Relias Advanced Dysrhythmia Exam A Actual
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Essential Rhythm Identification
Q1: You are looking at a rhythm strip and see a regular rhythm with a rate of 82 beats
per minute. Every QRS complex is preceded by a upright, rounded P wave, the PR
interval measures 0.16 seconds, and the QRS is narrow at 0.08 seconds. What is this
rhythm?
A. Sinus tachycardia
B. Normal sinus rhythm [CORRECT]
C. Sinus bradycardia
D. Atrial flutter
Correct Answer: B
Rationale: That matches the criteria for normal sinus rhythm perfectly because all the
measurements—the rate, the upright P waves, the normal PR interval, and the narrow
QRS—fall exactly within the standard normal parameters.
Q2: When you are measuring the PR interval on an ECG, what is the correct way to
define the normal range?
A. 0.12 to 0.20 seconds [CORRECT]
B. 0.08 to 0.12 seconds
C. 0.20 to 0.28 seconds
D. 0.36 to 0.44 seconds
Correct Answer: A
Rationale: The best answer is 0.12 to 0.20 seconds because this is the established
normal time it takes for the electrical impulse to travel from the atria through the AV
node and into the ventricles.
Q3: A rhythm strip shows a regular rhythm at a rate of 110 beats per minute. The P
waves are upright and look normal, the PR interval is 0.14 seconds, and the QRS
measures 0.06 seconds. How do you document this rhythm?
A. Sinus tachycardia [CORRECT]
B. Sinus arrhythmia
C. Normal sinus rhythm
D. Junctional tachycardia
,Correct Answer: A
Rationale: This rhythm is correct because the key features are a rate greater than 100
but with a completely normal P wave, PR interval, and narrow QRS, which defines a
sinus tachycardia.
Q4: You are assessing regularity on a rhythm strip and notice that the R-to-R distance
from the first beat to the second beat is 0.80 seconds, but the distance from the second
to the third beat is 0.92 seconds, and it continues to vary like this. Which term best
describes this pattern?
A. Regularly irregular
B. Irregularly irregular [CORRECT]
C. Completely regular
D. Occasionally irregular
Correct Answer: B
Rationale: The best answer is irregularly irregular because there is absolutely no
predictable pattern to the R-to-R intervals, which is a classic descriptor for rhythms like
atrial fibrillation.
Q5: Why do we specifically look at Lead II when we are trying to identify the origin of the
P wave?
A. Lead II is the only lead that shows ventricular activity
B. Lead II provides the best baseline for measuring the QT interval
C. Lead II is oriented so that normal atrial depolarization moves toward it, making
normal P waves upright [CORRECT]
D. Lead II is completely unaffected by artifact
Correct Answer: C
Rationale: Remember that in this rhythm we look for the positive deflection of the P
wave, and Lead II sits perfectly in the electrical axis of the atria so a normal sinus
impulse will naturally point upward in that lead.
Q6: The QRS complex on your patient's monitor measures 0.12 seconds. What does
this widened QRS tell you about the electrical conduction in the ventricles?
A. The impulse is traveling normally through the bundle branches
B. The impulse is originating in the ventricles or there is a delay in the ventricular
conduction system [CORRECT]
C. The atria are not depolarizing at all
D. The SA node is firing too slowly
Correct Answer: B
Rationale: That matches the criteria for a widened QRS because a normal quick trip
through the ventricles takes less than 0.12 seconds, so anything wider means the
impulse is bypassing the normal fast pathways and taking a slower route.
, Q7: A nursing student asks you how to quickly calculate the heart rate on a regular
rhythm strip. If there are exactly 20 R-to-R intervals in a 6-second strip, what is the rate?
A. 60 beats per minute
B. 80 beats per minute
C. 100 beats per minute [CORRECT]
D. 120 beats per minute
Correct Answer: C
Rationale: The best answer is 100 beats per minute because you simply multiply the
number of QRS complexes in a 6-second strip by 10 to get the rate per minute.
Q8: What is the standard normal duration for the QRS complex in an adult?
A. 0.04 to 0.08 seconds
B. 0.06 to 0.10 seconds [CORRECT]
C. 0.12 to 0.16 seconds
D. 0.20 to 0.24 seconds
Correct Answer: B
Rationale: This aligns with the principle that the ventricles should depolarize very
quickly, and a duration between 0.06 and 0.10 seconds reflects normal, rapid
conduction through the His-Purkinje system.
Q9: You are looking at a rhythm strip and notice a smooth, wavy baseline instead of a
flat line between the QRS complexes. There are no distinct P waves visible. What is the
most likely explanation?
A. The patient is in normal sinus rhythm
B. There is severe baseline artifact mimicking a rhythm
C. The rhythm is atrial fibrillation or atrial flutter [CORRECT]
D. The patient has a first-degree AV block
Correct Answer: C
Rationale: This choice is correct because a wavy, chaotic baseline without distinct P
waves is the hallmark of atrial dysrhythmias where the atria are quivering instead of
conducting a single unified impulse.
Q10: When measuring the QRS complex, what specific landmarks do you use to start
and stop your measurement?
