RELIAS DYSRHYTHMIA BASIC TEST (BASIC
A DYSRHYTHMIA) QUESTIONS AND
ANSWERS WITH RATIONALES 2026/27
150 Questions with Answers and Detailed Rationales
100 PERCENT GUARANTEED PASS
INSTANT DOWNLOAD ANSWERS INCLUDED
IMPORTANCE OF THIS DOCUMENT
This comprehensive examination preparation guide has been meticulously developed to help you succeed in the
RELIAS DYSRHYTHMIA BASIC TEST (BASIC A DYSRHYTHMIA) QUESTIONS AND ANSWERS WITH
RATIONALES 2026/27. It contains 150 carefully selected questions that reflect the most current exam content
and testing strategies. Each question is accompanied by a correct answer and a detailed rationale that explains
the underlying pathophysiology, pharmacology, or clinical reasoning.
Self-Assessment – Test your knowledge and Exam Preparation – Familiarize yourself with the
identify areas requiring further question format and content
study areas
Concept Reinforcement – Deepen your Confidence Building – Develop test-taking
understanding through strategies and reduce
evidence-based exam anxiety
rationales
Time Management – Practice answering
questions under simulated
exam conditions
Review Summary 150 Questions
Foundations - Application - Relias Dysrhythmia Basic Basic A Dysrhythmia AND WITH Rationales 2026/27
Health Sciences / Nursing Graduate / Advanced Undergraduate
All answers with rationales
,Table of Contents
Content Area Questions Key Topics
Basic Cardiac Anatomy AND 1-25 Tachycardia, Rhythm, Appropriate, Heart, Regular
Physiology
Electrophysiology AND 26-50 Rhythm, Regular, Tachycardia, Patient S, Appropriate
Conduction System
ECG LEAD Placement AND 51-75 Tachycardia, Rhythm, Regular, Seconds, Patient S
Waveform Components
Normal Sinus Rhythm AND 76-100 Tachycardia, Regular, Rhythm, Atrial, Waves
Sinus Arrhythmias
Atrial Rhythms PAC Atrial 101-125 Rhythm, Regular, Appropriate, Interval, Tachycardia
Fibrillation Atrial Flutter
Junctional Rhythms PJC 126-150 Tachycardia, Regular, Appropriate, Atrial, Waves
Junctional Rhythm
Accelerated Junctional
TOTAL 150 All questions include answers and detailed rationales
,Section A - Basic Cardiac Anatomy AND Physiology
Q1.
A 58-year-old patient with severe chest pain and diaphoresis presents with a 12-lead ECG
showing a regular wide-complex tachycardia at 210 bpm. The QRS duration is 0.16
seconds, and there is no discernible P wave. Which finding would most strongly support a
diagnosis of monomorphic ventricular tachycardia over supraventricular tachycardia with
aberrancy?
A. Presence of fusion beats B. QRS axis of -120 degrees
C. R wave in lead V1 with a taller left rabbit D. AV dissociation with capture beats
ear
Correct: D - AV dissociation with capture beats
Rationale:AV dissociation with capture/fusion beats is a specific and definitive sign of
ventricular tachycardia because it demonstrates independent atrial and ventricular activity,
which does not occur in SVT with aberrancy. Fusion beats (A) are also indicative but are a
subset of AV dissociation findings. Axis and morphology criteria (B, C) are suggestive but not
diagnostic.
Why the other answers are wrong:
A. Fusion beats are specific but less commonly observed and are a form of AV dissociation;
they are not the strongest single criterion.
B. Extreme axis deviation is a morphologic clue but can occur in SVT with aberrancy.
C. Morphology criteria in V1 are helpful but have limited sensitivity and specificity.
Reference: ACC/AHA/HRS Guideline on Management of Ventricular Arrhythmias, 2017; Goldberger,
Clinical Electrocardiography, 9e
Q2.
A patient with chronic kidney disease and a serum potassium of 6.8 mEq/L develops
bradycardia and hypotension. The ECG shows sine-wave morphology. Which intervention
should be administered first to stabilize the myocardium?
A. Intravenous calcium gluconate B. Intravenous regular insulin with dextrose
C. Sodium polystyrene sulfonate D. Hemodialysis
(Kayexalate)
Correct: A - Intravenous calcium gluconate
Page 3
, Section A - Basic Cardiac Anatomy AND Physiology
Rationale: In hyperkalemia with ECG changes and hemodynamic instability, IV calcium
gluconate is the first-line therapy to antagonize the cardiac effects of hyperkalemia and
stabilize the myocardium. Insulin with dextrose (B) shifts potassium intracellularly but takes
time; Kayexalate (C) and dialysis (D) remove potassium but are not immediate myocardial
stabilizers.
