COMPETENCY EXAM PREP · 2026/2027 EDITION
BayCare
EKG Test
Fifty verified-answer questions with detailed EKG
rationales covering conduction fundamentals,
dysrhythmias, ischemic patterns, electrolyte effects,
and emergency response — aligned with BayCare
competency domains and current ACLS guidelines.
Cardiac Monitoring Certification Preparation
50 Q UES T IO N S · V ER IFIED A N S WER S · GR A DED A+
2 0 2 0 2 7 E D I T I O N · I N D E P E N D E N T P R A C T I C E M AT E R I A L , N O T A F F I L I AT E D W I T H
O R E N D O R S E D B Y B AY C A R E H E A LT H S Y S T E M
,BAYCARE EKG TEST | 2026/2027 | COMPETENCY EXAM PREP
BayCare EKG Test
2026/2027 | Actual Questions and Verified Answers | Competency Exam Prep | Graded A+
Exam Overview: 50 multiple-choice questions in 5 sections, each with one best answer and a verified, explained rationale.
Items span recall (25%), application (50%), and analysis (25%) cognitive levels, aligned with BayCare Health System EKG
competency domains, telemetry monitoring standards, and current ACLS guidelines. Choose the single best option for each
item.
SECTION 1
Cardiac Conduction System and EKG Fundamentals
Questions 1 - 10
Conduction Pathway | Waveforms | Intervals | Measurement and Rate Calculation
Q1: A new graduate nurse is reviewing the cardiac conduction system with her BayCare preceptor
before the unit-based EKG competency check-off. The preceptor asks her to identify the normal
intrinsic firing rate of the sinoatrial (SA) node, the primary pacemaker of the heart. Which rate is
correct?
A. 20 to 40 beats per minute
B. 60 to 100 beats per minute [CORRECT]
C. 40 to 60 beats per minute
D. 100 to 150 beats per minute
Correct Answer: B
Rationale: The SA node is the heart's dominant pacemaker and fires intrinsically at 60 to 100 beats per minute, which
defines the normal resting heart rate. Option C (40 to 60) is the intrinsic rate of the AV junction, and Option A (20 to
40) is the intrinsic rate of the Purkinje fibers and ventricular tissue, so both reflect backup pacemakers that take over
only when higher centers fail. Option D (100 to 150) exceeds any intrinsic pacemaker rate and suggests enhanced
automaticity such as sinus tachycardia or SVT. BayCare competency standards expect the nurse to recall this pacemaker
hierarchy (SA node faster than AV junction, which is faster than the ventricles) because the intrinsic rates predict which
escape rhythm will appear when a higher pacemaker fails.
Cardiac Monitoring Certification Preparation | Graded A+ 1
, BAYCARE EKG TEST | 2026/2027 | COMPETENCY EXAM PREP
Q2: During a telemetry competency assessment, the educator asks the nurse to define the normal
duration of the PR interval as measured from the beginning of the P wave to the beginning of the QRS
complex on a standard EKG strip. Which value is correct?
A. 0.06 to 0.10 second
B. 0.20 to 0.30 second
C. 0.12 to 0.20 second [CORRECT]
D. 0.30 to 0.40 second
Correct Answer: C
Rationale: The normal PR interval measures 0.12 to 0.20 second, which equals 3 to 5 small boxes on standard EKG
paper, and represents the time the impulse takes to travel from the atria through the AV node to the ventricles. Option A
(0.06 to 0.10 second) is the normal QRS duration, a classic measurement mix-up. Options B and D exceed 0.20 second
and describe first-degree AV block territory, in which conduction through or below the AV node is delayed. Accurate
interval measurement is a core BayCare EKG competency because PR prolongation is the earliest measurable sign of
AV conduction disease and drives the stepwise AV block classification.
Q3: A nurse is calculating the ventricular rate on a regular telemetry strip using the 1500 method. She
counts 15 small boxes between the peak of one R wave and the peak of the next R wave. What is the
ventricular rate?
A. 75 beats per minute
B. 100 beats per minute [CORRECT]
C. 60 beats per minute
D. 150 beats per minute
Correct Answer: B
Rationale: The 1500 method is the most precise rate calculation for regular rhythms: divide 1500 (the number of small
boxes in one minute) by the number of small boxes between consecutive R waves, so 1500 divided by 15 equals 100
beats per minute. Option A (75) results from incorrectly using the large-box 300 method with an incorrect box count,
Option C (60) overcounts the interval, and Option D (150) reflects a half-count error such as using the P-P interval
incorrectly. BayCare competency standards require nurses to select the 1500 method for regular rhythms and to
recognize that 100 beats per minute sits at the upper edge of normal sinus rhythm, warranting continued observation for
progression to sinus tachycardia.
