BASIC ARRHYTHMIA SENTARA TEST 2026 |
VERIFIED PRACTICE QUESTIONS &
ANSWERS | COMPLETE EXAM STUDY GUIDE
WITH DETAILED RATIONALES
BASIC ARRHYTHMIA SENTARA TEST 2026 | VERIFIED PRACTICE QUESTIONS &
ANSWERS | COMPLETE EXAM STUDY GUIDE WITH DETAILED RATIONALES
OVERVIEW
• This comprehensive study guide contains 200 verified practice questions designed
to test your mastery of arrhythmia recognition, interpretation, and clinical
management following the Sentara Test 2026 standards
• Use these questions to build confidence in identifying rhythm strips,
understanding pathophysiology, and applying appropriate clinical interventions—
study systematically through each section and review detailed rationales for
maximum retention
QUESTIONS 1-50: NORMAL RHYTHM & BASIC CONCEPTS
1. Which of the following best describes the normal cardiac electrical
conduction pathway?
A) Sinoatrial node → ventricular septum → atrioventricular node → bundle
branches
B) Atrioventricular node → sinoatrial node → Purkinje fibers → bundle branches
C) Sinoatrial node → atrioventricular node → bundle of His → bundle branches →
Purkinje fibers
D) Purkinje fibers → bundle branches → atrioventricular node → sinoatrial node
E) Bundle of His → sinoatrial node → atrioventricular node → Purkinje fibers
C) Sinoatrial node → atrioventricular node → bundle of His → bundle
branches → Purkinje fibers
,Rationale: The normal electrical conduction pathway follows the sequence of the
sinoatrial (SA) node as the primary pacemaker, then impulses travel through the
right and left atria to the atrioventricular (AV) node, which acts as a delay
mechanism. From there, conduction passes through the bundle of His, splits into
right and left bundle branches, and finally terminates in the Purkinje fibers. This
pathway ensures organized and efficient electrical activation throughout the heart.
2. What is the normal heart rate range for an adult at rest?
A) 40 to 60 beats per minute
B) 60 to 100 beats per minute
C) 100 to 120 beats per minute
D) 120 to 140 beats per minute
E) 140 to 160 beats per minute
B) 60 to 100 beats per minute
Rationale: The normal resting heart rate for adults is defined as 60 to 100 beats per
minute (bpm). A rate below 60 bpm is considered bradycardia, and a rate above
100 bpm is considered tachycardia. Athletes and highly conditioned individuals may
have lower resting rates within normal parameters.
3. Which structure serves as the primary pacemaker of the heart?
A) Atrioventricular node
B) Bundle of His
C) Purkinje fibers
D) Sinoatrial node
E) Ventricular myocardium
D) Sinoatrial node
,Rationale: The sinoatrial (SA) node is the heart's primary pacemaker because it has
the highest intrinsic rate of automaticity (60-100 bpm). Located in the right atrium
near the entrance of the superior vena cava, the SA node normally initiates
impulses that spread throughout the atria and reach the AV node, controlling the
heart's rhythm under normal conditions.
4. What is the normal PR interval duration?
A) 0.04 to 0.08 seconds
B) 0.08 to 0.12 seconds
C) 0.12 to 0.20 seconds
D) 0.20 to 0.40 seconds
E) 0.40 to 0.60 seconds
C) 0.12 to 0.20 seconds
Rationale: The PR interval represents atrial depolarization and conduction delay
through the AV node. The normal PR interval is 0.12 to 0.20 seconds (or 3 to 5 small
squares on the ECG). A shortened PR interval may suggest pre-excitation, while a
prolonged PR interval indicates first-degree AV block.
5. Which of the following represents one small square on standard ECG paper?
A) 0.04 seconds
B) 0.10 seconds
C) 0.20 seconds
D) 0.40 seconds
E) 1.0 second
A) 0.04 seconds
, Rationale: Standard ECG paper moves at 25 mm/second. Each small square is 1 mm
wide and represents 0.04 seconds. Five small squares equal one large square (5
mm), which equals 0.20 seconds. This timing is crucial for calculating heart rate and
interval measurements.
6. What is the normal QRS complex duration?
A) Less than 0.06 seconds
B) 0.06 to 0.08 seconds
C) 0.08 to 0.12 seconds
D) 0.12 to 0.20 seconds
E) Greater than 0.20 seconds
C) 0.08 to 0.12 seconds
Rationale: The QRS complex represents ventricular depolarization. The normal
duration is 0.08 to 0.12 seconds (2 to 3 small squares). A QRS complex of 0.12
seconds or greater is considered wide and may indicate bundle branch block,
ventricular arrhythmia, or other conduction abnormalities.
