HCA Healthcare Telemetry Exam (NEW 2026/2027
Update) | 200 Questions with Verified Answers &
Detailed Rationales | Complete Solutions Guide
|Graded A+
SECTION 1: CARDIAC ELECTROPHYSIOLOGY FUNDAMENTALS (Questions 1–25)
1. The sinoatrial (SA) node is located in which chamber of the heart?
A. Left atrium
B. Right atrium
C. Left ventricle
D. Right ventricle
Correct Answer: B
Rationale: The SA node is located in the upper wall of the right atrium near the superior vena
cava. It is the heart's natural pacemaker, generating electrical impulses that initiate each cardiac
cycle .
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. 100–120 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 .
3. What is the normal intrinsic firing rate of the AV node?
,A. 20–40 beats per minute
B. 40–60 beats per minute
C. 60–100 beats per minute
D. 100–120 beats per minute
Correct Answer: B
Rationale: The AV node has an intrinsic rate of 40–60 bpm. If the SA node fails, the AV node can
act as a backup pacemaker .
4. What is the normal intrinsic firing rate of the Purkinje fibers?
A. 20–40 beats per minute
B. 40–60 beats per minute
C. 60–100 beats per minute
D. 100–120 beats per minute
Correct Answer: A
Rationale: Purkinje fibers have the slowest intrinsic rate at 20–40 bpm. They serve as the last-
resort pacemaker if higher nodes fail .
5. The AV node delays the electrical impulse by approximately how long?
A. 0.04–0.08 seconds
B. 0.12–0.20 seconds
C. 0.20–0.40 seconds
D. 0.40–0.60 seconds
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 .
6. Which component of the conduction system has the fastest intrinsic firing rate?
,A. SA node
B. AV node
C. Purkinje fibers
D. Bundle of His
Correct Answer: A
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 .
7. What does the P wave represent on an ECG?
A. Ventricular depolarization
B. Ventricular repolarization
C. Atrial depolarization
D. Atrial repolarization
Correct Answer: C
Rationale: The P wave represents atrial depolarization, which is the electrical activation of the
atria resulting in atrial contraction. In telemetry monitoring, we always look for the P wave first
to determine if the rhythm is originating from the sinus node .
8. What does the QRS complex represent on an ECG?
A. Atrial depolarization
B. Ventricular depolarization
C. Ventricular repolarization
D. Atrial repolarization
Correct Answer: B
Rationale: The QRS complex represents rapid ventricular depolarization. Atrial repolarization is
hidden within the QRS complex .
9. What does the T wave represent on an ECG?
, A. Atrial depolarization
B. Ventricular depolarization
C. Ventricular repolarization
D. Atrial repolarization
Correct Answer: C
Rationale: The T wave represents ventricular repolarization (relaxation). It follows the QRS
complex .
10. What is the normal duration of the PR interval?
A. 0.04–0.10 seconds
B. 0.12–0.20 seconds
C. 0.20–0.40 seconds
D. Greater than 0.40 seconds
Correct Answer: B
Rationale: Normal PR interval (from start of P wave to start of QRS) is 0.12–0.20 seconds (3–5
small boxes). Prolonged PR suggests heart block .
11. What is the normal duration of the QRS complex?
A. Less than 0.06 seconds
B. Less than 0.12 seconds
C. 0.12–0.20 seconds
D. Greater than 0.20 seconds
Correct Answer: B
Rationale: Normal QRS duration is ≤0.10–0.12 seconds (≤2.5–3 small boxes). A wide QRS (>0.12
sec) indicates a ventricular rhythm or bundle branch block .
12. A rhythm strip shows a QRS complex duration of 0.14 seconds. What does this indicate?
A. Normal ventricular conduction
B. Delayed ventricular conduction
Update) | 200 Questions with Verified Answers &
Detailed Rationales | Complete Solutions Guide
|Graded A+
SECTION 1: CARDIAC ELECTROPHYSIOLOGY FUNDAMENTALS (Questions 1–25)
1. The sinoatrial (SA) node is located in which chamber of the heart?
A. Left atrium
B. Right atrium
C. Left ventricle
D. Right ventricle
Correct Answer: B
Rationale: The SA node is located in the upper wall of the right atrium near the superior vena
cava. It is the heart's natural pacemaker, generating electrical impulses that initiate each cardiac
cycle .
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. 100–120 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 .
3. What is the normal intrinsic firing rate of the AV node?
,A. 20–40 beats per minute
B. 40–60 beats per minute
C. 60–100 beats per minute
D. 100–120 beats per minute
Correct Answer: B
Rationale: The AV node has an intrinsic rate of 40–60 bpm. If the SA node fails, the AV node can
act as a backup pacemaker .
4. What is the normal intrinsic firing rate of the Purkinje fibers?
A. 20–40 beats per minute
B. 40–60 beats per minute
C. 60–100 beats per minute
D. 100–120 beats per minute
Correct Answer: A
Rationale: Purkinje fibers have the slowest intrinsic rate at 20–40 bpm. They serve as the last-
resort pacemaker if higher nodes fail .
5. The AV node delays the electrical impulse by approximately how long?
A. 0.04–0.08 seconds
B. 0.12–0.20 seconds
C. 0.20–0.40 seconds
D. 0.40–0.60 seconds
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 .
6. Which component of the conduction system has the fastest intrinsic firing rate?
,A. SA node
B. AV node
C. Purkinje fibers
D. Bundle of His
Correct Answer: A
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 .
7. What does the P wave represent on an ECG?
A. Ventricular depolarization
B. Ventricular repolarization
C. Atrial depolarization
D. Atrial repolarization
Correct Answer: C
Rationale: The P wave represents atrial depolarization, which is the electrical activation of the
atria resulting in atrial contraction. In telemetry monitoring, we always look for the P wave first
to determine if the rhythm is originating from the sinus node .
8. What does the QRS complex represent on an ECG?
A. Atrial depolarization
B. Ventricular depolarization
C. Ventricular repolarization
D. Atrial repolarization
Correct Answer: B
Rationale: The QRS complex represents rapid ventricular depolarization. Atrial repolarization is
hidden within the QRS complex .
9. What does the T wave represent on an ECG?
, A. Atrial depolarization
B. Ventricular depolarization
C. Ventricular repolarization
D. Atrial repolarization
Correct Answer: C
Rationale: The T wave represents ventricular repolarization (relaxation). It follows the QRS
complex .
10. What is the normal duration of the PR interval?
A. 0.04–0.10 seconds
B. 0.12–0.20 seconds
C. 0.20–0.40 seconds
D. Greater than 0.40 seconds
Correct Answer: B
Rationale: Normal PR interval (from start of P wave to start of QRS) is 0.12–0.20 seconds (3–5
small boxes). Prolonged PR suggests heart block .
11. What is the normal duration of the QRS complex?
A. Less than 0.06 seconds
B. Less than 0.12 seconds
C. 0.12–0.20 seconds
D. Greater than 0.20 seconds
Correct Answer: B
Rationale: Normal QRS duration is ≤0.10–0.12 seconds (≤2.5–3 small boxes). A wide QRS (>0.12
sec) indicates a ventricular rhythm or bundle branch block .
12. A rhythm strip shows a QRS complex duration of 0.14 seconds. What does this indicate?
A. Normal ventricular conduction
B. Delayed ventricular conduction
