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HCA Healthcare Telemetry ECG/EKG Interpretation 2026
Comprehensive Exam Bank: 220 Multiple-Choice Questions
with Expert Rationales
SECTION I: CARDIAC ANATOMY & ELECTROPHYSIOLOGY (Questions 1–15)
Question 1
Which structure in the cardiac conduction system is known as the primary pacemaker of the
heart?
A) Atrioventricular (AV) node
B) Bundle of His
C) Purkinje fibers
D) Sinoatrial (SA) node
E) Left bundle branch
CorreCt Answer: D
Rationale: The sinoatrial (SA) node is the primary pacemaker of the heart, generating electrical
impulses at a rate of 60–100 beats per minute. The AV node (A) acts as a secondary pacemaker
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(40–60 bpm). The Bundle of His (B) and Purkinje fibers (C) are part of the conduction pathway.
The left bundle branch (E) conducts impulses to the left ventricle.
Question 2
What is the intrinsic firing rate of the atrioventricular (AV) node?
A) 20–40 beats per minute
B) 40–60 beats per minute
C) 60–100 beats per minute
D) 100–150 beats per minute
E) 150–220 beats per minute
CorreCt Answer: B
Rationale: The AV node has an intrinsic firing rate of 40–60 beats per minute. The SA node
(primary pacemaker) fires at 60–100 bpm (C). The Purkinje fibers have an intrinsic rate of 20–40
bpm (A). Tachyarrhythmias (D, E) are pathological.
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Question 3
Which wave on the ECG represents atrial depolarization?
A) P wave
B) QRS complex
C) T wave
D) U wave
E) PR segment
CorreCt Answer: A
Rationale: The P wave represents atrial depolarization (contraction). The QRS complex (B)
represents ventricular depolarization. The T wave (C) represents ventricular repolarization. The
U wave (D) is a small, late wave of uncertain significance. The PR segment (E) represents the
delay at the AV node.
Question 4
The QRS complex on the ECG represents which cardiac event?
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A) Atrial depolarization
B) Atrial repolarization
C) Ventricular depolarization
D) Ventricular repolarization
E) AV nodal delay
CorreCt Answer: C
Rationale: The QRS complex represents ventricular depolarization, which triggers ventricular
contraction. Atrial depolarization is represented by the P wave (A). Ventricular repolarization is
represented by the T wave (D). AV nodal delay is represented by the PR segment (E).
Question 5
What is the normal duration of the PR interval on a standard ECG?
A) 0.04–0.10 seconds
B) 0.12–0.20 seconds
C) 0.20–0.24 seconds
D) 0.24–0.30 seconds
E) 0.30–0.40 seconds
HCA Healthcare Telemetry ECG/EKG Interpretation 2026
Comprehensive Exam Bank: 220 Multiple-Choice Questions
with Expert Rationales
SECTION I: CARDIAC ANATOMY & ELECTROPHYSIOLOGY (Questions 1–15)
Question 1
Which structure in the cardiac conduction system is known as the primary pacemaker of the
heart?
A) Atrioventricular (AV) node
B) Bundle of His
C) Purkinje fibers
D) Sinoatrial (SA) node
E) Left bundle branch
CorreCt Answer: D
Rationale: The sinoatrial (SA) node is the primary pacemaker of the heart, generating electrical
impulses at a rate of 60–100 beats per minute. The AV node (A) acts as a secondary pacemaker
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(40–60 bpm). The Bundle of His (B) and Purkinje fibers (C) are part of the conduction pathway.
The left bundle branch (E) conducts impulses to the left ventricle.
Question 2
What is the intrinsic firing rate of the atrioventricular (AV) node?
A) 20–40 beats per minute
B) 40–60 beats per minute
C) 60–100 beats per minute
D) 100–150 beats per minute
E) 150–220 beats per minute
CorreCt Answer: B
Rationale: The AV node has an intrinsic firing rate of 40–60 beats per minute. The SA node
(primary pacemaker) fires at 60–100 bpm (C). The Purkinje fibers have an intrinsic rate of 20–40
bpm (A). Tachyarrhythmias (D, E) are pathological.
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Question 3
Which wave on the ECG represents atrial depolarization?
A) P wave
B) QRS complex
C) T wave
D) U wave
E) PR segment
CorreCt Answer: A
Rationale: The P wave represents atrial depolarization (contraction). The QRS complex (B)
represents ventricular depolarization. The T wave (C) represents ventricular repolarization. The
U wave (D) is a small, late wave of uncertain significance. The PR segment (E) represents the
delay at the AV node.
Question 4
The QRS complex on the ECG represents which cardiac event?
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A) Atrial depolarization
B) Atrial repolarization
C) Ventricular depolarization
D) Ventricular repolarization
E) AV nodal delay
CorreCt Answer: C
Rationale: The QRS complex represents ventricular depolarization, which triggers ventricular
contraction. Atrial depolarization is represented by the P wave (A). Ventricular repolarization is
represented by the T wave (D). AV nodal delay is represented by the PR segment (E).
Question 5
What is the normal duration of the PR interval on a standard ECG?
A) 0.04–0.10 seconds
B) 0.12–0.20 seconds
C) 0.20–0.24 seconds
D) 0.24–0.30 seconds
E) 0.30–0.40 seconds
