Relias Dysrhythmia Basic A Assessment Actual Exam
2026/2027 – Comprehensive Test with Detailed Rationales |
100% Verified | Pass Guaranteed – A+ Graded
Section 1: Normal Sinus Rhythm & Sinus Arrhythmias (8 Questions)
Q1: A 62-year-old patient is on telemetry after elective knee replacement. The monitor
shows a regular rhythm with a rate of 72 bpm, upright P waves preceding each QRS
complex, a PR interval of 0.16 seconds, and narrow QRS complexes. What is the correct
interpretation?
A. Sinus bradycardia with first-degree AV block
B. Sinus tachycardia with normal conduction
C. Normal sinus rhythm [CORRECT]
D. Junctional escape rhythm with retrograde conduction
Correct Answer: C
Rationale: This strip demonstrates all criteria for normal sinus rhythm: regular rhythm,
rate 60-100 bpm, upright P waves before each QRS, PR interval 0.12-0.20 seconds, and
narrow QRS complexes. Option A is incorrect because the rate is not <60 bpm and the
PR interval is normal. Option B is incorrect because the rate is not >100 bpm. Option D
is incorrect because junctional rhythms do not have upright P waves preceding the QRS.
Q2: During morning rounds, you notice a 45-year-old marathon runner's telemetry shows
a heart rate of 52 bpm. The rhythm is regular with normal P waves, PR interval of 0.14
seconds, and narrow QRS complexes. The patient is asymptomatic and blood pressure
is 118/72 mmHg. What is the most appropriate action?
,A. Prepare for transcutaneous pacing immediately
B. Administer atropine 1 mg IV push
C. Continue monitoring; this is sinus bradycardia in a well-conditioned athlete
[CORRECT]
D. Call the rapid response team for symptomatic bradycardia
Correct Answer: C
Rationale: This is sinus bradycardia (rate <60 bpm with normal sinus characteristics) in
an asymptomatic, well-conditioned athlete, which is a normal physiological adaptation.
No intervention is needed. Option A is incorrect because pacing is reserved for
symptomatic or unstable bradycardia. Option B is incorrect because atropine is not
indicated for asymptomatic sinus bradycardia. Option D is incorrect because the patient
shows no signs of instability.
Q3: A telemetry strip shows a rhythm with a rate of 110 bpm, regular R-R intervals,
upright P waves before each QRS, PR interval of 0.18 seconds, and narrow QRS
complexes. The patient reports mild anxiety and has a temperature of 38.2°C (100.8°F).
What rhythm is present?
A. Atrial flutter with 2:1 conduction
B. Sinus tachycardia [CORRECT]
C. Supraventricular tachycardia (SVT)
D. Junctional tachycardia
Correct Answer: B
Rationale: This is sinus tachycardia, evidenced by a rate >100 bpm with preserved
normal sinus P waves, normal PR interval, and narrow QRS complexes. The elevated
temperature explains the appropriate physiological response. Option A is incorrect
because there are no flutter waves. Option C is incorrect because SVT typically has
, absent or abnormal P waves and rates usually >150 bpm. Option D is incorrect because
junctional rhythms do not have upright sinus P waves.
Q4: You are reviewing a rhythm strip from a patient with sleep apnea. The strip shows a
heart rate that gradually increases from 62 bpm to 88 bpm during inspiration and
decreases back to 62 bpm during expiration. P waves are present and normal, PR
interval is constant at 0.16 seconds, and QRS complexes are narrow. What is this
rhythm?
A. Sinus arrhythmia [CORRECT]
B. Wandering atrial pacemaker
C. Sinus tachycardia with PACs
D. First-degree AV block with rate variation
Correct Answer: A
Rationale: Sinus arrhythmia is characterized by phasic variation in heart rate with
respiration (inspiration increases rate, expiration decreases rate) while maintaining
normal sinus P waves, constant PR interval, and narrow QRS complexes. Option B is
incorrect because wandering atrial pacemaker shows changing P wave morphologies.
Option C is incorrect because there are no premature beats. Option D is incorrect
because the PR interval is normal and constant.
Q5: A 78-year-old patient on telemetry has a rhythm strip showing a rate of 48 bpm. The
rhythm is regular with normal upright P waves, PR interval of 0.20 seconds, and narrow
QRS complexes. The patient reports dizziness when standing and blood pressure is
94/58 mmHg. What is the priority nursing intervention?