Why the other answers are wrong:
B. Insulin/glucose lowers potassium but does not immediately stabilize the myocardial
membrane.
C. Kayexalate acts slowly and does not acutely stabilize the myocardium.
D. Dialysis is definitive but requires time for initiation and is not the immediate emergency
measure.
Reference: KDIGO Clinical Practice Guideline for Acute Kidney Injury, 2012; ACC/AHA ACLS guidelines
Q3.
A patient presents with a heart rate of 44 bpm and an ECG showing a regular rhythm with
a P wave preceding each QRS, PR interval 0.20 sec, and QRS narrow. Despite atropine, the
patient remains symptomatic with dizziness. Which next step is most appropriate?
A. Initiate transcutaneous pacing B. Administer epinephrine infusion
C. Administer dopamine infusion D. Prepare for transvenous pacing
Correct: A - Initiate transcutaneous pacing
Rationale:For symptomatic bradycardia unresponsive to atropine, transcutaneous pacing is
the next recommended intervention per ACLS guidelines. Epinephrine or dopamine infusions
(B, C) are alternatives if pacing is not available but are not the preferred next step.
Transvenous pacing (D) is invasive and not first-line when transcutaneous pacing is available.
Why the other answers are wrong:
B. Epinephrine infusion is a second-line alternative when pacing is not available.
C. Dopamine infusion is also second-line, not the immediate next step.
D. Transvenous pacing is invasive and reserved for when transcutaneous pacing is ineffective
or not possible.
Reference: American Heart Association, 2020 AHA Guidelines for CPR and ECC, Part 7: Adult
Bradycardia
Q4.
A patient's ECG shows a regular narrow-complex tachycardia at 180 bpm. Adenosine 6 mg
IV is administered, and the rhythm transiently slows, revealing flutter waves. What is the
most likely diagnosis?
A. Atrial flutter with 2:1 conduction B. AV nodal reentrant tachycardia
Page 4
A DYSRHYTHMIA) QUESTIONS AND
ANSWERS WITH RATIONALES 2026/27
150 Questions with Answers and Detailed Rationales
100 PERCENT GUARANTEED PASS
INSTANT DOWNLOAD ANSWERS INCLUDED
IMPORTANCE OF THIS DOCUMENT
This comprehensive examination preparation guide has been meticulously developed to help you succeed in the
RELIAS DYSRHYTHMIA BASIC TEST (BASIC A DYSRHYTHMIA) QUESTIONS AND ANSWERS WITH
RATIONALES 2026/27. It contains 150 carefully selected questions that reflect the most current exam content
and testing strategies. Each question is accompanied by a correct answer and a detailed rationale that explains
the underlying pathophysiology, pharmacology, or clinical reasoning.
Self-Assessment – Test your knowledge and Exam Preparation – Familiarize yourself with the
identify areas requiring further question format and content
study areas
Concept Reinforcement – Deepen your Confidence Building – Develop test-taking
understanding through strategies and reduce
evidence-based exam anxiety
rationales
Time Management – Practice answering
questions under simulated
exam conditions
Review Summary 150 Questions
Foundations - Application - Relias Dysrhythmia Basic Basic A Dysrhythmia AND WITH Rationales 2026/27
Health Sciences / Nursing Graduate / Advanced Undergraduate
All answers with rationales
,Table of Contents
Content Area Questions Key Topics
Basic Cardiac Anatomy AND 1-25 Tachycardia, Rhythm, Appropriate, Heart, Regular
Physiology
Electrophysiology AND 26-50 Rhythm, Regular, Tachycardia, Patient S, Appropriate
Conduction System
ECG LEAD Placement AND 51-75 Tachycardia, Rhythm, Regular, Seconds, Patient S
Waveform Components
Normal Sinus Rhythm AND 76-100 Tachycardia, Regular, Rhythm, Atrial, Waves
Sinus Arrhythmias
Atrial Rhythms PAC Atrial 101-125 Rhythm, Regular, Appropriate, Interval, Tachycardia
Fibrillation Atrial Flutter
Junctional Rhythms PJC 126-150 Tachycardia, Regular, Appropriate, Atrial, Waves
Junctional Rhythm
Accelerated Junctional
TOTAL 150 All questions include answers and detailed rationales
,Section A - Basic Cardiac Anatomy AND Physiology
Q1.
