RELIAS Medical-Surgical Telemetry Updated 2026 | Comprehensive Study Guide, Practice
Exam Questions and Answers, Exam Prep Test Bank, ECG Interpretation and Rhythm
Analysis, Cardiac Dysrhythmia Recognition and Management, Telemetry Monitoring
Procedures, Cardiovascular Nursing Assessment, Hemodynamic Monitoring Principles,
Acute Care Clinical Decision-Making, and Detailed Rationales for Competency Exam
Preparation
Question 1: What is the primary purpose of telemetry monitoring on a medical-
surgical unit?
A. To continuously monitor blood pressure
B. To continuously monitor cardiac rhythm
C. To monitor respiratory rate continuously
D. To monitor urine output continuously
CORRECT ANSWER: B. To continuously monitor cardiac rhythm
Rationale: Telemetry primarily involves the continuous monitoring of a patient's
electrocardiogram (ECG) to detect arrhythmias, ischemia, and other cardiac
abnormalities in real-time.
Question 2: In a standard 3-lead telemetry setup, which electrode is typically
placed on the right arm or right side of the chest?
A. Black
B. Red
C. White
D. Green
CORRECT ANSWER: C. White
Rationale: In a standard 3-lead system following the "white on right" mnemonic, the
white electrode is placed on the right arm or the right upper chest.
Question 3: What is the recommended skin preparation step before applying
telemetry electrodes?
A. Apply a thick layer of conductive gel
B. Shave the hair and clean the skin with alcohol
C. Scrub the skin with povidone-iodine
D. Apply lotion to prevent skin breakdown
CORRECT ANSWER: B. Shave the hair and clean the skin with alcohol
Rationale: Proper skin preparation, including clipping or shaving hair and cleaning the
skin with alcohol to remove oils and dead skin cells, ensures good electrode contact
and reduces artifact.
Question 4: Which telemetry lead is most commonly used for monitoring the P
wave?
A. Lead I
B. Lead II
,C. Lead III
D. Lead MCL1
CORRECT ANSWER: B. Lead II
Rationale: Lead II runs parallel to the heart's normal electrical axis and provides
excellent visualization of the P wave, making it ideal for assessing atrial activity.
Question 5: What does the P wave on an ECG represent?
A. Ventricular depolarization
B. Ventricular repolarization
C. Atrial depolarization
D. Atrial repolarization
CORRECT ANSWER: C. Atrial depolarization
Rationale: The P wave represents the electrical activation (depolarization) of the right
and left atria, which leads to atrial contraction.
Question 6: Which ECG complex represents ventricular depolarization?
A. P wave
B. QRS complex
C. T wave
D. U wave
CORRECT ANSWER: B. QRS complex
Rationale: The QRS complex represents the rapid depolarization of the right and left
ventricles, which triggers ventricular contraction.
Question 7: What is the normal duration of the QRS complex in an adult?
A. 0.04 to 0.10 seconds
B. 0.12 to 0.20 seconds
C. 0.20 to 0.24 seconds
D. 0.36 to 0.44 seconds
CORRECT ANSWER: A. 0.04 to 0.10 seconds
Rationale: The normal QRS duration is less than 0.12 seconds, typically ranging
between 0.04 and 0.10 seconds, indicating rapid ventricular depolarization.
Question 8: The PR interval measures the time it takes for an electrical impulse to
travel from the:
A. Ventricles to the atria
B. SA node to the AV node and through the Bundle of His
C. Bundle of His to the Purkinje fibers
D. Atria to the ventricles
,CORRECT ANSWER: B. SA node to the AV node and through the Bundle of His
Rationale: The PR interval represents the time from the onset of atrial depolarization to
the onset of ventricular depolarization, reflecting conduction through the AV node and
His-Purkinje system.
Question 9: What is the normal duration for the PR interval?
A. 0.04 to 0.10 seconds
B. 0.12 to 0.20 seconds
C. 0.20 to 0.24 seconds
D. 0.36 to 0.44 seconds
CORRECT ANSWER: B. 0.12 to 0.20 seconds
Rationale: A normal PR interval lasts between 0.12 and 0.20 seconds (3 to 5 small
boxes on standard ECG paper).
Question 10: What does the T wave represent on an ECG strip?
A. Atrial depolarization
B. Atrial repolarization
C. Ventricular depolarization
D. Ventricular repolarization
CORRECT ANSWER: D. Ventricular repolarization
Rationale: The T wave represents ventricular repolarization, the recovery phase of the
ventricles before the next electrical impulse.
Question 11: Which characteristic defines Normal Sinus Rhythm (NSR)?
