RELIAS DYsRHYTHMIA BASIC A
2025–2026 COMPREHENSIVE PRACTICE
EXAMINATION
Original Questions • Correct Answers • Detailed Rationales
COVER PAGE
EXAMINATION TITLE
Relias Dysrhythmia Basic A – 2025/2026 Comprehensive Practice Examination
EXAM TYPE
Dysrhythmia Recognition, ECG Interpretation, and Basic Clinical Management
EDITION
2025–2026
QUESTION FORMAT
Single-best-answer multiple choice, clinical scenarios, rhythm-analysis questions, and priority
questions
TOTAL QUESTIONS
200
STUDENT NAME: ______________________________________
DATE: _______________________________________________
INSTRUCTOR: _________________________________________
SCORE: __________ / 200
TIME: ________________________________________________
questions or answers. The questions are designed around commonly
taught basic dysrhythmia-recognition and ECG-interpretation concepts.
,EXAMINATION DIRECTIONS
For each question, select the one best answer unless otherwise indicated.
When interpreting a rhythm, systematically evaluate:
1. Rate
2. Rhythm regularity
3. P-wave presence and morphology
4. PR interval
5. QRS duration
6. Relationship between P waves and QRS complexes
7. Patient symptoms and hemodynamic status
For clinical-priority questions, determine what should be done first.
CONTENT BLUEPRINT
Section Topic Questions
I ECG & Cardiac Conduction Fundamentals 1–20
II Sinus Rhythms 21–40
III Atrial Dysrhythmias 41–65
IV Junctional Rhythms 66–80
V Ventricular Dysrhythmias 81–110
VI AV Blocks 111–135
VII Pacemakers & Conduction Problems 136–150
VIII Clinical Assessment & Nursing Priorities 151–170
IX Integrated Rhythm Interpretation 171–185
X Comprehensive Challenge Questions 186–200
SECTION I — ECG & CARDIAC
CONDUCTION FUNDAMENTALS
Question 1
,Which structure normally functions as the primary pacemaker of the heart?
A. AV node
B. SA node
C. Bundle of His
D. Purkinje fibers
Correct Answer: B. SA node
Rationale: The sinoatrial node normally initiates the electrical impulse that produces sinus
rhythm. It has the fastest intrinsic firing rate among the normal cardiac pacemakers.
Question 2
Which ECG component represents atrial depolarization?
A. P wave
B. QRS complex
C. T wave
D. ST segment
Correct Answer: A. P wave
Rationale: The P wave represents electrical depolarization of the atria. Ventricular
depolarization is represented by the QRS complex, while ventricular repolarization is represented
primarily by the T wave.
Question 3
The normal PR interval is generally:
A. 0.04–0.08 second
B. 0.12–0.20 second
C. 0.24–0.32 second
D. 0.36–0.44 second
Correct Answer: B. 0.12–0.20 second
Rationale: A normal PR interval is approximately 0.12–0.20 second. It represents conduction
from atrial depolarization through the AV node and His-Purkinje system to the ventricles.
, Question 4
A QRS complex measures 0.08 second. How should this finding be interpreted?
A. Widened
B. Prolonged
C. Within the usual normal range
D. Consistent with complete heart block
Correct Answer: C. Within the usual normal range
Rationale: A normal QRS is generally less than 0.12 second. A narrow QRS suggests that
ventricular activation is occurring through the normal conduction system.
Question 5
Which ECG component represents ventricular depolarization?
A. P wave
B. PR interval
C. QRS complex
D. T wave
Correct Answer: C. QRS complex
Rationale: The QRS complex represents ventricular depolarization. The T wave represents
ventricular repolarization.
Question 6
A patient has an ECG with regular R-R intervals occurring approximately every 0.8 second.
What is the approximate ventricular rate?
A. 50 beats/min
B. 60 beats/min
C. 75 beats/min
D. 100 beats/min
Correct Answer: C. 75 beats/min
Rationale: Rate can be estimated by dividing 60 by the R-R interval in seconds: 60 ÷ 0.8 =
approximately 75 beats/min.
