, Relias Dysrhythmia Basic A Exam
– 300 Q&A with Rationales,
Rhythm Strips & Study Guide
(2026 Update)
SECTION 1: SINUS RHYTHMS (Questions 1–30)
Q1. A patient's rhythm strip shows a heart rate of 88 bpm, regular R-R intervals, upright
P waves before each QRS, PR interval 0.16 sec, and QRS 0.08 sec. What is the
interpretation?
A) Sinus Bradycardia
B) Sinus Tachycardia
C) Normal Sinus Rhythm
D) Atrial Fibrillation
Rationale: All criteria are within normal limits: rate 60–100, regular, upright P waves,
normal PR (0.12–0.20), and narrow QRS (<0.12). This defines Normal Sinus Rhythm.
Q2. A 45-year-old athlete has a resting heart rate of 52 bpm. The rhythm is regular, P
waves are upright and precede each QRS, PR is 0.18 sec, and QRS is 0.10 sec. What is the
rhythm?
,A) Sinus Bradycardia
B) Normal Sinus Rhythm
C) First-degree AV block
D) Junctional Rhythm
Rationale: Rate is <60 bpm (52) but all other criteria are normal, making this Sinus
Bradycardia. Athletes often have this as a normal variant.
Q3. A patient presents with anxiety and palpitations. The strip shows a rate of 130 bpm,
regular rhythm, upright P waves, PR 0.16 sec, QRS 0.08 sec. What is the rhythm?
A) Normal Sinus Rhythm
B) Sinus Tachycardia
C) Atrial Flutter
D) SVT
Rationale: Rate >100 bpm (130) with all other normal criteria indicates Sinus Tachycardia.
The P waves are upright and consistent, distinguishing it from SVT.
Q4. A rhythm strip shows a rate of 110 bpm, regular, with upright P waves. PR interval is
0.20 sec, QRS 0.10 sec. What is the interpretation?
A) Normal Sinus Rhythm
B) Sinus Tachycardia
C) First-degree AV block
D) Sinus Bradycardia
Rationale: Rate is 110 (>100), regular, with normal P waves and PR. This is Sinus
Tachycardia. The PR is at the upper limit of normal but still acceptable.
Q5. A 70-year-old patient has a heart rate of 55 bpm, regular, with upright P waves. PR
0.14 sec, QRS 0.08 sec. The patient is asymptomatic. What is the rhythm?
, A) Sinus Bradycardia
B) Normal Sinus Rhythm
C) Junctional Rhythm
D) First-degree AV block
Rationale: Rate <60 bpm qualifies as Sinus Bradycardia. Asymptomatic bradycardia may
be normal, especially in elderly or well-conditioned individuals.
Q6. A strip shows a rate of 150 bpm, regular, P waves buried in T waves, PR unable to
measure. What is the most likely rhythm?
A) Sinus Tachycardia
B) Supraventricular Tachycardia (SVT)
C) Atrial Fibrillation
D) Ventricular Tachycardia
Rationale: SVT typically presents with a rate of 150–250 bpm, regular rhythm, and P
waves that are often hidden or difficult to distinguish. Sinus tachycardia would have visible
upright P waves.
Q7. A patient has a rate of 48 bpm, regular rhythm, upright P waves, PR 0.20 sec, QRS
0.10 sec. The patient is dizzy. What is the rhythm?
A) Sinus Bradycardia
B) Normal Sinus Rhythm
C) First-degree AV block
D) Junctional Rhythm
Rationale: Rate <60 bpm with normal P wave morphology and conduction confirms Sinus
Bradycardia. Symptoms like dizziness warrant further evaluation.
Q8. A strip shows a rate of 95 bpm, regular, upright P waves, PR 0.18 sec, QRS 0.12 sec.
What is the rhythm?
– 300 Q&A with Rationales,
Rhythm Strips & Study Guide
(2026 Update)
SECTION 1: SINUS RHYTHMS (Questions 1–30)
Q1. A patient's rhythm strip shows a heart rate of 88 bpm, regular R-R intervals, upright
P waves before each QRS, PR interval 0.16 sec, and QRS 0.08 sec. What is the
interpretation?
A) Sinus Bradycardia
B) Sinus Tachycardia
C) Normal Sinus Rhythm
D) Atrial Fibrillation
Rationale: All criteria are within normal limits: rate 60–100, regular, upright P waves,
normal PR (0.12–0.20), and narrow QRS (<0.12). This defines Normal Sinus Rhythm.
Q2. A 45-year-old athlete has a resting heart rate of 52 bpm. The rhythm is regular, P
waves are upright and precede each QRS, PR is 0.18 sec, and QRS is 0.10 sec. What is the
rhythm?
,A) Sinus Bradycardia
B) Normal Sinus Rhythm
C) First-degree AV block
D) Junctional Rhythm
Rationale: Rate is <60 bpm (52) but all other criteria are normal, making this Sinus
Bradycardia. Athletes often have this as a normal variant.
Q3. A patient presents with anxiety and palpitations. The strip shows a rate of 130 bpm,
regular rhythm, upright P waves, PR 0.16 sec, QRS 0.08 sec. What is the rhythm?
A) Normal Sinus Rhythm
B) Sinus Tachycardia
C) Atrial Flutter
D) SVT
Rationale: Rate >100 bpm (130) with all other normal criteria indicates Sinus Tachycardia.
The P waves are upright and consistent, distinguishing it from SVT.
Q4. A rhythm strip shows a rate of 110 bpm, regular, with upright P waves. PR interval is
0.20 sec, QRS 0.10 sec. What is the interpretation?
A) Normal Sinus Rhythm
B) Sinus Tachycardia
C) First-degree AV block
D) Sinus Bradycardia
Rationale: Rate is 110 (>100), regular, with normal P waves and PR. This is Sinus
Tachycardia. The PR is at the upper limit of normal but still acceptable.
Q5. A 70-year-old patient has a heart rate of 55 bpm, regular, with upright P waves. PR
0.14 sec, QRS 0.08 sec. The patient is asymptomatic. What is the rhythm?
, A) Sinus Bradycardia
B) Normal Sinus Rhythm
C) Junctional Rhythm
D) First-degree AV block
Rationale: Rate <60 bpm qualifies as Sinus Bradycardia. Asymptomatic bradycardia may
be normal, especially in elderly or well-conditioned individuals.
Q6. A strip shows a rate of 150 bpm, regular, P waves buried in T waves, PR unable to
measure. What is the most likely rhythm?
A) Sinus Tachycardia
B) Supraventricular Tachycardia (SVT)
C) Atrial Fibrillation
D) Ventricular Tachycardia
Rationale: SVT typically presents with a rate of 150–250 bpm, regular rhythm, and P
waves that are often hidden or difficult to distinguish. Sinus tachycardia would have visible
upright P waves.
Q7. A patient has a rate of 48 bpm, regular rhythm, upright P waves, PR 0.20 sec, QRS
0.10 sec. The patient is dizzy. What is the rhythm?
A) Sinus Bradycardia
B) Normal Sinus Rhythm
C) First-degree AV block
D) Junctional Rhythm
Rationale: Rate <60 bpm with normal P wave morphology and conduction confirms Sinus
Bradycardia. Symptoms like dizziness warrant further evaluation.
Q8. A strip shows a rate of 95 bpm, regular, upright P waves, PR 0.18 sec, QRS 0.12 sec.
What is the rhythm?
