Relias Dysrhythmia Basic A Exam (2025/2026 Update) – Exam Elaboration with Questions and Answers | Graded A+

Relias Dysrhythmia Basic A Exam
(2025/2026 Update) – Exam Elaboration
with Questions and Answers | Graded A+
This Relias Dysrhythmia Basic A exam review is updated for 2025/2026, featuring 50 multiple-
choice questions on cardiac rhythms, ECG interpretation, and dysrhythmia management.
Questions include clinical scenarios, with correct answers in RED and detailed rationales based
on ACLS and AHA guidelines.



Question 1: What is the defining characteristic of normal sinus rhythm (NSR) on an ECG
strip? A regular rhythm with a rate between 60-100 bpm, upright P waves before each
QRS, and PR interval 0.12-0.20 seconds Rationale: NSR originates from the SA node, with
consistent P-QRS-T complexes indicating normal conduction; rate <60 bradycardia, >100
tachycardia.



Question 2: A client exhibits a regular rhythm with a heart rate of 45 bpm, normal P
waves, and PR interval of 0.16 seconds. What is this rhythm? Sinus bradycardia Rationale:
Sinus bradycardia has a rate <60 bpm but normal P wave and PR interval; common in athletes or
beta-blocker use; monitor for symptoms like dizziness.



Question 3: What rhythm is characterized by a regular rhythm, rate 101-150 bpm, normal
P waves, and PR interval 0.12-0.20 seconds? Sinus tachycardia Rationale: Sinus tachycardia
reflects sympathetic stimulation, with all sinus features but rate >100 bpm; treat underlying cause
like pain or hypovolemia.



Question 4: An ECG shows irregular rhythm with varying P-P intervals but normal QRS
complexes and rate 60-100 bpm; what is the diagnosis? Sinus arrhythmia Rationale: Sinus
arrhythmia is common with respiration, where P waves march out but rate varies; benign, no
treatment needed unless symptomatic.



Question 5: What rhythm features a regular rhythm, rate >150 bpm, P waves before QRS,
and PR 0.12-0.20 seconds? Supraventricular tachycardia (SVT) Rationale: SVT is rapid

, atrial rhythm; vagal maneuvers or adenosine to terminate; distinguish from sinus tach by sudden
onset.



Question 6: The ECG shows an irregular rhythm with no visible P waves, undulating
baseline, and irregular ventricular rate 100-175 bpm; identify the rhythm. Atrial
fibrillation with rapid ventricular response (A-fib RVR) Rationale: A-fib lacks organized
atrial activity (f waves), causing irregular conduction; rate control with beta-blockers or
cardioversion if unstable.



Question 7: What rhythm has regular atrial rate 250-350 bpm, sawtooth P waves, and
variable ventricular rate? Atrial flutter Rationale: Atrial flutter is macro-reentrant; 2:1
conduction common (150 bpm ventricular); anticoagulate if AFib history.



Question 8: An ECG demonstrates an irregular rhythm with premature P waves not
followed by QRS, rate 60-100 bpm; what is this? Premature atrial contractions (PACs)
Rationale: PACs are early atrial beats from ectopic focus; benign unless frequent, monitor for
progression to AFib.



Question 9: The rhythm is regular, rate 40-60 bpm, no P waves, PR absent, QRS narrow;
diagnosis? Junctional rhythm Rationale: Junctional rhythm originates from AV node;
retrograde P waves possible; treat underlying bradycardia if symptomatic.



Question 10: What rhythm shows regular rhythm, rate 60-100 bpm, premature P wave, PR
0.12-0.20 seconds? Premature atrial contraction (PAC) Rationale: PAC is early atrial beat;
often benign, assess for electrolyte imbalance.



Question 11: An ECG shows irregular rhythm, no P waves, irregular R-R intervals,
ventricular rate 100-175 bpm; what is it? Atrial fibrillation Rationale: A-fib causes chaotic
atrial activity; anticoagulate per CHA2DS2-VASc score.