Anatomy & Basic ECG Principles | Q1-Q11 | Relias Dysrhythmia Basic A Test 55 Questions and A
Q2 Question 2 of 55
Q2. During a routine physical examination, a nurse practitioner explains to a
45-year-old patient how the electrical impulse travels through the heart. The patient
asks which structure acts as the natural pacemaker that initiates each heartbeat.
A. The atrioventricular node generates the primary electrical impulse for the ventricles.
B. The bundle of His serves as the dominant pacemaker by initiating atrial depolarization.
C. The sinoatrial node spontaneously depolarizes and sets the intrinsic heart rate at 60 to 100
beats per minute.
D. The Purkinje fibers regulate the heart rate by overriding slower pacemaker sites in the atria.
Correct Answer: C
Rationale:
The sinoatrial (SA) node is the heart's primary pacemaker, located in the right atrium near the superior
vena cava. It spontaneously depolarizes at an intrinsic rate of 60 to 100 beats per minute, establishing
the normal sinus rhythm. The AV node, bundle of His, and Purkinje fibers are secondary pacemakers
with slower intrinsic rates that serve as backup mechanisms.
Q3 Question 3 of 55
Q3. A telemetry technician is calibrating the ECG monitor for a 78-year-old patient
admitted with chest pain. The technician must ensure that each small square on the
standard ECG graph paper represents the correct time interval.
A. Each small square represents 0.04 seconds, and each large square represents 0.20 seconds.
B. Each small square represents 0.10 seconds, and each large square represents 0.50 seconds.
C. Each small square represents 0.02 seconds, and each large square represents 0.10 seconds.
D. Each small square represents 0.08 seconds, and each large square represents 0.40 seconds.
Correct Answer: A
Rationale:
Standard ECG graph paper runs at 25 millimeters per second. Each small square is 1 mm wide,
representing 0.04 seconds (40 milliseconds). Each large square, composed of five small squares,
represents 0.20 seconds (200 milliseconds). These standard measurements are essential for accurately
calculating heart rate and interval durations.
Relias Dysrhythmia Basic A Test 55 Questions and Answers (Basic A Dysrhythmia) || A+ GRADED -- 2026/2027 | Passing Score: 80% | Page 3 of 46
, SECTION 1 | Cardiac Anatomy & Basic ECG Principles | Q1-Q11 | Relias Dysrhythmia Basic A Test 55 Questions and A
Q4 Question 4 of 55
Q4. A critical care nurse is assessing the ECG of a 55-year-old patient recovering
from coronary artery bypass surgery. The nurse notes that the QRS complex duration
measures 0.14 seconds on the rhythm strip.
A. The QRS duration is normal and indicates normal ventricular depolarization through the
His-Purkinje system.
B. The QRS duration is prolonged and suggests delayed ventricular depolarization, possibly from
a bundle branch block.
C. The QRS duration is shortened and indicates accelerated conduction through accessory
pathways.
D. The QRS duration is variable and reflects normal respiratory variation in cardiac conduction.
Correct Answer: B
Rationale:
A normal QRS complex duration is 0.12 seconds or less. A measurement of 0.14 seconds indicates
prolonged ventricular depolarization, most commonly caused by a bundle branch block where one
ventricle depolarizes later than the other. This finding warrants further evaluation to determine whether a
right or left bundle branch block is present.
Q5 Question 5 of 55
Q5. An emergency department nurse is caring for a 34-year-old patient who presents
with palpitations. The physician asks the nurse to calculate the heart rate from a
six-second ECG rhythm strip that shows 11 QRS complexes.
A. Multiply 11 by 10 to estimate a heart rate of 110 beats per minute.
B. Multiply 11 by 6 to estimate a heart rate of 66 beats per minute.
C. Divide 300 by 11 to estimate a heart rate of approximately 27 beats per minute.
D. Divide 1500 by 11 to estimate a heart rate of approximately 136 beats per minute.
Correct Answer: A
Rationale:
The six-second method for estimating heart rate involves counting the number of QRS complexes within
a six-second strip and multiplying that number by 10. With 11 QRS complexes, the estimated heart rate is
110 beats per minute. This method is particularly useful for irregular rhythms where the large-box method
may be less accurate.
Relias Dysrhythmia Basic A Test 55 Questions and Answers (Basic A Dysrhythmia) || A+ GRADED -- 2026/2027 | Passing Score: 80% | Page 4 of 46
