Page 1 of 71
RELIAS DYSRHYTHMIA BASIC A EXAM PREP BANK | 100
EXAM-STYLE PRACTICE QUESTIONS WITH DETAILED
RATIONALES
Health Sciences / Nursing / Clinical Medicine / Cardiology
Exam coverage :-
• Section 1 (Q1–15): Fundamentals of ECG interpretation,
including systematic analysis, rate calculation, regularity
assessment, and interval measurement.
• Section 2 (Q16–30): Sinus rhythms, including normal sinus
rhythm, sinus bradycardia, sinus tachycardia, sinus
arrhythmia, and first-degree AV block.
• Section 3 (Q31–45): Atrial rhythms, including atrial
fibrillation, atrial flutter, and junctional rhythms.
• Section 4 (Q46–75): Ventricular rhythms and heart blocks,
including idioventricular rhythm, accelerated
idioventricular rhythm, ventricular tachycardia, ventricular
fibrillation, and asystole.
• Section 5 (Q76–100): Pacemaker rhythms and clinical
decision-making, including atrial, ventricular, and AV
paced rhythms, failure to capture, and failure to sense.
, Page 2 of 71
• Section 1: Fundamentals of ECG Interpretation
(Questions 1–15)
• Question 1
A nurse is preparing to interpret a cardiac rhythm strip for
the Relias Dysrhythmia Basic A examination. The nurse
must demonstrate understanding of the systematic
approach to rhythm analysis. Which of the following
represents the correct sequence for analyzing a cardiac
rhythm strip?
A. Rate → Rhythm → P waves → PR interval → QRS complex →
QT interval
B. Rhythm → Rate → P waves → PR interval → QRS complex →
QT interval
C. P waves → QRS complex → Rate → Rhythm → PR interval →
QT interval
D. QRS complex → P waves → Rate → Rhythm → PR interval →
QT interval
CORRECT ANSWER: A ✅
RATIONALE: The systematic approach to rhythm analysis
begins with determining the rate, then assessing the
regularity (rhythm), followed by evaluating P waves,
measuring the PR interval, assessing the QRS complex,
and finally evaluating the QT interval. Option B is incorrect
because rate is determined first, before rhythm. Option C
is incorrect because rate and rhythm precede P wave
analysis. Option D is incorrect because rate and rhythm
are assessed before QRS complex analysis.
, Page 3 of 71
• Question 2
A nurse is interpreting an ECG strip and must calculate the
heart rate. The nurse identifies 15 small boxes between
two consecutive R waves. Using the 1,500 method, what is
the heart rate?
A. 60 beats per minute
B. 80 beats per minute
C. 100 beats per minute
D. 120 beats per minute
CORRECT ANSWER: C ✅
RATIONALE: The 1,500 method for calculating heart rate
involves dividing 1,500 by the number of small boxes
between two consecutive R waves. 1,500 ÷ 15 = 100 beats
per minute. Option A is incorrect because 1,500 ÷ 25 = 60.
Option B is incorrect because 1,500 ÷ 18.75 = 80. Option D
is incorrect because 1,500 ÷ 12.5 = 120.
• Question 3
A nurse is analyzing a rhythm strip and notices that the R-R
intervals are irregular. Which of the following rhythms is
most likely associated with an irregular ventricular
response?
A. Sinus rhythm
B. Atrial fibrillation
C. Sinus tachycardia
D. Junctional rhythm
CORRECT ANSWER: B ✅
, Page 4 of 71
RATIONALE: Atrial fibrillation is characterized by an
irregularly irregular ventricular response due to chaotic
atrial electrical activity. Option A is incorrect because
sinus rhythm is typically regular. Option C is incorrect
because sinus tachycardia is typically regular. Option D is
incorrect because junctional rhythm is typically regular.
• Question 4
A nurse is evaluating a rhythm strip and must determine
the origin of the rhythm. The presence of a normal P wave
before each QRS complex indicates which of the
following?
A. Junctional rhythm
B. Sinus rhythm
C. Ventricular rhythm
D. Atrial flutter
CORRECT ANSWER: B ✅
RATIONALE: A normal P wave before each QRS complex
indicates that the rhythm originates in the sinoatrial (SA)
node, which is characteristic of sinus rhythm. Option A is
incorrect because junctional rhythm may have inverted or
absent P waves. Option C is incorrect because ventricular
rhythm has wide QRS complexes without P waves. Option
D is incorrect because atrial flutter has sawtooth flutter
waves.
