RELIAS DYSRHYTHMIA BASIC TEST EXAM
2026 Comprehensive Study Guide – 200 Practice
Questions with Answers & Rationales
⚠️ IMPORTANT DISCLAIMER
> This study guide contains original practice questions designed to help you prepare for the
Relias Dysrhythmia Basic Test by covering the same core content areas tested on the actual
exam. The actual Relias exam questions are proprietary content owned by Relias Learning.
This guide is for educational purposes only.
EXAM OVERVIEW
| Component | Details |
|--||
| Exam Name | Relias Dysrhythmia Basic Test (Versions A & B) |
| Format | 35 multiple-choice questions (per version) |
| Time Limit | Typically 60 minutes |
| Content Areas | ECG fundamentals, sinus rhythms, atrial dysrhythmias, junctional rhythms,
heart blocks, ventricular rhythms, pacemaker rhythms, lethal rhythms, clinical interventions |
| Passing Score | Varies by facility (typically 80%) |
| Target Audience | Nurses, telemetry technicians, healthcare professionals |
SECTION 1: CARDIAC CONDUCTION SYSTEM & ECG FUNDAMENTALS
Q1. The electrical impulse normally originates from which structure of the heart?
A) AV node
B) Bundle of His
C) SA node
D) Purkinje fibers
Correct Answer: C
,Rationale: The sinoatrial (SA) node is the primary pacemaker of the heart, located in the right
atrium near the superior vena cava. It normally initiates impulses at a rate of 60 to 100 beats per
minute.
Q2. What is the normal intrinsic firing rate of the SA node?
A) 20-40 bpm
B) 40-60 bpm
C) 60-100 bpm
D) 100-150 bpm
Correct Answer: C
Rationale: The SA node normally fires at 60-100 beats per minute. If the SA node fails, the AV
node (40-60 bpm) or Purkinje fibers (20-40 bpm) may take over as the pacemaker.
Q3. What is the normal intrinsic firing rate of the AV node?
A) 20-40 bpm
B) 40-60 bpm
C) 60-100 bpm
D) 100-150 bpm
Correct Answer: B
Rationale: The AV node has an intrinsic firing rate of 40-60 beats per minute. It serves as a
secondary pacemaker when the SA node fails.
Q4. What is the normal intrinsic firing rate of the Purkinje fibers?
A) 20-40 bpm
B) 40-60 bpm
C) 60-100 bpm
D) 100-150 bpm
Correct Answer: A
,Rationale: The Purkinje fibers have an intrinsic firing rate of 20-40 beats per minute. They serve
as a tertiary pacemaker when both the SA and AV nodes fail.
Q5. Which of the following is the correct sequence of the cardiac conduction system?
A) SA node → AV node → Bundle of His → Bundle branches → Purkinje fibers
B) AV node → SA node → Bundle of His → Purkinje fibers → Bundle branches
C) Purkinje fibers → Bundle branches → Bundle of His → AV node → SA node
D) SA node → Bundle of His → AV node → Purkinje fibers → Bundle branches
Correct Answer: A
Rationale: The correct conduction pathway is: SA node → AV node → Bundle of His → Right
and Left Bundle Branches → Purkinje fibers. This sequence ensures coordinated atrial and
ventricular contraction.
Q6. What is the normal duration of the PR interval?
A) 0.04-0.08 seconds
B) 0.08-0.12 seconds
C) 0.12-0.20 seconds
D) 0.20-0.30 seconds
Correct Answer: C
Rationale: The normal PR interval is 0.12-0.20 seconds (3-5 small boxes at standard paper
speed). It represents the time from the onset of atrial depolarization to the onset of ventricular
depolarization.
Q7. What is the normal duration of the QRS complex?
A) <0.06 seconds
B) 0.06-0.10 seconds
C) 0.10-0.12 seconds
D) >0.12 seconds
Correct Answer: B
, Rationale: The normal QRS duration is 0.06-0.10 seconds. A QRS >0.12 seconds indicates an
intraventricular conduction delay (bundle branch block).
Q8. What is the normal duration of the QT interval?
A) 0.20-0.30 seconds
B) 0.30-0.40 seconds
C) 0.36-0.44 seconds
D) 0.44-0.52 seconds
Correct Answer: C
Rationale: The normal QT interval is 0.36-0.44 seconds. It varies with heart rate and should be
corrected (QTc). A prolonged QT interval increases the risk of Torsades de pointes.
Q9. The P wave on an ECG represents:
A) Atrial depolarization
B) Ventricular depolarization
C) Ventricular repolarization
D) Atrial repolarization
Correct Answer: A
Rationale: The P wave represents atrial depolarization (contraction). It is normally upright in
leads I, II, and aVF and has a duration of <0.12 seconds.