A. Heart rate 60-100 bpm, regular rhythm, normal P wave before every QRS
B. Heart rate >100 bpm, irregular rhythm, absent P waves
C. Heart rate <60 bpm, regular rhythm, prolonged PR interval
D. Heart rate 40-60 bpm, wide QRS complexes
CORRECT ANSWER: A. Heart rate 60-100 bpm, regular rhythm, normal P wave
before every QRS
Rationale: NSR is defined by a rate of 60-100 bpm, a regular rhythm, upright P waves in
Lead II preceding every QRS, and normal PR and QRS intervals.
Question 12: A patient on telemetry has a heart rate of 45 bpm with a normal P wave
before each QRS complex. This rhythm is identified as:
A. Sinus tachycardia
B. Sinus bradycardia
C. Normal sinus rhythm
D. Junctional rhythm
CORRECT ANSWER: B. Sinus bradycardia
, Rationale: Sinus bradycardia is characterized by a sinus rhythm (normal P waves,
normal intervals) but with a heart rate of less than 60 beats per minute.
Question 13: Which of the following is a common physiological cause of sinus
tachycardia?
A. Hypothermia
B. Hypothyroidism
C. Fever and pain
D. Beta-blocker administration
CORRECT ANSWER: C. Fever and pain
Rationale: Sinus tachycardia (HR > 100 bpm) is often a normal compensatory response
to physiological stressors such as fever, pain, anxiety, hypovolemia, or exercise.
Question 14: What is the primary nursing intervention for a symptomatic patient
with sinus bradycardia?
A. Administer epinephrine immediately
B. Administer atropine as prescribed
C. Defibrillate the patient
D. Perform synchronized cardioversion
CORRECT ANSWER: B. Administer atropine as prescribed
Rationale: Atropine is the first-line medication for symptomatic bradycardia as it blocks
vagal stimulation, increasing the heart rate.
Question 15: Premature Atrial Contractions (PACs) originate from an ectopic focus
in the:
A. Ventricles
B. Atria
C. AV node
D. Bundle of His
CORRECT ANSWER: B. Atria
Rationale: PACs are early electrical impulses that originate from an ectopic pacemaker
within the atria, causing an early, abnormal P wave.
Question 16: Which feature distinguishes a Premature Ventricular Contraction
(PVC) on a telemetry strip?
A. Early, narrow QRS complex with a normal P wave
B. Wide, bizarre QRS complex without a preceding P wave
C. Prolonged PR interval before a normal QRS
D. Absent QRS complexes for more than 6 seconds
CORRECT ANSWER: B. Wide, bizarre QRS complex without a preceding P wave
Exam Questions and Answers, Exam Prep Test Bank, ECG Interpretation and Rhythm
Analysis, Cardiac Dysrhythmia Recognition and Management, Telemetry Monitoring
Procedures, Cardiovascular Nursing Assessment, Hemodynamic Monitoring Principles,
Acute Care Clinical Decision-Making, and Detailed Rationales for Competency Exam
Preparation
Question 1: What is the primary purpose of telemetry monitoring on a medical-
surgical unit?
A. To continuously monitor blood pressure
B. To continuously monitor cardiac rhythm
C. To monitor respiratory rate continuously
D. To monitor urine output continuously
CORRECT ANSWER: B. To continuously monitor cardiac rhythm
Rationale: Telemetry primarily involves the continuous monitoring of a patient's
electrocardiogram (ECG) to detect arrhythmias, ischemia, and other cardiac
abnormalities in real-time.
Question 2: In a standard 3-lead telemetry setup, which electrode is typically
placed on the right arm or right side of the chest?
A. Black
B. Red
C. White
D. Green
CORRECT ANSWER: C. White
Rationale: In a standard 3-lead system following the "white on right" mnemonic, the
white electrode is placed on the right arm or the right upper chest.
Question 3: What is the recommended skin preparation step before applying
telemetry electrodes?
A. Apply a thick layer of conductive gel
B. Shave the hair and clean the skin with alcohol
C. Scrub the skin with povidone-iodine
D. Apply lotion to prevent skin breakdown
CORRECT ANSWER: B. Shave the hair and clean the skin with alcohol
Rationale: Proper skin preparation, including clipping or shaving hair and cleaning the
skin with alcohol to remove oils and dead skin cells, ensures good electrode contact
and reduces artifact.
Question 4: Which telemetry lead is most commonly used for monitoring the P
wave?
A. Lead I
B. Lead II
,C. Lead III
D. Lead MCL1
CORRECT ANSWER: B. Lead II
Rationale: Lead II runs parallel to the heart's normal electrical axis and provides
excellent visualization of the P wave, making it ideal for assessing atrial activity.
Question 5: What does the P wave on an ECG represent?
A. Ventricular depolarization
B. Ventricular repolarization
C. Atrial depolarization
D. Atrial repolarization
CORRECT ANSWER: C. Atrial depolarization
Rationale: The P wave represents the electrical activation (depolarization) of the right
and left atria, which leads to atrial contraction.