Cardiac Monitoring Certification Preparation | Graded A+ 2
BayCare
EKG Test
Fifty verified-answer questions with detailed EKG
rationales covering conduction fundamentals,
dysrhythmias, ischemic patterns, electrolyte effects,
and emergency response — aligned with BayCare
competency domains and current ACLS guidelines.
Cardiac Monitoring Certification Preparation
50 Q UES T IO N S · V ER IFIED A N S WER S · GR A DED A+
2 0 2 0 2 7 E D I T I O N · I N D E P E N D E N T P R A C T I C E M AT E R I A L , N O T A F F I L I AT E D W I T H
O R E N D O R S E D B Y B AY C A R E H E A LT H S Y S T E M
,BAYCARE EKG TEST | 2026/2027 | COMPETENCY EXAM PREP
BayCare EKG Test
2026/2027 | Actual Questions and Verified Answers | Competency Exam Prep | Graded A+
Exam Overview: 50 multiple-choice questions in 5 sections, each with one best answer and a verified, explained rationale.
Items span recall (25%), application (50%), and analysis (25%) cognitive levels, aligned with BayCare Health System EKG
competency domains, telemetry monitoring standards, and current ACLS guidelines. Choose the single best option for each
item.
SECTION 1
Cardiac Conduction System and EKG Fundamentals
Questions 1 - 10
Conduction Pathway | Waveforms | Intervals | Measurement and Rate Calculation
Q1: A new graduate nurse is reviewing the cardiac conduction system with her BayCare preceptor
before the unit-based EKG competency check-off. The preceptor asks her to identify the normal
intrinsic firing rate of the sinoatrial (SA) node, the primary pacemaker of the heart. Which rate is
correct?
A. 20 to 40 beats per minute
B. 60 to 100 beats per minute [CORRECT]
C. 40 to 60 beats per minute
D. 100 to 150 beats per minute
Correct Answer: B
Rationale: The SA node is the heart's dominant pacemaker and fires intrinsically at 60 to 100 beats per minute, which
defines the normal resting heart rate. Option C (40 to 60) is the intrinsic rate of the AV junction, and Option A (20 to
40) is the intrinsic rate of the Purkinje fibers and ventricular tissue, so both reflect backup pacemakers that take over
only when higher centers fail. Option D (100 to 150) exceeds any intrinsic pacemaker rate and suggests enhanced
automaticity such as sinus tachycardia or SVT. BayCare competency standards expect the nurse to recall this pacemaker
hierarchy (SA node faster than AV junction, which is faster than the ventricles) because the intrinsic rates predict which
escape rhythm will appear when a higher pacemaker fails.
Cardiac Monitoring Certification Preparation | Graded A+ 1
, BAYCARE EKG TEST | 2026/2027 | COMPETENCY EXAM PREP
Q2: During a telemetry competency assessment, the educator asks the nurse to define the normal
duration of the PR interval as measured from the beginning of the P wave to the beginning of the QRS
complex on a standard EKG strip. Which value is correct?
A. 0.06 to 0.10 second
B. 0.20 to 0.30 second
C. 0.12 to 0.20 second [CORRECT]
D. 0.30 to 0.40 second
Correct Answer: C
Rationale: The normal PR interval measures 0.12 to 0.20 second, which equals 3 to 5 small boxes on standard EKG
paper, and represents the time the impulse takes to travel from the atria through the AV node to the ventricles. Option A
(0.06 to 0.10 second) is the normal QRS duration, a classic measurement mix-up. Options B and D exceed 0.20 second
and describe first-degree AV block territory, in which conduction through or below the AV node is delayed. Accurate
interval measurement is a core BayCare EKG competency because PR prolongation is the earliest measurable sign of
AV conduction disease and drives the stepwise AV block classification.
Q3: A nurse is calculating the ventricular rate on a regular telemetry strip using the 1500 method. She
counts 15 small boxes between the peak of one R wave and the peak of the next R wave. What is the
ventricular rate?
A. 75 beats per minute
B. 100 beats per minute [CORRECT]
C. 60 beats per minute
D. 150 beats per minute
Correct Answer: B
Rationale: The 1500 method is the most precise rate calculation for regular rhythms: divide 1500 (the number of small
boxes in one minute) by the number of small boxes between consecutive R waves, so 1500 divided by 15 equals 100
beats per minute. Option A (75) results from incorrectly using the large-box 300 method with an incorrect box count,
Option C (60) overcounts the interval, and Option D (150) reflects a half-count error such as using the P-P interval
incorrectly. BayCare competency standards require nurses to select the 1500 method for regular rhythms and to
recognize that 100 beats per minute sits at the upper edge of normal sinus rhythm, warranting continued observation for
progression to sinus tachycardia.
Cardiac Monitoring Certification Preparation | Graded A+ 2