A 58-year-old patient with severe chest pain and diaphoresis presents with a 12-lead ECG
showing a regular wide-complex tachycardia at 210 bpm. The QRS duration is 0.16
seconds, and there is no discernible P wave. Which finding would most strongly support a
diagnosis of monomorphic ventricular tachycardia over supraventricular tachycardia with
aberrancy?
A. Presence of fusion beats B. QRS axis of -120 degrees
C. R wave in lead V1 with a taller left rabbit D. AV dissociation with capture beats
ear
Correct: D - AV dissociation with capture beats
Rationale:AV dissociation with capture/fusion beats is a specific and definitive sign of
ventricular tachycardia because it demonstrates independent atrial and ventricular activity,
which does not occur in SVT with aberrancy. Fusion beats (A) are also indicative but are a
subset of AV dissociation findings. Axis and morphology criteria (B, C) are suggestive but not
diagnostic.
Why the other answers are wrong:
A. Fusion beats are specific but less commonly observed and are a form of AV dissociation;
they are not the strongest single criterion.
B. Extreme axis deviation is a morphologic clue but can occur in SVT with aberrancy.
C. Morphology criteria in V1 are helpful but have limited sensitivity and specificity.
Reference: ACC/AHA/HRS Guideline on Management of Ventricular Arrhythmias, 2017; Goldberger,
Clinical Electrocardiography, 9e
Q2.
A patient with chronic kidney disease and a serum potassium of 6.8 mEq/L develops
bradycardia and hypotension. The ECG shows sine-wave morphology. Which intervention
should be administered first to stabilize the myocardium?
A. Intravenous calcium gluconate B. Intravenous regular insulin with dextrose
C. Sodium polystyrene sulfonate D. Hemodialysis
(Kayexalate)
Correct: A - Intravenous calcium gluconate
Page 3
, Section A - Basic Cardiac Anatomy AND Physiology
Rationale: In hyperkalemia with ECG changes and hemodynamic instability, IV calcium
gluconate is the first-line therapy to antagonize the cardiac effects of hyperkalemia and
stabilize the myocardium. Insulin with dextrose (B) shifts potassium intracellularly but takes
time; Kayexalate (C) and dialysis (D) remove potassium but are not immediate myocardial
stabilizers.
Why the other answers are wrong:
B. Insulin/glucose lowers potassium but does not immediately stabilize the myocardial
membrane.
C. Kayexalate acts slowly and does not acutely stabilize the myocardium.
D. Dialysis is definitive but requires time for initiation and is not the immediate emergency
measure.
Reference: KDIGO Clinical Practice Guideline for Acute Kidney Injury, 2012; ACC/AHA ACLS guidelines
Q3.
A patient presents with a heart rate of 44 bpm and an ECG showing a regular rhythm with
a P wave preceding each QRS, PR interval 0.20 sec, and QRS narrow. Despite atropine, the
patient remains symptomatic with dizziness. Which next step is most appropriate?
A. Initiate transcutaneous pacing B. Administer epinephrine infusion
C. Administer dopamine infusion D. Prepare for transvenous pacing
Correct: A - Initiate transcutaneous pacing
Rationale:For symptomatic bradycardia unresponsive to atropine, transcutaneous pacing is
the next recommended intervention per ACLS guidelines. Epinephrine or dopamine infusions
(B, C) are alternatives if pacing is not available but are not the preferred next step.
Transvenous pacing (D) is invasive and not first-line when transcutaneous pacing is available.
Why the other answers are wrong:
B. Epinephrine infusion is a second-line alternative when pacing is not available.
C. Dopamine infusion is also second-line, not the immediate next step.
D. Transvenous pacing is invasive and reserved for when transcutaneous pacing is ineffective
or not possible.
Reference: American Heart Association, 2020 AHA Guidelines for CPR and ECC, Part 7: Adult
Bradycardia
Q4.
A patient's ECG shows a regular narrow-complex tachycardia at 180 bpm. Adenosine 6 mg
IV is administered, and the rhythm transiently slows, revealing flutter waves. What is the
most likely diagnosis?
A. Atrial flutter with 2:1 conduction B. AV nodal reentrant tachycardia
Page 4