A. Administer adenosine 6 mg rapid IV push
B. Apply transcutaneous pacing pads and prepare for pacing [CORRECT]
C. Increase the telemetry alarm limits to avoid false alarms
2026/2027 – Comprehensive Test with Detailed Rationales |
100% Verified | Pass Guaranteed – A+ Graded
Section 1: Normal Sinus Rhythm & Sinus Arrhythmias (8 Questions)
Q1: A 62-year-old patient is on telemetry after elective knee replacement. The monitor
shows a regular rhythm with a rate of 72 bpm, upright P waves preceding each QRS
complex, a PR interval of 0.16 seconds, and narrow QRS complexes. What is the correct
interpretation?
A. Sinus bradycardia with first-degree AV block
B. Sinus tachycardia with normal conduction
C. Normal sinus rhythm [CORRECT]
D. Junctional escape rhythm with retrograde conduction
Correct Answer: C
Rationale: This strip demonstrates all criteria for normal sinus rhythm: regular rhythm,
rate 60-100 bpm, upright P waves before each QRS, PR interval 0.12-0.20 seconds, and
narrow QRS complexes. Option A is incorrect because the rate is not <60 bpm and the
PR interval is normal. Option B is incorrect because the rate is not >100 bpm. Option D
is incorrect because junctional rhythms do not have upright P waves preceding the QRS.
Q2: During morning rounds, you notice a 45-year-old marathon runner's telemetry shows
a heart rate of 52 bpm. The rhythm is regular with normal P waves, PR interval of 0.14
seconds, and narrow QRS complexes. The patient is asymptomatic and blood pressure
is 118/72 mmHg. What is the most appropriate action?
,A. Prepare for transcutaneous pacing immediately
B. Administer atropine 1 mg IV push
C. Continue monitoring; this is sinus bradycardia in a well-conditioned athlete
[CORRECT]
D. Call the rapid response team for symptomatic bradycardia
Correct Answer: C
Rationale: This is sinus bradycardia (rate <60 bpm with normal sinus characteristics) in
an asymptomatic, well-conditioned athlete, which is a normal physiological adaptation.
No intervention is needed. Option A is incorrect because pacing is reserved for
symptomatic or unstable bradycardia. Option B is incorrect because atropine is not
indicated for asymptomatic sinus bradycardia. Option D is incorrect because the patient
shows no signs of instability.
Q3: A telemetry strip shows a rhythm with a rate of 110 bpm, regular R-R intervals,
upright P waves before each QRS, PR interval of 0.18 seconds, and narrow QRS
complexes. The patient reports mild anxiety and has a temperature of 38.2°C (100.8°F).
What rhythm is present?
A. Atrial flutter with 2:1 conduction
B. Sinus tachycardia [CORRECT]
C. Supraventricular tachycardia (SVT)
D. Junctional tachycardia
Correct Answer: B
Rationale: This is sinus tachycardia, evidenced by a rate >100 bpm with preserved
normal sinus P waves, normal PR interval, and narrow QRS complexes. The elevated
temperature explains the appropriate physiological response. Option A is incorrect
because there are no flutter waves. Option C is incorrect because SVT typically has
, absent or abnormal P waves and rates usually >150 bpm. Option D is incorrect because
junctional rhythms do not have upright sinus P waves.
Q4: You are reviewing a rhythm strip from a patient with sleep apnea. The strip shows a
heart rate that gradually increases from 62 bpm to 88 bpm during inspiration and
decreases back to 62 bpm during expiration. P waves are present and normal, PR
interval is constant at 0.16 seconds, and QRS complexes are narrow. What is this
rhythm?
A. Sinus arrhythmia [CORRECT]
B. Wandering atrial pacemaker
C. Sinus tachycardia with PACs
D. First-degree AV block with rate variation
Correct Answer: A
Rationale: Sinus arrhythmia is characterized by phasic variation in heart rate with
respiration (inspiration increases rate, expiration decreases rate) while maintaining
normal sinus P waves, constant PR interval, and narrow QRS complexes. Option B is
incorrect because wandering atrial pacemaker shows changing P wave morphologies.
Option C is incorrect because there are no premature beats. Option D is incorrect
because the PR interval is normal and constant.
Q5: A 78-year-old patient on telemetry has a rhythm strip showing a rate of 48 bpm. The
rhythm is regular with normal upright P waves, PR interval of 0.20 seconds, and narrow
QRS complexes. The patient reports dizziness when standing and blood pressure is
94/58 mmHg. What is the priority nursing intervention?
A. Administer adenosine 6 mg rapid IV push
B. Apply transcutaneous pacing pads and prepare for pacing [CORRECT]
C. Increase the telemetry alarm limits to avoid false alarms
