RELIAS MEDICAL SURGICAL TELEMETRY EXAM 2026 COMPLETE QUESTIONS AND
CORRECT DETAILED ANSWERS WITH RATIONALES |GET IT 100% RIGHT| (VERIFIED
ANSWERS) |ALREADY GRADED A+
Question 1
A patient presents with a heart rate of 45 bpm and is experiencing dizziness and lightheadedness.
What is the most appropriate initial nursing intervention?
A) Prepare for immediate cardioversion
B) Administer a 500 mL bolus of Normal Saline
C) Assess the patient's blood pressure and clinical status
D) Call a Code Blue immediately
E) Administer 1 mg of Epinephrine IV push
Correct Answer: C) Assess the patient's blood pressure and clinical status
Rationale: Before initiating invasive interventions or medications, the nurse must determine
if the bradycardia is symptomatic and causing hemodynamic instability. Assessing blood
pressure, mentation, and skin signs helps guide the urgency of the next steps, such as
atropine administration or pacing.
Question 2
When monitoring a patient's telemetry, the nurse notes a wide QRS complex (greater than 0.12
seconds). What does this finding most likely indicate?
A) An atrial-driven rhythm
B) A delay in conduction through the AV node
C) A bundle branch block or ventricular origin of the beat
D) A normal finding in geriatric patients
E) Shortened ventricular depolarization
Correct Answer: C) A bundle branch block or ventricular origin of the beat
Rationale: A normal QRS complex is less than 0.12 seconds. Widening indicates that the
electrical impulse is taking a longer path through the ventricles, often due to a bundle
branch block or because the impulse originated in the ventricles (like a PVC or Ventricular
Tachycardia).
Question 3
Which of the following is a common complication associated with prolonged telemetry
monitoring?
A) Increased risk of localized seizure activity
B) Skin irritation or breakdown from electrode placement
C) Permanent changes in cardiac conductivity
D) Interference with internal cardiac pacemakers
E) Development of hospital-acquired pneumonia
Correct Answer: B) Skin irritation or breakdown from electrode placement
Rationale: Adhesives and conductive gels used in telemetry electrodes can cause skin
, 2
irritation, redness, or allergic dermatitis. Nurses should rotate lead sites and assess skin
integrity daily to prevent breakdown.
Question 4
A telemetry technician notices that a patient's heart rate suddenly increases from 70 bpm to 150
bpm. What should be the technician's or nurse's first action?
A) Document the rhythm as sinus tachycardia
B) Administer PRN Diltiazem
C) Assess the patient for symptoms and check lead placement
D) Immediately start chest compressions
E) Wait five minutes to see if the rhythm resolves
Correct Answer: C) Assess the patient for symptoms and check lead placement
Rationale: A sudden change in heart rate requires immediate bedside assessment to
determine if the patient is stable (hemodynamics) and to ensure the change is not due to
artifact or lead displacement.
Question 5
In telemetry monitoring, what does ST-segment elevation in two or more contiguous leads
typically indicate?
A) Electrolyte imbalance (hypokalemia)
B) Myocardial injury or acute infarction
C) A history of old myocardial scarring
D) Digitalis toxicity
E) Normal repolarization
Correct Answer: B) Myocardial injury or acute infarction
Rationale: ST-segment elevation is a hallmark sign of myocardial injury (STEMI). It
indicates that the heart muscle is currently being deprived of oxygen and undergoing
injury, requiring immediate intervention to restore blood flow.
Question 6
A patient in the telemetry unit develops a rhythm characterized by a rapid rate, no discernible P
waves, and wide, "tombstone" QRS complexes. What is the priority intervention?
A) Administer 1 mg of Atropine
B) Perform a carotid sinus massage
C) Check for a pulse and prepare for defibrillation if pulseless
D) Obtain a 12-lead EKG and wait for the doctor
E) Encourage the patient to cough vigorously
Correct Answer: C) Check for a pulse and prepare for defibrillation if pulseless
Rationale: The description fits Ventricular Tachycardia. The nurse must first check for a
pulse. If the patient is pulseless, ACLS protocols for V-Tach (defibrillation and CPR) must
begin immediately.
, 3
Question 7
What is the best position for a patient experiencing shortness of breath, orthopnea, and
tachycardia?
A) Trendelenburg position
B) Supine with legs elevated
C) High Fowler's position
D) Left lateral recumbent
E) Prone position
Correct Answer: C) High Fowler's position
Rationale: High Fowler's (90 degrees) allows for maximum chest expansion and reduces the
workload of breathing by using gravity to pull the diaphragm downward and reducing
venous return to an overworked heart.
Question 8
If a telemetry monitor displays a flat line (asystole), what should the nurse do first?
A) Start chest compressions immediately
B) Check the patient's leads and clinical status
C) Administer 1 mg of Epinephrine
D) Shock the patient at 200 Joules
E) Call the physician to pronounce death
Correct Answer: B) Check the patient's leads and clinical status
Rationale: "Check the patient, not the monitor." A flat line can be caused by a detached
lead or a powered-off transmitter. Always verify the patient's responsiveness and pulse
before starting resuscitative efforts.
Question 9
A patient has a history of chronic Atrial Fibrillation. Which class of medication is most
commonly prescribed to prevent the primary complication of this rhythm?
A) Beta-blockers
B) Calcium channel blockers
C) Anticoagulants
D) Loop diuretics
E) Nitrates
Correct Answer: C) Anticoagulants
Rationale: In Atrial Fibrillation, the atria quiver rather than contract, leading to blood
stasis in the atrial appendages. This creates a high risk for thrombus formation and
subsequent embolic stroke, necessitating anticoagulant therapy (e.g., Warfarin or
Apixaban).
