Basic Arrhythmia Sentara Test
Questions and Answers GRADED A+
1. ECG Basics & Sinus Rhythms
1. What does the QRS complex represent?
A. Atrial depolarization
B. Ventricular depolarization
C. Ventricular repolarization
D. Atrial repolarization
Answer: B) Ventricular depolarization – The QRS complex
represents the electrical impulse spreading through the ventricles,
causing them to contract.
2. A patient has a heart rate of 45 bpm with upright, uniform
P waves before each QRS. This is called:
A. Sinus Tachycardia
B. Junctional Escape Rhythm
C. Normal Sinus Rhythm
D. Sinus Bradycardia
Answer: D) Sinus Bradycardia – The key features are a rate less
than 60 bpm with normal sinus rhythm characteristics (P waves
before each QRS).
3. Sinus Arrhythmia is characterized by:
A. A heart rate greater than 100 bpm
B. An irregular rhythm that is "regularly irregular" with the P-P
interval varying with respiration
C. Missing P waves
,D. A prolonged PR interval
Answer: B – Sinus arrhythmia is a variation of normal sinus
rhythm where the heart rate increases with inspiration and
decreases with expiration.
2. Atrial Dysrhythmias
4. A rhythm strip shows an irregularly irregular rhythm with
no distinct P waves. This is most consistent with:
A. Atrial Flutter
B. Atrial Fibrillation
C. Sinus Tachycardia
D. 2nd-degree AV Block Type II
Answer: B) Atrial Fibrillation – The hallmark of atrial fibrillation
is the chaotic, disorganized atrial activity resulting in no
discernible P waves and an irregularly irregular ventricular
response.
5. Which rhythm classically presents with a regular narrow-
complex tachycardia at 150 bpm and "sawtooth" flutter
waves?
A. Atrial Fibrillation
B. Atrial Flutter with 2:1 Conduction
C. Ventricular Tachycardia
D. Sinus Tachycardia
Answer: B) Atrial Flutter with 2:1 Conduction – Atrial flutter has
an atrial rate of 220-400 bpm. A 2:1 block is common, resulting in
a ventricular rate of ~150 bpm.
6. What is a Premature Atrial Contraction (PAC)?
A. A premature wide QRS complex
B. A premature abnormal P wave followed by a normal QRS
,C. A dropped QRS after a prolonged PR interval
D. An absence of P waves for a complete cycle
Answer: B – PACs originate from an ectopic focus in the atria,
creating an early, abnormally shaped P wave.
3. Junctional Rhythms
7. A patient has a slow regular rhythm at 45 bpm, no visible P
waves, and narrow QRS complexes. This rhythm is most likely:
A. Idioventricular Rhythm
B. Junctional Escape Rhythm
C. Sinus Bradycardia
D. Atrial Fibrillation
Answer: B) Junctional Escape Rhythm – This rhythm originates
from the AV junction, resulting in a normal QRS (narrow) and a
rate of 40-60 bpm. The P waves are often absent, inverted, or
occur after the QRS because the impulse is traveling backward.
8. A junctional tachycardia is defined as a junctional rhythm
with a rate greater than:
A. 60 bpm
B. 80 bpm
C. 100 bpm
D. 120 bpm
Answer: C) 100 bpm – Tachycardia is defined as a rate over 100
bpm.
4. Ventricular Dysrhythmias
9. Premature Ventricular Contractions (PVCs) are identified
by:
A. Early narrow QRS complexes
, B. Early wide bizarre QRS complexes without a preceding P wave
C. Sawtooth atrial activity
D. Prolonged PR intervals
Answer: B – PVCs originate in the ventricles, so the electrical
impulse bypasses the normal conduction pathway, resulting in a
wide (>0.12 seconds) and bizarre-looking QRS complex.
10. Frequent PVCs may be concerning because they can:
A. Prevent all arrhythmias
B. Precede ventricular tachycardia
C. Cause first-degree AV block
D. Always require immediate defibrillation
Answer: B – Frequent ventricular ectopy can be a sign of
increased ventricular irritability and may be a warning sign for
more serious ventricular arrhythmias like VT.
11. Which rhythm is most likely associated with a wide QRS
complex and a rate above 100 bpm?
A. Atrial Fibrillation
B. Sinus Tachycardia
C. Ventricular Tachycardia
D. Junctional Escape Rhythm
Answer: C) Ventricular Tachycardia – Ventricular tachycardia
(VT) is a fast rhythm originating from the ventricles, producing
wide QRS complexes.
