Relias DysRhythmia Basic a actual exam – Relias leaRning –
2026/2027 acaDemic yeaR – VeRifieD Questions anD answeRs ||
just ReleaseD !!
This comprehensive practice exam is designed to help you prepare for the Relias Dysrhythmia
Basic A Certification Exam. The questions cover fundamental ECG rhythm interpretation,
including sinus rhythms, atrial dysrhythmias, junctional rhythms, ventricular rhythms, heart
blocks, and life-threatening arrhythmias, aligned with current AHA and AACN guidelines.
SECTION 1: ECG FOUNDATIONS & MEASUREMENTS
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
answeR: C – SA node
Rationale: The sinoatrial (SA) node, located in the right atrium, is the heart's natural
pacemaker. It normally discharges at 60–100 beats per minute. The AV node delays impulses to
allow ventricular filling; the Bundle of His and Purkinje fibers are part of the conduction pathway
below the AV node. The SA node's inherent rate is 60–100 bpm, the AV junction is 40–60 bpm,
and Purkinje fibers are 20–40 bpm.
Question 2
At what rate does the SA node normally fire 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
answeR: C – 60–100 beats per minute
Rationale: The SA node is the primary pacemaker with an intrinsic firing rate of 60–100 bpm.
The AV junction has a backup rate of 40–60 bpm, and the Purkinje fibers have an intrinsic rate of
20–40 bpm.
Question 3
Which component of the ECG represents ventricular depolarization?
• A) P wave
• B) PR interval
• C) QRS complex
• D) T wave
answeR: C – QRS complex
Rationale: The QRS complex represents the electrical impulse traveling through the
ventricles, causing them to contract (ventricular depolarization). The P wave represents atrial
depolarization, and the T wave represents ventricular repolarization.
Question 4
On standard ECG paper, what is the standard speed?
• A) 15 mm/second
• B) 25 mm/second
• C) 50 mm/second
• D) 100 mm/second
answeR: B – 25 mm/second
Rationale: The standard ECG paper speed is 25 mm per second. At this speed, each small
box (1 mm) represents 0.04 seconds, and each large box (5 mm) represents 0.20 seconds.
Question 5
On standard ECG paper, 1 small box (1 mm) represents how many seconds?
, • A) 0.04 seconds
• B) 0.10 seconds
• C) 0.20 seconds
• D) 0.50 seconds
answeR: A – 0.04 seconds
Rationale: At standard speed (25 mm/sec), each small box = 0.04 sec (40 ms) . Each large
box (5 small boxes) = 0.20 sec. The PR interval is normally 0.12–0.20 sec (3–5 small boxes).
Question 6
A normal PR interval should measure:
• A) 0.04–0.08 seconds
• B) 0.08–0.12 seconds
• C) 0.12–0.20 seconds
• D) 0.20–0.30 seconds
answeR: C – 0.12–0.20 seconds
Rationale: The normal PR interval ranges from 0.12 to 0.20 seconds (3–5 small boxes). It
represents the time from the onset of atrial depolarization to the onset of ventricular
depolarization.
Question 7
A normal QRS duration should measure:
• A) < 0.06 seconds
• B) < 0.12 seconds
• C) < 0.20 seconds
• D) < 0.40 seconds
answeR: B – < 0.12 seconds
Rationale: A normal QRS duration is less than 0.12 seconds (3 small boxes). A widened QRS
(> 0.12 sec) indicates a ventricular conduction delay or ventricular origin of the rhythm.
, Question 8
The P wave represents which cardiac event?
• A) Ventricular depolarization
• B) Atrial depolarization
• C) Ventricular repolarization
• D) AV nodal delay
answeR: B – Atrial depolarization
Rationale: The P wave represents atrial depolarization—the electrical activation of the atria
just before they contract. The PR interval represents the time from atrial depolarization to
ventricular depolarization (including AV nodal delay).
Question 9
The T wave represents which cardiac event?
• A) Ventricular depolarization
• B) Atrial depolarization
• C) Ventricular repolarization
• D) Atrial repolarization
answeR: C – Ventricular repolarization
Rationale: The T wave represents ventricular repolarization—the recovery of the ventricles
after contraction. Atrial repolarization is typically hidden within the QRS complex and is not
visible on a standard ECG.
Question 10
Which of the following correctly describes the normal P wave morphology?
