Basic Arrhythmia Sentara Test Prep- ECG Rhythm
Recognition Practice Questions & Rationales 2026-2027
This specialized clinical preparation resource provides targeted practice questions,
verified answers, and detailed telemetry rationales designed for the Sentara Healthcare
Basic Arrhythmia competency assessment. It covers core electrocardiogram (ECG)
tracking capabilities, including calculating heart rates, measuring cardiac intervals, and
identifying lethal dysrhythmias such as ventricular fibrillation and various heart blocks.
Critical care nurses, telemetry technicians, and allied health professionals will master
rhythm strip analysis and immediate nursing intervention protocols to ensure clinical
safety and pass their mandatory employment screening.
Question 1
What is the normal axis range for the QRS complex on a 12-lead ECG?
A. -30° to +90°
B. 0° to +120°
C. -90° to 0°
D. +90° to +180°
Correct Answer: A) -30° to +90°
Rationale: The normal QRS axis falls between -30° and +90°. Deviation outside this range
may indicate bundle branch block, ventricular hypertrophy, or other conduction
abnormalities.
Question 2
What is the primary ECG finding in left bundle branch block (LBBB)?
A. QRS >0.12 sec with a broad, notched R wave in leads I, V5, and V6
B. QRS >0.12 sec with a broad, notched R wave in leads V1 and V2
C. QRS <0.12 sec with a normal R wave progression
D. QRS >0.12 sec with a sawtooth baseline
,Correct Answer: A) QRS >0.12 sec with a broad, notched R wave in leads I, V5, and
V6
Rationale: LBBB is characterized by a QRS duration >0.12 seconds with a broad, notched R
wave in lateral leads (I, V5, V6) and a QS or rS pattern in right precordial leads (V1, V2).
Question 3
What is the primary ECG finding in right bundle branch block (RBBB)?
A. QRS >0.12 sec with an rSR' pattern in leads V1 and V2
B. QRS >0.12 sec with a broad, notched R wave in leads I, V5, and V6
C. QRS <0.12 sec with a normal R wave progression
D. QRS >0.12 sec with a sawtooth baseline
Correct Answer: A) QRS >0.12 sec with an rSR' pattern in leads V1 and V2
Rationale: RBBB is characterized by a QRS duration >0.12 seconds with an rSR' pattern
("rabbit ears") in leads V1 and V2, and a broad, slurred S wave in lateral leads (I, V5, V6).
Question 4
What is the primary ECG finding in left ventricular hypertrophy (LVH)?
A. Increased R wave amplitude in left precordial leads (V5, V6) and S wave depth in right
precordial leads (V1, V2)
B. Increased R wave amplitude in right precordial leads (V1, V2)
C. Low voltage QRS complexes
D. Sawtooth baseline
Correct Answer: A) Increased R wave amplitude in left precordial leads (V5, V6)
and S wave depth in right precordial leads (V1, V2)
Rationale: LVH is characterized by increased R wave amplitude in left precordial leads (V5,
V6) and increased S wave depth in right precordial leads (V1, V2), often with ST-T wave
changes.
,Question 5
What is the primary ECG finding in right ventricular hypertrophy (RVH)?
A. Increased R wave amplitude in right precordial leads (V1, V2) with right axis deviation
B. Increased R wave amplitude in left precordial leads (V5, V6)
C. Low voltage QRS complexes
D. Sawtooth baseline
Correct Answer: A) Increased R wave amplitude in right precordial leads (V1, V2)
with right axis deviation
Rationale: RVH is characterized by increased R wave amplitude in right precordial leads
(V1, V2) with right axis deviation and often ST-T wave changes.
Question 6
What is the primary ECG finding in left atrial enlargement?
A. Broad, notched P wave in leads I, II, and V1 (P mitrale)
B. Tall, peaked P wave in leads II, III, and aVF (P pulmonale)
C. Absent P waves
D. Inverted P waves
Correct Answer: A) Broad, notched P wave in leads I, II, and V1 (P mitrale)
Rationale: Left atrial enlargement is characterized by a broad, notched P wave (P mitrale)
in leads I, II, and V1, with a duration >0.12 seconds.
Question 7
What is the primary ECG finding in right atrial enlargement?
, A. Tall, peaked P wave in leads II, III, and aVF (P pulmonale)
B. Broad, notched P wave in leads I, II, and V1
C. Absent P waves
D. Inverted P waves
Correct Answer: A) Tall, peaked P wave in leads II, III, and aVF (P pulmonale)
Rationale: Right atrial enlargement is characterized by a tall, peaked P wave (P
pulmonale) in leads II, III, and aVF, with an amplitude >2.5 mm.
Question 8
What is the primary ECG finding in acute pericarditis?
A. Diffuse ST segment elevation with PR segment depression
B. Localized ST segment elevation in a single coronary artery distribution
C. ST segment depression
D. T wave inversion
Correct Answer: A) Diffuse ST segment elevation with PR segment depression
Rationale: Acute pericarditis is characterized by diffuse ST segment elevation and PR
segment depression, often with chest pain that improves when sitting forward.
Question 9
What is the primary ECG finding in hyperkalemia?
A. Tall, peaked T waves with a narrow base
B. Flat T waves
C. ST segment elevation
D. U waves
Correct Answer: A) Tall, peaked T waves with a narrow base
Rationale: Hyperkalemia is characterized by tall, peaked T waves with a narrow base,
which may progress to QRS widening and a sine wave pattern in severe cases.
