EKGs FOR THE NURSE PRACTITIONER AND
PHYSICIAN ASSISSTANT EXAM NEWEST EXAM
QUESTIONS AND CORRECT DETAILED A NEW
UPDATED VERSION LATEST 2026-2027 FULLY
REVISED EXAM/EKGs EXAM 2026 (EXPERT
VERIFIED ANSWERS) MOST RECENT EXAM
ALREADY GRADED A+
A 68-year-old male with a history of hypertension presents with acute onset
substernal chest pressure radiating to the jaw. His initial ECG shows 2-mm ST-
segment elevations in leads V1 through V4. Which of the following is the most
likely diagnosis?
A) Acute pericarditis
B) Left ventricular hypertrophy
C) Anteroseptal ST-elevation myocardial infarction
D) Early repolarization
Answer: C
Rationale: ST-segment elevation in contiguous precordial leads V1-V4
indicates an anteroseptal wall MI, typically due to occlusion of the left anterior
descending artery. Pericarditis would show diffuse, concave-up ST elevations,
while LVH shows high-voltage QRS complexes with strain patterns. Early
repolarization is a benign finding in young, healthy patients.
,A 72-year-old female complains of palpitations and dizziness. Her ECG shows
a regular rhythm with a rate of 160 bpm, narrow QRS complexes, and no
visible P waves. What is the most appropriate interpretation?
A) Atrial fibrillation
B) Atrial flutter with 2:1 conduction
C) Paroxysmal supraventricular tachycardia (PSVT)
D) Sinus tachycardia
Answer: C
Rationale: PSVT presents with a regular, narrow-complex tachycardia at 150-
250 bpm with absent or retrograde P waves. Atrial fibrillation is irregularly
irregular. Atrial flutter typically has sawtooth flutter waves and is often regular
but may have variable conduction. Sinus tachycardia has identifiable P waves
and a gradual onset.
A 55-year-old man presents with syncope. His ECG reveals a prolonged PR
interval >200 ms and a fixed, delayed conduction to the ventricles with a
normal QRS duration. Which of the following best describes this finding?
A) First-degree AV block
B) Second-degree AV block Mobitz type I
C) Second-degree AV block Mobitz type II
D) Third-degree AV block
Answer: A
Rationale: First-degree AV block is defined by a PR interval >0.20 seconds
(200 ms) with all P waves conducting. Mobitz type I shows progressive PR
prolongation before a dropped beat; Mobitz type II shows fixed PR intervals
with intermittent nonconducted P waves; third-degree AV block has no atrial
impulses conducted to the ventricles.
,A 60-year-old diabetic patient has an ECG showing Q waves in leads II, III,
and aVF, with 1-mm ST elevations. These findings are consistent with which
type of myocardial infarction?
A) Anterior wall MI
B) Lateral wall MI
C) Inferior wall MI
D) Posterior wall MI
Answer: C
Rationale: Q waves and ST elevations in the inferior leads (II, III, aVF)
indicate an inferior wall MI, usually from right coronary artery occlusion.
Anterior MI involves V1-V4; lateral involves I, aVL, V5-V6; posterior MI
shows tall R waves and ST depressions in V1-V3.
A 45-year-old female has an ECG with a heart rate of 48 bpm, a normal QRS
duration, and a P wave preceding every QRS complex. What is the most likely
diagnosis?
A) Sinus bradycardia
B) Junctional rhythm
C) Atrial fibrillation with slow ventricular response
D) First-degree AV block
Answer: A
Rationale: Sinus bradycardia is a sinus rhythm with a rate <60 bpm, with
normal P waves preceding each QRS. Junctional rhythm lacks P waves or has
inverted P waves. Atrial fibrillation has no P waves and an irregular rhythm.
First-degree AV block has a prolonged PR interval but normal rate.
, A patient’s ECG shows a heart rate of 220 bpm, a wide QRS complex (>120
ms), and no identifiable P waves. The rhythm is regular. Which of the
following is the most likely arrhythmia?
A) Atrial fibrillation with aberrancy
B) Ventricular tachycardia
C) Supraventricular tachycardia with bundle branch block
D) Wolff-Parkinson-White syndrome
Answer: B
Rationale: A regular, wide-complex tachycardia at >200 bpm with no P waves
is ventricular tachycardia until proven otherwise. Atrial fibrillation is
irregularly irregular. SVT with aberrancy is possible but less common; WPW
has a delta wave and short PR interval, not usually this fast without
preexcitation.
A 50-year-old male has ECG changes including ST-segment depressions in
leads V1-V3 and a prominent R wave in V1. What is the most likely diagnosis?
A) Posterior wall MI
B) Anterior wall MI
C) Inferior wall MI
D) Lateral wall MI
Answer: A
Rationale: Posterior MI is diagnosed by reciprocal changes in anterior leads:
ST depression and tall R waves in V1-V3, since posterior leads are not
routinely obtained. Anterior MI shows ST elevation in V1-V4; inferior in II,
III, aVF; lateral in I, aVL, V5-V6.