7. Which of the following best characterizes normal sinus rhythm?
A) Heart rate 40-60 bpm, regular rhythm, normal PR and QRS intervals
B) Heart rate 60-100 bpm, regular rhythm, P wave before each QRS, normal PR and
QRS intervals
C) Heart rate 100-120 bpm, regular rhythm, absent P waves, normal QRS intervals
D) Heart rate 60-100 bpm, irregular rhythm, occasional P waves, variable PR
intervals
E) Heart rate 60-100 bpm, regular rhythm, no P waves, wide QRS complexes
B) Heart rate 60-100 bpm, regular rhythm, P wave before each QRS, normal
PR and QRS intervals
VERIFIED PRACTICE QUESTIONS &
ANSWERS | COMPLETE EXAM STUDY GUIDE
WITH DETAILED RATIONALES
BASIC ARRHYTHMIA SENTARA TEST 2026 | VERIFIED PRACTICE QUESTIONS &
ANSWERS | COMPLETE EXAM STUDY GUIDE WITH DETAILED RATIONALES
OVERVIEW
• This comprehensive study guide contains 200 verified practice questions designed
to test your mastery of arrhythmia recognition, interpretation, and clinical
management following the Sentara Test 2026 standards
• Use these questions to build confidence in identifying rhythm strips,
understanding pathophysiology, and applying appropriate clinical interventions—
study systematically through each section and review detailed rationales for
maximum retention
QUESTIONS 1-50: NORMAL RHYTHM & BASIC CONCEPTS
1. Which of the following best describes the normal cardiac electrical
conduction pathway?
A) Sinoatrial node → ventricular septum → atrioventricular node → bundle
branches
B) Atrioventricular node → sinoatrial node → Purkinje fibers → bundle branches
C) Sinoatrial node → atrioventricular node → bundle of His → bundle branches →
Purkinje fibers
D) Purkinje fibers → bundle branches → atrioventricular node → sinoatrial node
E) Bundle of His → sinoatrial node → atrioventricular node → Purkinje fibers
C) Sinoatrial node → atrioventricular node → bundle of His → bundle
branches → Purkinje fibers
,Rationale: The normal electrical conduction pathway follows the sequence of the
sinoatrial (SA) node as the primary pacemaker, then impulses travel through the
right and left atria to the atrioventricular (AV) node, which acts as a delay
mechanism. From there, conduction passes through the bundle of His, splits into
right and left bundle branches, and finally terminates in the Purkinje fibers. This
pathway ensures organized and efficient electrical activation throughout the heart.
2. What is the normal heart rate range for an adult at rest?
A) 40 to 60 beats per minute
B) 60 to 100 beats per minute
C) 100 to 120 beats per minute
D) 120 to 140 beats per minute
E) 140 to 160 beats per minute
B) 60 to 100 beats per minute
Rationale: The normal resting heart rate for adults is defined as 60 to 100 beats per
minute (bpm). A rate below 60 bpm is considered bradycardia, and a rate above
100 bpm is considered tachycardia. Athletes and highly conditioned individuals may
have lower resting rates within normal parameters.
3. Which structure serves as the primary pacemaker of the heart?
A) Atrioventricular node
B) Bundle of His
C) Purkinje fibers
D) Sinoatrial node
E) Ventricular myocardium
D) Sinoatrial node
,Rationale: The sinoatrial (SA) node is the heart's primary pacemaker because it has
the highest intrinsic rate of automaticity (60-100 bpm). Located in the right atrium
near the entrance of the superior vena cava, the SA node normally initiates
impulses that spread throughout the atria and reach the AV node, controlling the
heart's rhythm under normal conditions.
4. What is the normal PR interval duration?
A) 0.04 to 0.08 seconds
B) 0.08 to 0.12 seconds
C) 0.12 to 0.20 seconds
D) 0.20 to 0.40 seconds
E) 0.40 to 0.60 seconds
C) 0.12 to 0.20 seconds
Rationale: The PR interval represents atrial depolarization and conduction delay
through the AV node. The normal PR interval is 0.12 to 0.20 seconds (or 3 to 5 small
squares on the ECG). A shortened PR interval may suggest pre-excitation, while a
prolonged PR interval indicates first-degree AV block.
5. Which of the following represents one small square on standard ECG paper?
A) 0.04 seconds
B) 0.10 seconds
C) 0.20 seconds
D) 0.40 seconds
E) 1.0 second
A) 0.04 seconds
, Rationale: Standard ECG paper moves at 25 mm/second. Each small square is 1 mm
wide and represents 0.04 seconds. Five small squares equal one large square (5
mm), which equals 0.20 seconds. This timing is crucial for calculating heart rate and
interval measurements.
6. What is the normal QRS complex duration?
A) Less than 0.06 seconds
B) 0.06 to 0.08 seconds
C) 0.08 to 0.12 seconds
D) 0.12 to 0.20 seconds
E) Greater than 0.20 seconds
C) 0.08 to 0.12 seconds
Rationale: The QRS complex represents ventricular depolarization. The normal
duration is 0.08 to 0.12 seconds (2 to 3 small squares). A QRS complex of 0.12
seconds or greater is considered wide and may indicate bundle branch block,
ventricular arrhythmia, or other conduction abnormalities.
7. Which of the following best characterizes normal sinus rhythm?
A) Heart rate 40-60 bpm, regular rhythm, normal PR and QRS intervals
B) Heart rate 60-100 bpm, regular rhythm, P wave before each QRS, normal PR and
QRS intervals
C) Heart rate 100-120 bpm, regular rhythm, absent P waves, normal QRS intervals
D) Heart rate 60-100 bpm, irregular rhythm, occasional P waves, variable PR
intervals
E) Heart rate 60-100 bpm, regular rhythm, no P waves, wide QRS complexes
B) Heart rate 60-100 bpm, regular rhythm, P wave before each QRS, normal
PR and QRS intervals