Q10. The QRS complex on an ECG represents:
A) Atrial depolarization
B) Ventricular depolarization
C) Ventricular repolarization
D) Atrial repolarization
Correct Answer: B
2026 Comprehensive Study Guide – 200 Practice
Questions with Answers & Rationales
⚠️ IMPORTANT DISCLAIMER
> This study guide contains original practice questions designed to help you prepare for the
Relias Dysrhythmia Basic Test by covering the same core content areas tested on the actual
exam. The actual Relias exam questions are proprietary content owned by Relias Learning.
This guide is for educational purposes only.
EXAM OVERVIEW
| Component | Details |
|--||
| Exam Name | Relias Dysrhythmia Basic Test (Versions A & B) |
| Format | 35 multiple-choice questions (per version) |
| Time Limit | Typically 60 minutes |
| Content Areas | ECG fundamentals, sinus rhythms, atrial dysrhythmias, junctional rhythms,
heart blocks, ventricular rhythms, pacemaker rhythms, lethal rhythms, clinical interventions |
| Passing Score | Varies by facility (typically 80%) |
| Target Audience | Nurses, telemetry technicians, healthcare professionals |
SECTION 1: CARDIAC CONDUCTION SYSTEM & ECG FUNDAMENTALS
Q1. The electrical impulse normally originates from which structure of the heart?
A) AV node
B) Bundle of His
C) SA node
D) Purkinje fibers
Correct Answer: C
,Rationale: The sinoatrial (SA) node is the primary pacemaker of the heart, located in the right
atrium near the superior vena cava. It normally initiates impulses at a rate of 60 to 100 beats per
minute.
Q2. What is the normal intrinsic firing rate of the SA node?
A) 20-40 bpm
B) 40-60 bpm
C) 60-100 bpm
D) 100-150 bpm
Correct Answer: C
Rationale: The SA node normally fires at 60-100 beats per minute. If the SA node fails, the AV
node (40-60 bpm) or Purkinje fibers (20-40 bpm) may take over as the pacemaker.
Q3. What is the normal intrinsic firing rate of the AV node?
A) 20-40 bpm
B) 40-60 bpm
C) 60-100 bpm
D) 100-150 bpm
Correct Answer: B
Rationale: The AV node has an intrinsic firing rate of 40-60 beats per minute. It serves as a
secondary pacemaker when the SA node fails.
Q4. What is the normal intrinsic firing rate of the Purkinje fibers?
A) 20-40 bpm
B) 40-60 bpm
C) 60-100 bpm
D) 100-150 bpm
Correct Answer: A
,Rationale: The Purkinje fibers have an intrinsic firing rate of 20-40 beats per minute. They serve
as a tertiary pacemaker when both the SA and AV nodes fail.
Q5. Which of the following is the correct sequence of the cardiac conduction system?
A) SA node → AV node → Bundle of His → Bundle branches → Purkinje fibers
B) AV node → SA node → Bundle of His → Purkinje fibers → Bundle branches
C) Purkinje fibers → Bundle branches → Bundle of His → AV node → SA node
D) SA node → Bundle of His → AV node → Purkinje fibers → Bundle branches
Correct Answer: A
Rationale: The correct conduction pathway is: SA node → AV node → Bundle of His → Right
and Left Bundle Branches → Purkinje fibers. This sequence ensures coordinated atrial and
ventricular contraction.
Q6. What is the normal duration of the PR interval?
A) 0.04-0.08 seconds
B) 0.08-0.12 seconds
C) 0.12-0.20 seconds
D) 0.20-0.30 seconds
Correct Answer: C
Rationale: The normal PR interval is 0.12-0.20 seconds (3-5 small boxes at standard paper
speed). It represents the time from the onset of atrial depolarization to the onset of ventricular
depolarization.
Q7. What is the normal duration of the QRS complex?
A) <0.06 seconds
B) 0.06-0.10 seconds
C) 0.10-0.12 seconds
D) >0.12 seconds
Correct Answer: B
, Rationale: The normal QRS duration is 0.06-0.10 seconds. A QRS >0.12 seconds indicates an
intraventricular conduction delay (bundle branch block).
Q8. What is the normal duration of the QT interval?
A) 0.20-0.30 seconds
B) 0.30-0.40 seconds
C) 0.36-0.44 seconds
D) 0.44-0.52 seconds
Correct Answer: C
Rationale: The normal QT interval is 0.36-0.44 seconds. It varies with heart rate and should be
corrected (QTc). A prolonged QT interval increases the risk of Torsades de pointes.
Q9. The P wave on an ECG represents:
A) Atrial depolarization
B) Ventricular depolarization
C) Ventricular repolarization
D) Atrial repolarization
Correct Answer: A
Rationale: The P wave represents atrial depolarization (contraction). It is normally upright in
leads I, II, and aVF and has a duration of <0.12 seconds.
Q10. The QRS complex on an ECG represents:
A) Atrial depolarization
B) Ventricular depolarization
C) Ventricular repolarization
D) Atrial repolarization
Correct Answer: B