A. From the beginning of the P wave to the end of the T wave
B. From the beginning of the Q wave (or R wave if no Q) to the end of the S wave (or J
point) [CORRECT]
C. From the end of the P wave to the beginning of the T wave
D. From the peak of the R wave to the bottom of the S wave
Correct Answer: B
Exam | Complete 85 Real Questions Correct
Answers Verified – Pass Guaranteed - A+ Graded
Essential Rhythm Identification
Q1: You are looking at a rhythm strip and see a regular rhythm with a rate of 82 beats
per minute. Every QRS complex is preceded by a upright, rounded P wave, the PR
interval measures 0.16 seconds, and the QRS is narrow at 0.08 seconds. What is this
rhythm?
A. Sinus tachycardia
B. Normal sinus rhythm [CORRECT]
C. Sinus bradycardia
D. Atrial flutter
Correct Answer: B
Rationale: That matches the criteria for normal sinus rhythm perfectly because all the
measurements—the rate, the upright P waves, the normal PR interval, and the narrow
QRS—fall exactly within the standard normal parameters.
Q2: When you are measuring the PR interval on an ECG, what is the correct way to
define the normal range?
A. 0.12 to 0.20 seconds [CORRECT]
B. 0.08 to 0.12 seconds
C. 0.20 to 0.28 seconds
D. 0.36 to 0.44 seconds
Correct Answer: A
Rationale: The best answer is 0.12 to 0.20 seconds because this is the established
normal time it takes for the electrical impulse to travel from the atria through the AV
node and into the ventricles.
Q3: A rhythm strip shows a regular rhythm at a rate of 110 beats per minute. The P
waves are upright and look normal, the PR interval is 0.14 seconds, and the QRS
measures 0.06 seconds. How do you document this rhythm?
A. Sinus tachycardia [CORRECT]
B. Sinus arrhythmia
C. Normal sinus rhythm
D. Junctional tachycardia
,Correct Answer: A
Rationale: This rhythm is correct because the key features are a rate greater than 100
but with a completely normal P wave, PR interval, and narrow QRS, which defines a
sinus tachycardia.
Q4: You are assessing regularity on a rhythm strip and notice that the R-to-R distance
from the first beat to the second beat is 0.80 seconds, but the distance from the second
to the third beat is 0.92 seconds, and it continues to vary like this. Which term best
describes this pattern?
A. Regularly irregular
B. Irregularly irregular [CORRECT]
C. Completely regular
D. Occasionally irregular
Correct Answer: B
Rationale: The best answer is irregularly irregular because there is absolutely no
predictable pattern to the R-to-R intervals, which is a classic descriptor for rhythms like
atrial fibrillation.
Q5: Why do we specifically look at Lead II when we are trying to identify the origin of the
P wave?
A. Lead II is the only lead that shows ventricular activity
B. Lead II provides the best baseline for measuring the QT interval
C. Lead II is oriented so that normal atrial depolarization moves toward it, making
normal P waves upright [CORRECT]
D. Lead II is completely unaffected by artifact
Correct Answer: C
Rationale: Remember that in this rhythm we look for the positive deflection of the P
wave, and Lead II sits perfectly in the electrical axis of the atria so a normal sinus
impulse will naturally point upward in that lead.
Q6: The QRS complex on your patient's monitor measures 0.12 seconds. What does
this widened QRS tell you about the electrical conduction in the ventricles?
A. The impulse is traveling normally through the bundle branches
B. The impulse is originating in the ventricles or there is a delay in the ventricular
conduction system [CORRECT]
C. The atria are not depolarizing at all
D. The SA node is firing too slowly
Correct Answer: B
Rationale: That matches the criteria for a widened QRS because a normal quick trip
through the ventricles takes less than 0.12 seconds, so anything wider means the
impulse is bypassing the normal fast pathways and taking a slower route.
, Q7: A nursing student asks you how to quickly calculate the heart rate on a regular
rhythm strip. If there are exactly 20 R-to-R intervals in a 6-second strip, what is the rate?
A. 60 beats per minute
B. 80 beats per minute
C. 100 beats per minute [CORRECT]
D. 120 beats per minute
Correct Answer: C
Rationale: The best answer is 100 beats per minute because you simply multiply the
number of QRS complexes in a 6-second strip by 10 to get the rate per minute.
Q8: What is the standard normal duration for the QRS complex in an adult?
A. 0.04 to 0.08 seconds
B. 0.06 to 0.10 seconds [CORRECT]
C. 0.12 to 0.16 seconds
D. 0.20 to 0.24 seconds
Correct Answer: B
Rationale: This aligns with the principle that the ventricles should depolarize very
quickly, and a duration between 0.06 and 0.10 seconds reflects normal, rapid
conduction through the His-Purkinje system.
Q9: You are looking at a rhythm strip and notice a smooth, wavy baseline instead of a
flat line between the QRS complexes. There are no distinct P waves visible. What is the
most likely explanation?
A. The patient is in normal sinus rhythm
B. There is severe baseline artifact mimicking a rhythm
C. The rhythm is atrial fibrillation or atrial flutter [CORRECT]
D. The patient has a first-degree AV block
Correct Answer: C
Rationale: This choice is correct because a wavy, chaotic baseline without distinct P
waves is the hallmark of atrial dysrhythmias where the atria are quivering instead of
conducting a single unified impulse.
Q10: When measuring the QRS complex, what specific landmarks do you use to start
and stop your measurement?
A. From the beginning of the P wave to the end of the T wave
B. From the beginning of the Q wave (or R wave if no Q) to the end of the S wave (or J
point) [CORRECT]
C. From the end of the P wave to the beginning of the T wave
D. From the peak of the R wave to the bottom of the S wave
Correct Answer: B