Question 10
In telemetry monitoring, what does a sinus rhythm with a PR interval of 0.24 seconds suggest?
CORRECT DETAILED ANSWERS WITH RATIONALES |GET IT 100% RIGHT| (VERIFIED
ANSWERS) |ALREADY GRADED A+
Question 1
A patient presents with a heart rate of 45 bpm and is experiencing dizziness and lightheadedness.
What is the most appropriate initial nursing intervention?
A) Prepare for immediate cardioversion
B) Administer a 500 mL bolus of Normal Saline
C) Assess the patient's blood pressure and clinical status
D) Call a Code Blue immediately
E) Administer 1 mg of Epinephrine IV push
Correct Answer: C) Assess the patient's blood pressure and clinical status
Rationale: Before initiating invasive interventions or medications, the nurse must determine
if the bradycardia is symptomatic and causing hemodynamic instability. Assessing blood
pressure, mentation, and skin signs helps guide the urgency of the next steps, such as
atropine administration or pacing.
Question 2
When monitoring a patient's telemetry, the nurse notes a wide QRS complex (greater than 0.12
seconds). What does this finding most likely indicate?
A) An atrial-driven rhythm
B) A delay in conduction through the AV node
C) A bundle branch block or ventricular origin of the beat
D) A normal finding in geriatric patients
E) Shortened ventricular depolarization
Correct Answer: C) A bundle branch block or ventricular origin of the beat
Rationale: A normal QRS complex is less than 0.12 seconds. Widening indicates that the
electrical impulse is taking a longer path through the ventricles, often due to a bundle
branch block or because the impulse originated in the ventricles (like a PVC or Ventricular
Tachycardia).
Question 3
Which of the following is a common complication associated with prolonged telemetry
monitoring?
A) Increased risk of localized seizure activity
B) Skin irritation or breakdown from electrode placement
C) Permanent changes in cardiac conductivity
D) Interference with internal cardiac pacemakers
E) Development of hospital-acquired pneumonia
Correct Answer: B) Skin irritation or breakdown from electrode placement
Rationale: Adhesives and conductive gels used in telemetry electrodes can cause skin
, 2
irritation, redness, or allergic dermatitis. Nurses should rotate lead sites and assess skin
integrity daily to prevent breakdown.
Question 4
A telemetry technician notices that a patient's heart rate suddenly increases from 70 bpm to 150
bpm. What should be the technician's or nurse's first action?
A) Document the rhythm as sinus tachycardia
B) Administer PRN Diltiazem
C) Assess the patient for symptoms and check lead placement
D) Immediately start chest compressions
E) Wait five minutes to see if the rhythm resolves
Correct Answer: C) Assess the patient for symptoms and check lead placement
Rationale: A sudden change in heart rate requires immediate bedside assessment to
determine if the patient is stable (hemodynamics) and to ensure the change is not due to
artifact or lead displacement.
Question 5
In telemetry monitoring, what does ST-segment elevation in two or more contiguous leads
typically indicate?
A) Electrolyte imbalance (hypokalemia)
B) Myocardial injury or acute infarction
C) A history of old myocardial scarring
D) Digitalis toxicity
E) Normal repolarization
Correct Answer: B) Myocardial injury or acute infarction
Rationale: ST-segment elevation is a hallmark sign of myocardial injury (STEMI). It
indicates that the heart muscle is currently being deprived of oxygen and undergoing
injury, requiring immediate intervention to restore blood flow.
Question 6
A patient in the telemetry unit develops a rhythm characterized by a rapid rate, no discernible P
waves, and wide, "tombstone" QRS complexes. What is the priority intervention?
A) Administer 1 mg of Atropine
B) Perform a carotid sinus massage
C) Check for a pulse and prepare for defibrillation if pulseless
D) Obtain a 12-lead EKG and wait for the doctor
E) Encourage the patient to cough vigorously
Correct Answer: C) Check for a pulse and prepare for defibrillation if pulseless
Rationale: The description fits Ventricular Tachycardia. The nurse must first check for a
pulse. If the patient is pulseless, ACLS protocols for V-Tach (defibrillation and CPR) must
begin immediately.
, 3
Question 7
What is the best position for a patient experiencing shortness of breath, orthopnea, and
tachycardia?
A) Trendelenburg position
B) Supine with legs elevated
C) High Fowler's position
D) Left lateral recumbent
E) Prone position
Correct Answer: C) High Fowler's position
Rationale: High Fowler's (90 degrees) allows for maximum chest expansion and reduces the
workload of breathing by using gravity to pull the diaphragm downward and reducing
venous return to an overworked heart.
Question 8
If a telemetry monitor displays a flat line (asystole), what should the nurse do first?
A) Start chest compressions immediately
B) Check the patient's leads and clinical status
C) Administer 1 mg of Epinephrine
D) Shock the patient at 200 Joules
E) Call the physician to pronounce death
Correct Answer: B) Check the patient's leads and clinical status
Rationale: "Check the patient, not the monitor." A flat line can be caused by a detached
lead or a powered-off transmitter. Always verify the patient's responsiveness and pulse
before starting resuscitative efforts.
Question 9
A patient has a history of chronic Atrial Fibrillation. Which class of medication is most
commonly prescribed to prevent the primary complication of this rhythm?
A) Beta-blockers
B) Calcium channel blockers
C) Anticoagulants
D) Loop diuretics
E) Nitrates
Correct Answer: C) Anticoagulants
Rationale: In Atrial Fibrillation, the atria quiver rather than contract, leading to blood
stasis in the atrial appendages. This creates a high risk for thrombus formation and
subsequent embolic stroke, necessitating anticoagulant therapy (e.g., Warfarin or
Apixaban).
Question 10
In telemetry monitoring, what does a sinus rhythm with a PR interval of 0.24 seconds suggest?
