Basic Arrhythmia Sentara Test Prep- ECG Rhythm
Recognition Practice Questions & Rationales 2026
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 duration of the P wave on an ECG tracing?
A. 0.04-0.08 seconds
B. 0.08-0.11 seconds
C. 0.12-0.20 seconds
D. 0.20-0.32 seconds
Correct Answer: B) 0.08-0.11 seconds
Rationale: The normal P wave duration is 0.08-0.11 seconds. A prolonged P wave may
indicate left atrial enlargement, while a peaked P wave may indicate right atrial
enlargement.
Question 2
What is the normal amplitude of the P wave in lead II?
A. 0.5-1.0 mm
B. 1.0-2.5 mm
,C. 2.5-4.0 mm
D. 4.0-6.0 mm
Correct Answer: B) 1.0-2.5 mm
Rationale: The normal P wave amplitude in lead II is 1.0-2.5 mm. A P wave >2.5 mm may
indicate right atrial enlargement.
Question 3
What does a prolonged QRS duration (>0.12 seconds) indicate?
A. Normal ventricular conduction
B. Bundle branch block or ventricular origin
C. Atrial enlargement
D. Normal atrial conduction
Correct Answer: B) Bundle branch block or ventricular origin
Rationale: A QRS duration >0.12 seconds indicates delayed ventricular conduction, which
can be caused by bundle branch block or a ventricular origin of the impulse.
Question 4
What is the normal amplitude of the QRS complex in the precordial leads?
A. 5-10 mm
B. 10-20 mm
C. 20-30 mm
D. 30-40 mm
Correct Answer: C) 20-30 mm
Rationale: The normal QRS amplitude in precordial leads is 20-30 mm. Increased
amplitude may indicate ventricular hypertrophy.
,Question 5
What does a flat or inverted T wave indicate?
A. Normal ventricular repolarization
B. Myocardial ischemia or electrolyte imbalance
C. Normal atrial repolarization
D. Normal ventricular depolarization
Correct Answer: B) Myocardial ischemia or electrolyte imbalance
Rationale: A flat or inverted T wave may indicate myocardial ischemia, electrolyte
imbalances, or other cardiac abnormalities.
Question 6
What is the normal duration of the QT interval corrected for heart rate (QTc)?
A. 0.20-0.30 seconds
B. 0.30-0.44 seconds
C. 0.44-0.52 seconds
D. 0.52-0.60 seconds
Correct Answer: B) 0.30-0.44 seconds
Rationale: The normal QTc is 0.30-0.44 seconds. A prolonged QTc increases the risk of
Torsades de Pointes.
Question 7
What does the U wave on an ECG represent?
A. Atrial repolarization
B. Ventricular repolarization
C. Purkinje fiber repolarization
D. Atrial depolarization
, Correct Answer: C) Purkinje fiber repolarization
Rationale: The U wave represents repolarization of the Purkinje fibers. Prominent U waves
may indicate hypokalemia.
Question 8
What is the normal PR segment duration?
A. 0.02-0.04 seconds
B. 0.04-0.08 seconds
C. 0.08-0.12 seconds
D. 0.12-0.20 seconds
Correct Answer: B) 0.04-0.08 seconds
Rationale: The PR segment is the isoelectric line between the end of the P wave and the
beginning of the QRS complex, normally lasting 0.04-0.08 seconds.
Question 9
What does ST segment elevation indicate?
A. Normal ventricular repolarization
B. Myocardial injury or infarction
C. Normal atrial repolarization
D. Normal ventricular depolarization
Correct Answer: B) Myocardial injury or infarction
Rationale: ST segment elevation indicates acute myocardial injury or infarction and
requires immediate intervention.
Question 10
Recognition Practice Questions & Rationales 2026
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 duration of the P wave on an ECG tracing?
A. 0.04-0.08 seconds
B. 0.08-0.11 seconds
C. 0.12-0.20 seconds
D. 0.20-0.32 seconds
Correct Answer: B) 0.08-0.11 seconds
Rationale: The normal P wave duration is 0.08-0.11 seconds. A prolonged P wave may
indicate left atrial enlargement, while a peaked P wave may indicate right atrial
enlargement.
Question 2
What is the normal amplitude of the P wave in lead II?
A. 0.5-1.0 mm
B. 1.0-2.5 mm
,C. 2.5-4.0 mm
D. 4.0-6.0 mm
Correct Answer: B) 1.0-2.5 mm
Rationale: The normal P wave amplitude in lead II is 1.0-2.5 mm. A P wave >2.5 mm may
indicate right atrial enlargement.
Question 3
What does a prolonged QRS duration (>0.12 seconds) indicate?
A. Normal ventricular conduction
B. Bundle branch block or ventricular origin
C. Atrial enlargement
D. Normal atrial conduction
Correct Answer: B) Bundle branch block or ventricular origin
Rationale: A QRS duration >0.12 seconds indicates delayed ventricular conduction, which
can be caused by bundle branch block or a ventricular origin of the impulse.
Question 4
What is the normal amplitude of the QRS complex in the precordial leads?
A. 5-10 mm
B. 10-20 mm
C. 20-30 mm
D. 30-40 mm
Correct Answer: C) 20-30 mm
Rationale: The normal QRS amplitude in precordial leads is 20-30 mm. Increased
amplitude may indicate ventricular hypertrophy.
,Question 5
What does a flat or inverted T wave indicate?
A. Normal ventricular repolarization
B. Myocardial ischemia or electrolyte imbalance
C. Normal atrial repolarization
D. Normal ventricular depolarization
Correct Answer: B) Myocardial ischemia or electrolyte imbalance
Rationale: A flat or inverted T wave may indicate myocardial ischemia, electrolyte
imbalances, or other cardiac abnormalities.
Question 6
What is the normal duration of the QT interval corrected for heart rate (QTc)?
A. 0.20-0.30 seconds
B. 0.30-0.44 seconds
C. 0.44-0.52 seconds
D. 0.52-0.60 seconds
Correct Answer: B) 0.30-0.44 seconds
Rationale: The normal QTc is 0.30-0.44 seconds. A prolonged QTc increases the risk of
Torsades de Pointes.
Question 7
What does the U wave on an ECG represent?
A. Atrial repolarization
B. Ventricular repolarization
C. Purkinje fiber repolarization
D. Atrial depolarization
, Correct Answer: C) Purkinje fiber repolarization
Rationale: The U wave represents repolarization of the Purkinje fibers. Prominent U waves
may indicate hypokalemia.
Question 8
What is the normal PR segment duration?
A. 0.02-0.04 seconds
B. 0.04-0.08 seconds
C. 0.08-0.12 seconds
D. 0.12-0.20 seconds
Correct Answer: B) 0.04-0.08 seconds
Rationale: The PR segment is the isoelectric line between the end of the P wave and the
beginning of the QRS complex, normally lasting 0.04-0.08 seconds.
Question 9
What does ST segment elevation indicate?
A. Normal ventricular repolarization
B. Myocardial injury or infarction
C. Normal atrial repolarization
D. Normal ventricular depolarization
Correct Answer: B) Myocardial injury or infarction
Rationale: ST segment elevation indicates acute myocardial injury or infarction and
requires immediate intervention.
Question 10