Recognition Practice Questions & Rationales 2026-2027
This specialized clinical preparation resource provides targeted practice questions,
verified answers, and detailed telemetry rationales designed for the Sentara Healthcare
Basic Arrhythmia competency assessment. It covers core electrocardiogram (ECG)
tracking capabilities, including calculating heart rates, measuring cardiac intervals, and
identifying lethal dysrhythmias such as ventricular fibrillation and various heart blocks.
Critical care nurses, telemetry technicians, and allied health professionals will master
rhythm strip analysis and immediate nursing intervention protocols to ensure clinical
safety and pass their mandatory employment screening.
Question 1
What is the normal axis range for the QRS complex on a 12-lead ECG?
A. -30° to +90°
B. 0° to +120°
C. -90° to 0°
D. +90° to +180°
Correct Answer: A) -30° to +90°
Rationale: The normal QRS axis falls between -30° and +90°. Deviation outside this range
may indicate bundle branch block, ventricular hypertrophy, or other conduction
abnormalities.
Question 2
What is the primary ECG finding in left bundle branch block (LBBB)?
A. QRS >0.12 sec with a broad, notched R wave in leads I, V5, and V6
B. QRS >0.12 sec with a broad, notched R wave in leads V1 and V2
C. QRS <0.12 sec with a normal R wave progression
D. QRS >0.12 sec with a sawtooth baseline
,Correct Answer: A) QRS >0.12 sec with a broad, notched R wave in leads I, V5, and
V6
Rationale: LBBB is characterized by a QRS duration >0.12 seconds with a broad, notched R
wave in lateral leads (I, V5, V6) and a QS or rS pattern in right precordial leads (V1, V2).
Question 3
What is the primary ECG finding in right bundle branch block (RBBB)?
A. QRS >0.12 sec with an rSR' pattern in leads V1 and V2
B. QRS >0.12 sec with a broad, notched R wave in leads I, V5, and V6
C. QRS <0.12 sec with a normal R wave progression
D. QRS >0.12 sec with a sawtooth baseline
Correct Answer: A) QRS >0.12 sec with an rSR' pattern in leads V1 and V2
Rationale: RBBB is characterized by a QRS duration >0.12 seconds with an rSR' pattern
("rabbit ears") in leads V1 and V2, and a broad, slurred S wave in lateral leads (I, V5, V6).
Question 4
What is the primary ECG finding in left ventricular hypertrophy (LVH)?
A. Increased R wave amplitude in left precordial leads (V5, V6) and S wave depth in right
precordial leads (V1, V2)
B. Increased R wave amplitude in right precordial leads (V1, V2)
C. Low voltage QRS complexes
D. Sawtooth baseline
Correct Answer: A) Increased R wave amplitude in left precordial leads (V5, V6)
and S wave depth in right precordial leads (V1, V2)
Rationale: LVH is characterized by increased R wave amplitude in left precordial leads (V5,
V6) and increased S wave depth in right precordial leads (V1, V2), often with ST-T wave
changes.
,Question 5
What is the primary ECG finding in right ventricular hypertrophy (RVH)?
A. Increased R wave amplitude in right precordial leads (V1, V2) with right axis deviation
B. Increased R wave amplitude in left precordial leads (V5, V6)
C. Low voltage QRS complexes
D. Sawtooth baseline
Correct Answer: A) Increased R wave amplitude in right precordial leads (V1, V2)
with right axis deviation
Rationale: RVH is characterized by increased R wave amplitude in right precordial leads
(V1, V2) with right axis deviation and often ST-T wave changes.
Question 6
What is the primary ECG finding in left atrial enlargement?
A. Broad, notched P wave in leads I, II, and V1 (P mitrale)
B. Tall, peaked P wave in leads II, III, and aVF (P pulmonale)
C. Absent P waves
D. Inverted P waves
Correct Answer: A) Broad, notched P wave in leads I, II, and V1 (P mitrale)
Rationale: Left atrial enlargement is characterized by a broad, notched P wave (P mitrale)
in leads I, II, and V1, with a duration >0.12 seconds.
Question 7
What is the primary ECG finding in right atrial enlargement?
, A. Tall, peaked P wave in leads II, III, and aVF (P pulmonale)
B. Broad, notched P wave in leads I, II, and V1
C. Absent P waves
D. Inverted P waves
Correct Answer: A) Tall, peaked P wave in leads II, III, and aVF (P pulmonale)
Rationale: Right atrial enlargement is characterized by a tall, peaked P wave (P
pulmonale) in leads II, III, and aVF, with an amplitude >2.5 mm.
Question 8
What is the primary ECG finding in acute pericarditis?
A. Diffuse ST segment elevation with PR segment depression
B. Localized ST segment elevation in a single coronary artery distribution
C. ST segment depression
D. T wave inversion
Correct Answer: A) Diffuse ST segment elevation with PR segment depression
Rationale: Acute pericarditis is characterized by diffuse ST segment elevation and PR
segment depression, often with chest pain that improves when sitting forward.
Question 9
What is the primary ECG finding in hyperkalemia?
A. Tall, peaked T waves with a narrow base
B. Flat T waves
C. ST segment elevation
D. U waves
Correct Answer: A) Tall, peaked T waves with a narrow base
Rationale: Hyperkalemia is characterized by tall, peaked T waves with a narrow base,
which may progress to QRS widening and a sine wave pattern in severe cases.
