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HCA Healthcare Telemetry ECG/EKG Interpretation
Exam Comprehensive 200-Question Practice Test Bank
Advanced/Hard Difficulty Level | Target Audience:
Telemetry Technicians, Critical Care Nurses,
Progressive Care Nurses, and Healthcare Professionals
Preparing for HCA Telemetry Competency Assessment
Aligned with HCA Telemetry Competency Standards
and AHA 2025/2026 Guidelines
SECTION 1: CARDIAC ELECTROPHYSIOLOGY FUNDAMENTALS (Questions 1–25)
Question 1
The sinoatrial (SA) node is located in which chamber of the heart and at what anatomical
position?
A) Left atrium, near the pulmonary veins
B) Right ventricle, near the interventricular septum
C) Right atrium, near the superior vena cava
D) Left ventricle, near the apex
Correct Answer: C
Rationale: The SA node is located in the upper wall of the right atrium near the superior vena
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cava. It is the heart's natural pacemaker, generating electrical impulses that initiate each
cardiac cycle.
Question 2
What is the normal intrinsic firing rate of the sinoatrial (SA) node in a resting adult?
A) 20–40 beats per minute
B) 40–60 beats per minute
C) 60–100 beats per minute
D) 100–150 beats per minute
Correct Answer: C
Rationale: The SA node typically fires at 60–100 beats per minute in a resting adult. Rates
below 60 indicate bradycardia; rates above 100 indicate tachycardia.
Question 3
The primary function of the atrioventricular (AV) node is to:
A) Generate the initial electrical impulse of the cardiac cycle
B) Delay the electrical impulse before ventricular depolarization
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C) Conduct impulses rapidly through the ventricular myocardium
D) Depolarize the atria and initiate atrial contraction
Correct Answer: B
Rationale: The AV node delays the electrical impulse by approximately 0.12–0.20 seconds,
allowing the atria to complete contraction and fill the ventricles before ventricular
depolarization occurs.
Question 4
Which structure in the cardiac conduction system has the fastest intrinsic firing rate?
A) Bundle of His
B) Purkinje fibers
C) Atrioventricular (AV) node
D) Sinoatrial (SA) node
Correct Answer: D
Rationale: The SA node has the fastest intrinsic firing rate (60–100 bpm) and normally functions
as the dominant pacemaker. The AV node has a rate of 40–60 bpm, and Purkinje fibers have a
rate of 20–40 bpm.
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Question 5
The P wave on a normal ECG represents:
A) Ventricular depolarization
B) Atrial depolarization
C) Ventricular repolarization
D) Atrial repolarization
Correct Answer: B
Rationale: The P wave represents atrial depolarization, which is the electrical activation of the
atria resulting in atrial contraction. Ventricular depolarization is represented by the QRS
complex.
Question 6
The QRS complex on an ECG represents:
A) Atrial depolarization
B) Ventricular repolarization
HCA Healthcare Telemetry ECG/EKG Interpretation
Exam Comprehensive 200-Question Practice Test Bank
Advanced/Hard Difficulty Level | Target Audience:
Telemetry Technicians, Critical Care Nurses,
Progressive Care Nurses, and Healthcare Professionals
Preparing for HCA Telemetry Competency Assessment
Aligned with HCA Telemetry Competency Standards
and AHA 2025/2026 Guidelines
SECTION 1: CARDIAC ELECTROPHYSIOLOGY FUNDAMENTALS (Questions 1–25)
Question 1
The sinoatrial (SA) node is located in which chamber of the heart and at what anatomical
position?
A) Left atrium, near the pulmonary veins
B) Right ventricle, near the interventricular septum
C) Right atrium, near the superior vena cava
D) Left ventricle, near the apex
Correct Answer: C
Rationale: The SA node is located in the upper wall of the right atrium near the superior vena
, 2
cava. It is the heart's natural pacemaker, generating electrical impulses that initiate each
cardiac cycle.
Question 2
What is the normal intrinsic firing rate of the sinoatrial (SA) node in a resting adult?
A) 20–40 beats per minute
B) 40–60 beats per minute
C) 60–100 beats per minute
D) 100–150 beats per minute
Correct Answer: C
Rationale: The SA node typically fires at 60–100 beats per minute in a resting adult. Rates
below 60 indicate bradycardia; rates above 100 indicate tachycardia.
Question 3
The primary function of the atrioventricular (AV) node is to:
A) Generate the initial electrical impulse of the cardiac cycle
B) Delay the electrical impulse before ventricular depolarization
, 3
C) Conduct impulses rapidly through the ventricular myocardium
D) Depolarize the atria and initiate atrial contraction
Correct Answer: B
Rationale: The AV node delays the electrical impulse by approximately 0.12–0.20 seconds,
allowing the atria to complete contraction and fill the ventricles before ventricular
depolarization occurs.
Question 4
Which structure in the cardiac conduction system has the fastest intrinsic firing rate?
A) Bundle of His
B) Purkinje fibers
C) Atrioventricular (AV) node
D) Sinoatrial (SA) node
Correct Answer: D
Rationale: The SA node has the fastest intrinsic firing rate (60–100 bpm) and normally functions
as the dominant pacemaker. The AV node has a rate of 40–60 bpm, and Purkinje fibers have a
rate of 20–40 bpm.
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Question 5
The P wave on a normal ECG represents:
A) Ventricular depolarization
B) Atrial depolarization
C) Ventricular repolarization
D) Atrial repolarization
Correct Answer: B
Rationale: The P wave represents atrial depolarization, which is the electrical activation of the
atria resulting in atrial contraction. Ventricular depolarization is represented by the QRS
complex.
Question 6
The QRS complex on an ECG represents:
A) Atrial depolarization
B) Ventricular repolarization