PHYSICIAN ASSISSTANT EXAM NEWEST EXAM
QUESTIONS AND CORRECT DETAILED A NEW
UPDATED VERSION LATEST 2026-2027 FULLY
REVISED EXAM/EKGs EXAM 2026 (EXPERT
VERIFIED ANSWERS) MOST RECENT EXAM
ALREADY GRADED A+
A 68-year-old male with a history of hypertension presents with acute onset
substernal chest pressure radiating to the jaw. His initial ECG shows 2-mm ST-
segment elevations in leads V1 through V4. Which of the following is the most
likely diagnosis?
A) Acute pericarditis
B) Left ventricular hypertrophy
C) Anteroseptal ST-elevation myocardial infarction
D) Early repolarization
Answer: C
Rationale: ST-segment elevation in contiguous precordial leads V1-V4
indicates an anteroseptal wall MI, typically due to occlusion of the left anterior
descending artery. Pericarditis would show diffuse, concave-up ST elevations,
while LVH shows high-voltage QRS complexes with strain patterns. Early
repolarization is a benign finding in young, healthy patients.
,A 72-year-old female complains of palpitations and dizziness. Her ECG shows
a regular rhythm with a rate of 160 bpm, narrow QRS complexes, and no
visible P waves. What is the most appropriate interpretation?
A) Atrial fibrillation
B) Atrial flutter with 2:1 conduction
C) Paroxysmal supraventricular tachycardia (PSVT)
D) Sinus tachycardia
Answer: C
Rationale: PSVT presents with a regular, narrow-complex tachycardia at 150-
250 bpm with absent or retrograde P waves. Atrial fibrillation is irregularly
irregular. Atrial flutter typically has sawtooth flutter waves and is often regular
but may have variable conduction. Sinus tachycardia has identifiable P waves
and a gradual onset.
A 55-year-old man presents with syncope. His ECG reveals a prolonged PR
interval >200 ms and a fixed, delayed conduction to the ventricles with a
normal QRS duration. Which of the following best describes this finding?
A) First-degree AV block
B) Second-degree AV block Mobitz type I
C) Second-degree AV block Mobitz type II
D) Third-degree AV block
Answer: A
Rationale: First-degree AV block is defined by a PR interval >0.20 seconds
(200 ms) with all P waves conducting. Mobitz type I shows progressive PR
prolongation before a dropped beat; Mobitz type II shows fixed PR intervals
with intermittent nonconducted P waves; third-degree AV block has no atrial
impulses conducted to the ventricles.
,A 60-year-old diabetic patient has an ECG showing Q waves in leads II, III,
and aVF, with 1-mm ST elevations. These findings are consistent with which
type of myocardial infarction?
A) Anterior wall MI
B) Lateral wall MI
C) Inferior wall MI
D) Posterior wall MI
Answer: C
Rationale: Q waves and ST elevations in the inferior leads (II, III, aVF)
indicate an inferior wall MI, usually from right coronary artery occlusion.
Anterior MI involves V1-V4; lateral involves I, aVL, V5-V6; posterior MI
shows tall R waves and ST depressions in V1-V3.
A 45-year-old female has an ECG with a heart rate of 48 bpm, a normal QRS
duration, and a P wave preceding every QRS complex. What is the most likely
diagnosis?
A) Sinus bradycardia
B) Junctional rhythm
C) Atrial fibrillation with slow ventricular response
D) First-degree AV block
Answer: A
Rationale: Sinus bradycardia is a sinus rhythm with a rate <60 bpm, with
normal P waves preceding each QRS. Junctional rhythm lacks P waves or has
inverted P waves. Atrial fibrillation has no P waves and an irregular rhythm.
First-degree AV block has a prolonged PR interval but normal rate.
, A patient’s ECG shows a heart rate of 220 bpm, a wide QRS complex (>120
ms), and no identifiable P waves. The rhythm is regular. Which of the
following is the most likely arrhythmia?
A) Atrial fibrillation with aberrancy
B) Ventricular tachycardia
C) Supraventricular tachycardia with bundle branch block
D) Wolff-Parkinson-White syndrome
Answer: B
Rationale: A regular, wide-complex tachycardia at >200 bpm with no P waves
is ventricular tachycardia until proven otherwise. Atrial fibrillation is
irregularly irregular. SVT with aberrancy is possible but less common; WPW
has a delta wave and short PR interval, not usually this fast without
preexcitation.
A 50-year-old male has ECG changes including ST-segment depressions in
leads V1-V3 and a prominent R wave in V1. What is the most likely diagnosis?
A) Posterior wall MI
B) Anterior wall MI
C) Inferior wall MI
D) Lateral wall MI
Answer: A
Rationale: Posterior MI is diagnosed by reciprocal changes in anterior leads:
ST depression and tall R waves in V1-V3, since posterior leads are not
routinely obtained. Anterior MI shows ST elevation in V1-V4; inferior in II,
III, aVF; lateral in I, aVL, V5-V6.