2025–2026 COMPREHENSIVE PRACTICE
EXAMINATION
Original Questions • Correct Answers • Detailed Rationales
COVER PAGE
EXAMINATION TITLE
Relias Dysrhythmia Basic A – 2025/2026 Comprehensive Practice Examination
EXAM TYPE
Dysrhythmia Recognition, ECG Interpretation, and Basic Clinical Management
EDITION
2025–2026
QUESTION FORMAT
Single-best-answer multiple choice, clinical scenarios, rhythm-analysis questions, and priority
questions
TOTAL QUESTIONS
200
STUDENT NAME: ______________________________________
DATE: _______________________________________________
INSTRUCTOR: _________________________________________
SCORE: __________ / 200
TIME: ________________________________________________
questions or answers. The questions are designed around commonly
taught basic dysrhythmia-recognition and ECG-interpretation concepts.
,EXAMINATION DIRECTIONS
For each question, select the one best answer unless otherwise indicated.
When interpreting a rhythm, systematically evaluate:
1. Rate
2. Rhythm regularity
3. P-wave presence and morphology
4. PR interval
5. QRS duration
6. Relationship between P waves and QRS complexes
7. Patient symptoms and hemodynamic status
For clinical-priority questions, determine what should be done first.
CONTENT BLUEPRINT
Section Topic Questions
I ECG & Cardiac Conduction Fundamentals 1–20
II Sinus Rhythms 21–40
III Atrial Dysrhythmias 41–65
IV Junctional Rhythms 66–80
V Ventricular Dysrhythmias 81–110
VI AV Blocks 111–135
VII Pacemakers & Conduction Problems 136–150
VIII Clinical Assessment & Nursing Priorities 151–170
IX Integrated Rhythm Interpretation 171–185
X Comprehensive Challenge Questions 186–200
SECTION I — ECG & CARDIAC
CONDUCTION FUNDAMENTALS
Question 1
,Which structure normally functions as the primary pacemaker of the heart?
A. AV node
B. SA node
C. Bundle of His
D. Purkinje fibers
Correct Answer: B. SA node
Rationale: The sinoatrial node normally initiates the electrical impulse that produces sinus
rhythm. It has the fastest intrinsic firing rate among the normal cardiac pacemakers.
Question 2
Which ECG component represents atrial depolarization?
A. P wave
B. QRS complex
C. T wave
D. ST segment
Correct Answer: A. P wave
Rationale: The P wave represents electrical depolarization of the atria. Ventricular
depolarization is represented by the QRS complex, while ventricular repolarization is represented
primarily by the T wave.
Question 3
The normal PR interval is generally:
A. 0.04–0.08 second
B. 0.12–0.20 second
C. 0.24–0.32 second
D. 0.36–0.44 second
Correct Answer: B. 0.12–0.20 second
Rationale: A normal PR interval is approximately 0.12–0.20 second. It represents conduction
from atrial depolarization through the AV node and His-Purkinje system to the ventricles.
, Question 4
A QRS complex measures 0.08 second. How should this finding be interpreted?
A. Widened
B. Prolonged
C. Within the usual normal range
D. Consistent with complete heart block
Correct Answer: C. Within the usual normal range
Rationale: A normal QRS is generally less than 0.12 second. A narrow QRS suggests that
ventricular activation is occurring through the normal conduction system.
Question 5
Which ECG component represents ventricular depolarization?
A. P wave
B. PR interval
C. QRS complex
D. T wave
Correct Answer: C. QRS complex
Rationale: The QRS complex represents ventricular depolarization. The T wave represents
ventricular repolarization.
Question 6
A patient has an ECG with regular R-R intervals occurring approximately every 0.8 second.
What is the approximate ventricular rate?
A. 50 beats/min
B. 60 beats/min
C. 75 beats/min
D. 100 beats/min
Correct Answer: C. 75 beats/min
Rationale: Rate can be estimated by dividing 60 by the R-R interval in seconds: 60 ÷ 0.8 =
approximately 75 beats/min.