Question 6: Which ECG complex represents ventricular depolarization?
A. P wave
B. QRS complex
C. T wave
D. U wave
CORRECT ANSWER: B. QRS complex
Rationale: The QRS complex represents the rapid depolarization of the right and left
ventricles, which triggers ventricular contraction.
Question 7: What is the normal duration of the QRS complex in an adult?
A. 0.04 to 0.10 seconds
B. 0.12 to 0.20 seconds
C. 0.20 to 0.24 seconds
D. 0.36 to 0.44 seconds
CORRECT ANSWER: A. 0.04 to 0.10 seconds
Rationale: The normal QRS duration is less than 0.12 seconds, typically ranging
between 0.04 and 0.10 seconds, indicating rapid ventricular depolarization.
Question 8: The PR interval measures the time it takes for an electrical impulse to
travel from the:
A. Ventricles to the atria
B. SA node to the AV node and through the Bundle of His
C. Bundle of His to the Purkinje fibers
D. Atria to the ventricles
,CORRECT ANSWER: B. SA node to the AV node and through the Bundle of His
Rationale: The PR interval represents the time from the onset of atrial depolarization to
the onset of ventricular depolarization, reflecting conduction through the AV node and
His-Purkinje system.
Question 9: What is the normal duration for the PR interval?
A. 0.04 to 0.10 seconds
B. 0.12 to 0.20 seconds
C. 0.20 to 0.24 seconds
D. 0.36 to 0.44 seconds
CORRECT ANSWER: B. 0.12 to 0.20 seconds
Rationale: A normal PR interval lasts between 0.12 and 0.20 seconds (3 to 5 small
boxes on standard ECG paper).
Question 10: What does the T wave represent on an ECG strip?
A. Atrial depolarization
B. Atrial repolarization
C. Ventricular depolarization
D. Ventricular repolarization
CORRECT ANSWER: D. Ventricular repolarization
Rationale: The T wave represents ventricular repolarization, the recovery phase of the
ventricles before the next electrical impulse.
Question 11: Which characteristic defines Normal Sinus Rhythm (NSR)?
A. Heart rate 60-100 bpm, regular rhythm, normal P wave before every QRS
B. Heart rate >100 bpm, irregular rhythm, absent P waves
C. Heart rate <60 bpm, regular rhythm, prolonged PR interval
D. Heart rate 40-60 bpm, wide QRS complexes
CORRECT ANSWER: A. Heart rate 60-100 bpm, regular rhythm, normal P wave
before every QRS
Rationale: NSR is defined by a rate of 60-100 bpm, a regular rhythm, upright P waves in
Lead II preceding every QRS, and normal PR and QRS intervals.
Question 12: A patient on telemetry has a heart rate of 45 bpm with a normal P wave
before each QRS complex. This rhythm is identified as:
A. Sinus tachycardia
B. Sinus bradycardia
C. Normal sinus rhythm
D. Junctional rhythm
CORRECT ANSWER: B. Sinus bradycardia
, Rationale: Sinus bradycardia is characterized by a sinus rhythm (normal P waves,
normal intervals) but with a heart rate of less than 60 beats per minute.
Question 13: Which of the following is a common physiological cause of sinus
tachycardia?
A. Hypothermia
B. Hypothyroidism
C. Fever and pain
D. Beta-blocker administration
CORRECT ANSWER: C. Fever and pain
Rationale: Sinus tachycardia (HR > 100 bpm) is often a normal compensatory response
to physiological stressors such as fever, pain, anxiety, hypovolemia, or exercise.
Question 14: What is the primary nursing intervention for a symptomatic patient
with sinus bradycardia?
A. Administer epinephrine immediately
B. Administer atropine as prescribed
C. Defibrillate the patient
D. Perform synchronized cardioversion
CORRECT ANSWER: B. Administer atropine as prescribed
Rationale: Atropine is the first-line medication for symptomatic bradycardia as it blocks
vagal stimulation, increasing the heart rate.
Question 15: Premature Atrial Contractions (PACs) originate from an ectopic focus
in the:
A. Ventricles
B. Atria
C. AV node
D. Bundle of His
CORRECT ANSWER: B. Atria
Rationale: PACs are early electrical impulses that originate from an ectopic pacemaker
within the atria, causing an early, abnormal P wave.
Question 16: Which feature distinguishes a Premature Ventricular Contraction
(PVC) on a telemetry strip?
A. Early, narrow QRS complex with a normal P wave
B. Wide, bizarre QRS complex without a preceding P wave
C. Prolonged PR interval before a normal QRS
D. Absent QRS complexes for more than 6 seconds
CORRECT ANSWER: B. Wide, bizarre QRS complex without a preceding P wave
