RELIAS DYSRHYTHMIA BASIC TEST -
COMPREHENSIVE EXAM 2026
QUESTIONS AND ANSWERS WITH
RATIONALES!!! ACTUAL
QUESTION 1
What is the cardiac rhythm characterized by a regular rhythm, rate of 60-100 bpm, normal P waves, and
a PR interval of 0.12-0.20 seconds?
A. Sinus tachycardia
B. Sinus bradycardia
C. Normal sinus rhythm
D. Atrial fibrillation
ANSWER: C. Normal sinus rhythm
Rationale: Normal sinus rhythm (NSR) is defined by a regular rhythm with a ventricular rate between 60-
100 beats per minute. Each QRS complex is preceded by a normal P wave (upright in lead II), the PR
interval is 0.12-0.20 seconds, and the QRS duration is less than 0.12 seconds. Option A is incorrect
because sinus tachycardia has a rate >100 bpm. Option B is incorrect because sinus bradycardia has a
rate <60 bpm. Option D is incorrect because atrial fibrillation has no discernible P waves and an
irregularly irregular rhythm.
QUESTION 2
,A patient presents with a heart rate of 150 bpm, regular rhythm, and normal P waves preceding each
QRS complex. What is the most likely cardiac rhythm?
A. Normal sinus rhythm
B. Sinus tachycardia
C. Atrial flutter
D. Supraventricular tachycardia
ANSWER: B. Sinus tachycardia
Rationale: Sinus tachycardia is characterized by a heart rate greater than 100 bpm (typically 100-160
bpm) with a regular rhythm. The P waves are normal in morphology and precede each QRS complex.
Option A is incorrect because the rate exceeds 100 bpm. Option C is incorrect because atrial flutter
typically presents with a saw-tooth pattern of flutter waves. Option D is incorrect because SVT typically
has a rate of 150-250 bpm and P waves may be difficult to identify or absent.
QUESTION 3
What cardiac rhythm shows a regular rhythm with a rate of 42 bpm, normal P waves, and a PR interval
of 0.16 seconds?
A. Sinus tachycardia
B. Normal sinus rhythm
C. Sinus bradycardia
D. Junctional rhythm
ANSWER: C. Sinus bradycardia
Rationale: Sinus bradycardia is defined as a sinus rhythm with a rate less than 60 bpm. The rhythm is
regular, P waves are normal and precede each QRS, and the PR interval is within normal limits (0.12-0.20
seconds). Option A is incorrect because the rate is below 60 bpm. Option B is incorrect because normal
sinus rhythm requires a rate of 60-100 bpm. Option D is incorrect because junctional rhythm typically
has inverted or absent P waves.
,QUESTION 4
A patient's ECG shows an irregularly irregular rhythm with no discernible P waves and a ventricular rate
of 110 bpm. What is the rhythm?
A. Sinus tachycardia
B. Atrial flutter
C. Atrial fibrillation
D. Multifocal atrial tachycardia
ANSWER: C. Atrial fibrillation
Rationale: Atrial fibrillation is characterized by an irregularly irregular rhythm, absence of distinct P
waves, and presence of fibrillatory (f) waves. The ventricular response can be rapid, controlled, or slow.
Option A is incorrect because sinus tachycardia has regular rhythm and P waves. Option B is incorrect
because atrial flutter typically has a regular or regularly irregular rhythm with flutter waves. Option D is
incorrect because MAT has multiple P wave morphologies and is irregular but with identifiable P waves.
QUESTION 5
What rhythm is characterized by a regular rhythm, rate of 300 bpm at the atrial level with a 2:1
conduction resulting in a ventricular rate of 150 bpm, and saw-toothed flutter waves?
A. Atrial fibrillation
B. Atrial flutter
C. Supraventricular tachycardia
D. Ventricular tachycardia
ANSWER: B. Atrial flutter
Rationale: Atrial flutter is characterized by regular flutter (F) waves with a saw-tooth appearance,
typically at a rate of 250-350 bpm. With 2:1 conduction, the ventricular rate is approximately 150 bpm.
Option A is incorrect because atrial fibrillation has no discernible P waves and is irregularly irregular.
, Option C is incorrect because SVT typically has a rate of 150-250 bpm without flutter waves. Option D is
incorrect because ventricular tachycardia originates from the ventricles with wide QRS complexes.
QUESTION 6
What is the cardiac rhythm when the ECG shows a prolonged PR interval >0.20 seconds with a regular
rhythm and rate of 68 bpm?
A. First-degree AV block
B. Second-degree AV block Type I
C. Second-degree AV block Type II
D. Third-degree AV block
ANSWER: A. First-degree AV block
Rationale: First-degree AV block is characterized by a prolonged PR interval (>0.20 seconds) with a
regular rhythm. Every P wave is followed by a QRS complex. The rate can be normal, slow, or fast
depending on the underlying sinus rhythm. Option B is incorrect because Type I block shows progressive
PR prolongation. Option C is incorrect because Type II block shows intermittent non-conducted P waves.
Option D is incorrect because third-degree block shows no relationship between P waves and QRS
complexes.
QUESTION 7
A patient's ECG demonstrates progressive prolongation of the PR interval until a QRS complex is
dropped, then the pattern repeats. What is this rhythm?
