Learning Systems – 2026/2027 Academic Year –
Verified Questions and Answers for Healthcare
Professionals and Nursing Staff
Exam Description
The Relias Dysrhythmia Basic B Exam is a standardized competency assessment designed
for healthcare professionals, particularly nurses and telemetry technicians, to validate their
ability to interpret cardiac rhythms accurately. This exam is widely used by healthcare
institutions as part of clinical orientation or annual competency verification.
Exam Format: 400 multiple-choice questions
Testing Time: 120 minutes
Passing Score: Typically 70% or higher
Target Audience: Nurses, telemetry techs, critical care professionals, nursing students
Key Topics Covered:
Cardiac conduction system fundamentals (SA node, AV node, Bundle branches, Purkinje
fibers)
Normal Sinus Rhythm and variations
Atrial dysrhythmias (PAC, Atrial Flutter, Atrial Fibrillation)
Junctional rhythms (Junctional escape, Accelerated junctional)
Ventricular dysrhythmias (PVCs, Ventricular Tachycardia, Ventricular Fibrillation)
Heart blocks (First-degree, Second-degree Type I & II, Third-degree complete block)
ECG waveform components (P wave, QRS complex, PR interval, QT interval)
Pacemaker rhythms and interpretation
Emergency interventions and ACLS protocols
Basic pharmacologic management of arrhythmias
,SECTION 1: CARDIAC CONDUCTION SYSTEM & ECG
FUNDAMENTALS (Questions 1-50)
Question 1
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 heart's primary pacemaker, initiating electrical
impulses at 60-100 beats per minute. The impulse travels through the atria, causing atrial
contraction, before reaching the AV node.
Why Other Answers Are Wrong:
A: The AV node delays conduction, it does not initiate the primary impulse
B: The Bundle of His transmits impulses from AV node to ventricles
D: Purkinje fibers distribute depolarization throughout the ventricles
Question 2
Which ECG component represents ventricular depolarization?
A) P wave
B) PR interval
C) QRS complex
D) T wave
Correct Answer: C
Rationale: The QRS complex reflects ventricular depolarization. It is normally narrow
(0.06-0.10 seconds). A widened QRS may indicate a ventricular origin or conduction delay.
Why Other Answers Are Wrong:
A: The P wave represents atrial depolarization
,B: The PR interval represents the time from atrial depolarization to ventricular
depolarization
D: The T wave represents ventricular repolarization
Question 3
A rhythm strip shows a regular rhythm, heart rate of 68 bpm, upright P waves before
every QRS, and a PR interval of 0.16 seconds. This rhythm is:
A) Sinus bradycardia
B) Normal sinus rhythm
C) Atrial fibrillation
D) First-degree AV block
Correct Answer: B
Rationale: The rate is within normal range (60-100 bpm), rhythm is regular, P waves
precede each QRS, and the PR interval is normal (0.12-0.20 seconds). These findings
indicate normal sinus rhythm.
Why Other Answers Are Wrong:
A: Sinus bradycardia would have a rate below 60 bpm
C: Atrial fibrillation lacks P waves and has an irregularly irregular rhythm
D: First-degree AV block would show a PR interval >0.20 seconds
Question 4
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 it fails, lower
pacemakers (AV node at 40-60 bpm or ventricles at 20-40 bpm) may take over at slower
rates.
Why Other Answers Are Wrong:
A: This is the ventricular escape rate
B: This is the AV node intrinsic rate
D: This is too fast for normal SA node firing
Question 5
The SA node is located in which part of the heart?
A) Left ventricle
B) Right atrium
C) Left atrium
D) Right ventricle
Correct Answer: B
Rationale: The SA node is located in the right atrium near the opening of the superior vena
cava.
Why Other Answers Are Wrong:
A: The SA node is not located in the ventricles
C: The SA node is in the right atrium, not left atrium
D: The SA node is in the atrium, not ventricle
Question 6
What is the normal PR interval duration?
A) 0.04-0.08 seconds
B) 0.06-0.10 seconds
C) 0.12-0.20 seconds
D) 0.20-0.30 seconds