12. The greatest risk with sustained Ventricular Tachycardia is:
A. It is a benign rhythm requiring no treatment
B. It may deteriorate into Ventricular Fibrillation (V-Fib) or cause
hemodynamic collapse
C. It always causes a stroke
Questions and Answers GRADED A+
1. ECG Basics & Sinus Rhythms
1. What does the QRS complex represent?
A. Atrial depolarization
B. Ventricular depolarization
C. Ventricular repolarization
D. Atrial repolarization
Answer: B) Ventricular depolarization – The QRS complex
represents the electrical impulse spreading through the ventricles,
causing them to contract.
2. A patient has a heart rate of 45 bpm with upright, uniform
P waves before each QRS. This is called:
A. Sinus Tachycardia
B. Junctional Escape Rhythm
C. Normal Sinus Rhythm
D. Sinus Bradycardia
Answer: D) Sinus Bradycardia – The key features are a rate less
than 60 bpm with normal sinus rhythm characteristics (P waves
before each QRS).
3. Sinus Arrhythmia is characterized by:
A. A heart rate greater than 100 bpm
B. An irregular rhythm that is "regularly irregular" with the P-P
interval varying with respiration
C. Missing P waves
,D. A prolonged PR interval
Answer: B – Sinus arrhythmia is a variation of normal sinus
rhythm where the heart rate increases with inspiration and
decreases with expiration.
2. Atrial Dysrhythmias
4. A rhythm strip shows an irregularly irregular rhythm with
no distinct P waves. This is most consistent with:
A. Atrial Flutter
B. Atrial Fibrillation
C. Sinus Tachycardia
D. 2nd-degree AV Block Type II
Answer: B) Atrial Fibrillation – The hallmark of atrial fibrillation
is the chaotic, disorganized atrial activity resulting in no
discernible P waves and an irregularly irregular ventricular
response.
5. Which rhythm classically presents with a regular narrow-
complex tachycardia at 150 bpm and "sawtooth" flutter
waves?
A. Atrial Fibrillation
B. Atrial Flutter with 2:1 Conduction
C. Ventricular Tachycardia
D. Sinus Tachycardia
Answer: B) Atrial Flutter with 2:1 Conduction – Atrial flutter has
an atrial rate of 220-400 bpm. A 2:1 block is common, resulting in
a ventricular rate of ~150 bpm.
6. What is a Premature Atrial Contraction (PAC)?
A. A premature wide QRS complex
B. A premature abnormal P wave followed by a normal QRS
,C. A dropped QRS after a prolonged PR interval
D. An absence of P waves for a complete cycle
Answer: B – PACs originate from an ectopic focus in the atria,
creating an early, abnormally shaped P wave.
3. Junctional Rhythms
7. A patient has a slow regular rhythm at 45 bpm, no visible P
waves, and narrow QRS complexes. This rhythm is most likely:
A. Idioventricular Rhythm
B. Junctional Escape Rhythm
C. Sinus Bradycardia
D. Atrial Fibrillation
Answer: B) Junctional Escape Rhythm – This rhythm originates
from the AV junction, resulting in a normal QRS (narrow) and a
rate of 40-60 bpm. The P waves are often absent, inverted, or
occur after the QRS because the impulse is traveling backward.
8. A junctional tachycardia is defined as a junctional rhythm
with a rate greater than:
A. 60 bpm
B. 80 bpm
C. 100 bpm
D. 120 bpm
Answer: C) 100 bpm – Tachycardia is defined as a rate over 100
bpm.
4. Ventricular Dysrhythmias
9. Premature Ventricular Contractions (PVCs) are identified
by:
A. Early narrow QRS complexes
, B. Early wide bizarre QRS complexes without a preceding P wave
C. Sawtooth atrial activity
D. Prolonged PR intervals
Answer: B – PVCs originate in the ventricles, so the electrical
impulse bypasses the normal conduction pathway, resulting in a
wide (>0.12 seconds) and bizarre-looking QRS complex.
10. Frequent PVCs may be concerning because they can:
A. Prevent all arrhythmias
B. Precede ventricular tachycardia
C. Cause first-degree AV block
D. Always require immediate defibrillation
Answer: B – Frequent ventricular ectopy can be a sign of
increased ventricular irritability and may be a warning sign for
more serious ventricular arrhythmias like VT.
11. Which rhythm is most likely associated with a wide QRS
complex and a rate above 100 bpm?
A. Atrial Fibrillation
B. Sinus Tachycardia
C. Ventricular Tachycardia
D. Junctional Escape Rhythm
Answer: C) Ventricular Tachycardia – Ventricular tachycardia
(VT) is a fast rhythm originating from the ventricles, producing
wide QRS complexes.
12. The greatest risk with sustained Ventricular Tachycardia is:
A. It is a benign rhythm requiring no treatment
B. It may deteriorate into Ventricular Fibrillation (V-Fib) or cause
hemodynamic collapse
C. It always causes a stroke