A. First-degree AV block
B. Second-degree AV block Type I (Mobitz I/Wenckebach)
C. Second-degree AV block Type II (Mobitz II)
D. Third-degree AV block
ANSWER: B. Second-degree AV block Type I (Mobitz I/Wenckebach)
COMPREHENSIVE EXAM 2026
QUESTIONS AND ANSWERS WITH
RATIONALES!!! ACTUAL
QUESTION 1
What is the cardiac rhythm characterized by a regular rhythm, rate of 60-100 bpm, normal P waves, and
a PR interval of 0.12-0.20 seconds?
A. Sinus tachycardia
B. Sinus bradycardia
C. Normal sinus rhythm
D. Atrial fibrillation
ANSWER: C. Normal sinus rhythm
Rationale: Normal sinus rhythm (NSR) is defined by a regular rhythm with a ventricular rate between 60-
100 beats per minute. Each QRS complex is preceded by a normal P wave (upright in lead II), the PR
interval is 0.12-0.20 seconds, and the QRS duration is less than 0.12 seconds. Option A is incorrect
because sinus tachycardia has a rate >100 bpm. Option B is incorrect because sinus bradycardia has a
rate <60 bpm. Option D is incorrect because atrial fibrillation has no discernible P waves and an
irregularly irregular rhythm.
QUESTION 2
,A patient presents with a heart rate of 150 bpm, regular rhythm, and normal P waves preceding each
QRS complex. What is the most likely cardiac rhythm?
A. Normal sinus rhythm
B. Sinus tachycardia
C. Atrial flutter
D. Supraventricular tachycardia
ANSWER: B. Sinus tachycardia
Rationale: Sinus tachycardia is characterized by a heart rate greater than 100 bpm (typically 100-160
bpm) with a regular rhythm. The P waves are normal in morphology and precede each QRS complex.
Option A is incorrect because the rate exceeds 100 bpm. Option C is incorrect because atrial flutter
typically presents with a saw-tooth pattern of flutter waves. Option D is incorrect because SVT typically
has a rate of 150-250 bpm and P waves may be difficult to identify or absent.
QUESTION 3
What cardiac rhythm shows a regular rhythm with a rate of 42 bpm, normal P waves, and a PR interval
of 0.16 seconds?
A. Sinus tachycardia
B. Normal sinus rhythm
C. Sinus bradycardia
D. Junctional rhythm
ANSWER: C. Sinus bradycardia
Rationale: Sinus bradycardia is defined as a sinus rhythm with a rate less than 60 bpm. The rhythm is
regular, P waves are normal and precede each QRS, and the PR interval is within normal limits (0.12-0.20
seconds). Option A is incorrect because the rate is below 60 bpm. Option B is incorrect because normal
sinus rhythm requires a rate of 60-100 bpm. Option D is incorrect because junctional rhythm typically
has inverted or absent P waves.
,QUESTION 4
A patient's ECG shows an irregularly irregular rhythm with no discernible P waves and a ventricular rate
of 110 bpm. What is the rhythm?
A. Sinus tachycardia
B. Atrial flutter
C. Atrial fibrillation
D. Multifocal atrial tachycardia
ANSWER: C. Atrial fibrillation
Rationale: Atrial fibrillation is characterized by an irregularly irregular rhythm, absence of distinct P
waves, and presence of fibrillatory (f) waves. The ventricular response can be rapid, controlled, or slow.
Option A is incorrect because sinus tachycardia has regular rhythm and P waves. Option B is incorrect
because atrial flutter typically has a regular or regularly irregular rhythm with flutter waves. Option D is
incorrect because MAT has multiple P wave morphologies and is irregular but with identifiable P waves.
QUESTION 5
What rhythm is characterized by a regular rhythm, rate of 300 bpm at the atrial level with a 2:1
conduction resulting in a ventricular rate of 150 bpm, and saw-toothed flutter waves?
A. Atrial fibrillation
B. Atrial flutter
C. Supraventricular tachycardia
D. Ventricular tachycardia
ANSWER: B. Atrial flutter
Rationale: Atrial flutter is characterized by regular flutter (F) waves with a saw-tooth appearance,
typically at a rate of 250-350 bpm. With 2:1 conduction, the ventricular rate is approximately 150 bpm.
Option A is incorrect because atrial fibrillation has no discernible P waves and is irregularly irregular.
, Option C is incorrect because SVT typically has a rate of 150-250 bpm without flutter waves. Option D is
incorrect because ventricular tachycardia originates from the ventricles with wide QRS complexes.
QUESTION 6
What is the cardiac rhythm when the ECG shows a prolonged PR interval >0.20 seconds with a regular
rhythm and rate of 68 bpm?
A. First-degree AV block
B. Second-degree AV block Type I
C. Second-degree AV block Type II
D. Third-degree AV block
ANSWER: A. First-degree AV block
Rationale: First-degree AV block is characterized by a prolonged PR interval (>0.20 seconds) with a
regular rhythm. Every P wave is followed by a QRS complex. The rate can be normal, slow, or fast
depending on the underlying sinus rhythm. Option B is incorrect because Type I block shows progressive
PR prolongation. Option C is incorrect because Type II block shows intermittent non-conducted P waves.
Option D is incorrect because third-degree block shows no relationship between P waves and QRS
complexes.
QUESTION 7
A patient's ECG demonstrates progressive prolongation of the PR interval until a QRS complex is
dropped, then the pattern repeats. What is this rhythm?
A. First-degree AV block
B. Second-degree AV block Type I (Mobitz I/Wenckebach)
C. Second-degree AV block Type II (Mobitz II)
D. Third-degree AV block
ANSWER: B. Second-degree AV block Type I (Mobitz I/Wenckebach)