• Question 5
A nurse is measuring the PR interval on an ECG strip. The
nurse counts 5 small boxes from the beginning of the P
RELIAS DYSRHYTHMIA BASIC A EXAM PREP BANK | 100
EXAM-STYLE PRACTICE QUESTIONS WITH DETAILED
RATIONALES
Health Sciences / Nursing / Clinical Medicine / Cardiology
Exam coverage :-
• Section 1 (Q1–15): Fundamentals of ECG interpretation,
including systematic analysis, rate calculation, regularity
assessment, and interval measurement.
• Section 2 (Q16–30): Sinus rhythms, including normal sinus
rhythm, sinus bradycardia, sinus tachycardia, sinus
arrhythmia, and first-degree AV block.
• Section 3 (Q31–45): Atrial rhythms, including atrial
fibrillation, atrial flutter, and junctional rhythms.
• Section 4 (Q46–75): Ventricular rhythms and heart blocks,
including idioventricular rhythm, accelerated
idioventricular rhythm, ventricular tachycardia, ventricular
fibrillation, and asystole.
• Section 5 (Q76–100): Pacemaker rhythms and clinical
decision-making, including atrial, ventricular, and AV
paced rhythms, failure to capture, and failure to sense.
, Page 2 of 71
• Section 1: Fundamentals of ECG Interpretation
(Questions 1–15)
• Question 1
A nurse is preparing to interpret a cardiac rhythm strip for
the Relias Dysrhythmia Basic A examination. The nurse
must demonstrate understanding of the systematic
approach to rhythm analysis. Which of the following
represents the correct sequence for analyzing a cardiac
rhythm strip?
A. Rate → Rhythm → P waves → PR interval → QRS complex →
QT interval
B. Rhythm → Rate → P waves → PR interval → QRS complex →
QT interval
C. P waves → QRS complex → Rate → Rhythm → PR interval →
QT interval
D. QRS complex → P waves → Rate → Rhythm → PR interval →
QT interval
CORRECT ANSWER: A ✅
RATIONALE: The systematic approach to rhythm analysis
begins with determining the rate, then assessing the
regularity (rhythm), followed by evaluating P waves,
measuring the PR interval, assessing the QRS complex,
and finally evaluating the QT interval. Option B is incorrect
because rate is determined first, before rhythm. Option C
is incorrect because rate and rhythm precede P wave
analysis. Option D is incorrect because rate and rhythm
are assessed before QRS complex analysis.
, Page 3 of 71
• Question 2
A nurse is interpreting an ECG strip and must calculate the
heart rate. The nurse identifies 15 small boxes between
two consecutive R waves. Using the 1,500 method, what is
the heart rate?
A. 60 beats per minute
B. 80 beats per minute
C. 100 beats per minute
D. 120 beats per minute
CORRECT ANSWER: C ✅
RATIONALE: The 1,500 method for calculating heart rate
involves dividing 1,500 by the number of small boxes
between two consecutive R waves. 1,500 ÷ 15 = 100 beats
per minute. Option A is incorrect because 1,500 ÷ 25 = 60.
Option B is incorrect because 1,500 ÷ 18.75 = 80. Option D
is incorrect because 1,500 ÷ 12.5 = 120.
• Question 3
A nurse is analyzing a rhythm strip and notices that the R-R
intervals are irregular. Which of the following rhythms is
most likely associated with an irregular ventricular
response?
A. Sinus rhythm
B. Atrial fibrillation
C. Sinus tachycardia
D. Junctional rhythm
CORRECT ANSWER: B ✅
, Page 4 of 71
RATIONALE: Atrial fibrillation is characterized by an
irregularly irregular ventricular response due to chaotic
atrial electrical activity. Option A is incorrect because
sinus rhythm is typically regular. Option C is incorrect
because sinus tachycardia is typically regular. Option D is
incorrect because junctional rhythm is typically regular.
• Question 4
A nurse is evaluating a rhythm strip and must determine
the origin of the rhythm. The presence of a normal P wave
before each QRS complex indicates which of the
following?
A. Junctional rhythm
B. Sinus rhythm
C. Ventricular rhythm
D. Atrial flutter
CORRECT ANSWER: B ✅
RATIONALE: A normal P wave before each QRS complex
indicates that the rhythm originates in the sinoatrial (SA)
node, which is characteristic of sinus rhythm. Option A is
incorrect because junctional rhythm may have inverted or
absent P waves. Option C is incorrect because ventricular
rhythm has wide QRS complexes without P waves. Option
D is incorrect because atrial flutter has sawtooth flutter
waves.
• Question 5
A nurse is measuring the PR interval on an ECG strip. The
nurse counts 5 small boxes from the beginning of the P