• A) Inverted in lead II
• B) Upright in lead II and biphasic in lead V1
• C) Sawtooth pattern
2026/2027 acaDemic yeaR – VeRifieD Questions anD answeRs ||
just ReleaseD !!
This comprehensive practice exam is designed to help you prepare for the Relias Dysrhythmia
Basic A Certification Exam. The questions cover fundamental ECG rhythm interpretation,
including sinus rhythms, atrial dysrhythmias, junctional rhythms, ventricular rhythms, heart
blocks, and life-threatening arrhythmias, aligned with current AHA and AACN guidelines.
SECTION 1: ECG FOUNDATIONS & MEASUREMENTS
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
answeR: C – SA node
Rationale: The sinoatrial (SA) node, located in the right atrium, is the heart's natural
pacemaker. It normally discharges at 60–100 beats per minute. The AV node delays impulses to
allow ventricular filling; the Bundle of His and Purkinje fibers are part of the conduction pathway
below the AV node. The SA node's inherent rate is 60–100 bpm, the AV junction is 40–60 bpm,
and Purkinje fibers are 20–40 bpm.
Question 2
At what rate does the SA node normally fire 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
answeR: C – 60–100 beats per minute
Rationale: The SA node is the primary pacemaker with an intrinsic firing rate of 60–100 bpm.
The AV junction has a backup rate of 40–60 bpm, and the Purkinje fibers have an intrinsic rate of
20–40 bpm.
Question 3
Which component of the ECG represents ventricular depolarization?
• A) P wave
• B) PR interval
• C) QRS complex
• D) T wave
answeR: C – QRS complex
Rationale: The QRS complex represents the electrical impulse traveling through the
ventricles, causing them to contract (ventricular depolarization). The P wave represents atrial
depolarization, and the T wave represents ventricular repolarization.
Question 4
On standard ECG paper, what is the standard speed?
• A) 15 mm/second
• B) 25 mm/second
• C) 50 mm/second
• D) 100 mm/second
answeR: B – 25 mm/second
Rationale: The standard ECG paper speed is 25 mm per second. At this speed, each small
box (1 mm) represents 0.04 seconds, and each large box (5 mm) represents 0.20 seconds.
Question 5
On standard ECG paper, 1 small box (1 mm) represents how many seconds?
, • A) 0.04 seconds
• B) 0.10 seconds
• C) 0.20 seconds
• D) 0.50 seconds
answeR: A – 0.04 seconds
Rationale: At standard speed (25 mm/sec), each small box = 0.04 sec (40 ms) . Each large
box (5 small boxes) = 0.20 sec. The PR interval is normally 0.12–0.20 sec (3–5 small boxes).
Question 6
A normal PR interval should measure:
• A) 0.04–0.08 seconds
• B) 0.08–0.12 seconds
• C) 0.12–0.20 seconds
• D) 0.20–0.30 seconds
answeR: C – 0.12–0.20 seconds
Rationale: The normal PR interval ranges from 0.12 to 0.20 seconds (3–5 small boxes). It
represents the time from the onset of atrial depolarization to the onset of ventricular
depolarization.
Question 7
A normal QRS duration should measure:
• A) < 0.06 seconds
• B) < 0.12 seconds
• C) < 0.20 seconds
• D) < 0.40 seconds
answeR: B – < 0.12 seconds
Rationale: A normal QRS duration is less than 0.12 seconds (3 small boxes). A widened QRS
(> 0.12 sec) indicates a ventricular conduction delay or ventricular origin of the rhythm.
, Question 8
The P wave represents which cardiac event?
• A) Ventricular depolarization
• B) Atrial depolarization
• C) Ventricular repolarization
• D) AV nodal delay
answeR: B – Atrial depolarization
Rationale: The P wave represents atrial depolarization—the electrical activation of the atria
just before they contract. The PR interval represents the time from atrial depolarization to
ventricular depolarization (including AV nodal delay).
Question 9
The T wave represents which cardiac event?
• A) Ventricular depolarization
• B) Atrial depolarization
• C) Ventricular repolarization
• D) Atrial repolarization
answeR: C – Ventricular repolarization
Rationale: The T wave represents ventricular repolarization—the recovery of the ventricles
after contraction. Atrial repolarization is typically hidden within the QRS complex and is not
visible on a standard ECG.
Question 10
Which of the following correctly describes the normal P wave morphology?
• A) Inverted in lead II
• B) Upright in lead II and biphasic in lead V1
• C) Sawtooth pattern
