Relias Dysrhythmia Basic A Exam 2026 |
Complete Questions, Verified Answers &
Study Guide
RELIAS DYSRHYTHMIA BASIC A EXAM 2026 | COMPLETE QUESTIONS, VERIFIED
ANSWERS & STUDY GUIDE
• Comprehensive 200-question exam bank covering all dysrhythmia topics with
detailed clinical rationales for deep understanding
• Master rhythm recognition, EKG interpretation, and clinical management through
systematic practice and evidence-based learning strategies
QUESTION 1
A 62-year-old patient presents with sudden onset palpitations. The monitor shows
a regular rhythm at 160 bpm with narrow QRS complexes and no visible P waves.
What is the most likely diagnosis?
A) Atrial Fibrillation
B) Supraventricular Tachycardia
C) Atrial Flutter
D) Sinus Tachycardia
E) Ventricular Tachycardia
CORRECT ANSWER: B) Supraventricular Tachycardia
RATIONALE: SVT typically presents with a regular rhythm at rates between 140-250
bpm with narrow QRS complexes. The P waves are often buried in the T wave or
immediately before the QRS, making them difficult to visualize. Atrial fibrillation
would show an irregular rhythm. Atrial flutter would show a sawtooth pattern.
Sinus tachycardia would have visible P waves and rarely exceeds 150 bpm in adults.
Ventricular tachycardia would present with wide QRS complexes.
QUESTION 2
,Which of the following findings would you expect to see on an EKG of a patient with
normal sinus rhythm?
A) PR interval greater than 0.2 seconds
B) QRS duration of 0.08-0.12 seconds
C) T wave inversion in leads V1-V3
D) ST segment elevation in all leads
E) Heart rate of 40 bpm
CORRECT ANSWER: B) QRS duration of 0.08-0.12 seconds
RATIONALE: In normal sinus rhythm, the QRS duration should measure between
0.08 and 0.12 seconds (2-3 small boxes on standard EKG paper). A PR interval
greater than 0.2 seconds indicates first-degree AV block. T wave inversion in V1-V3
is abnormal. ST segment elevation in all leads would indicate pericarditis or
Takotsubo cardiomyopathy. A heart rate of 40 bpm would be bradycardia. Normal
sinus rhythm ranges from 60-100 bpm.
QUESTION 3
A patient exhibits a rhythm strip showing absent P waves, an irregular ventricular
rhythm, and a ventricular rate between 60-100 bpm. Which dysrhythmia is most
likely?
A) Atrial Fibrillation with slow ventricular response
B) Sinus Arrhythmia
C) Premature Atrial Contractions
D) Wandering Atrial Pacemaker
E) Sick Sinus Syndrome
CORRECT ANSWER: A) Atrial Fibrillation with slow ventricular response
RATIONALE: Atrial fibrillation is characterized by the absence of discernible P waves,
an irregular ventricular rhythm (described as "irregularly irregular"), and a baseline
,that appears wavy due to fibrillation waves. The ventricular rate can range from
slow (under 60) to fast (over 100) depending on AV node conduction. Sinus
arrhythmia would show visible P waves. Premature atrial contractions would show
ectopic P waves. Wandering atrial pacemaker would show varying P wave
morphology. Sick sinus syndrome involves inappropriate sinus node function.
QUESTION 4
A 55-year-old patient is being treated with digoxin for atrial fibrillation. On the
monitor, you observe a regular rhythm at 70 bpm with an irregular PR interval. This
finding is most consistent with which rhythm?
A) Atrial Flutter with fixed AV block
B) Digoxin toxicity with junctional escape rhythm
C) Complete Heart Block
D) Second-degree AV block Type II
E) Sinus Rhythm with PACs
CORRECT ANSWER: B) Digoxin toxicity with junctional escape rhythm
RATIONALE: The combination of a regular rhythm at a normal rate with an irregular
PR interval is characteristic of a junctional rhythm. This can occur with digoxin
toxicity, which increases automaticity of the AV junction. In a junctional rhythm, the
AV junction paces the heart, creating a regular rhythm without visible P waves (they
may be buried in or after the QRS). Digoxin toxicity is a common cause of junctional
rhythms in patients on this medication. Atrial flutter would show a flutter wave
pattern. Complete heart block would show dissociation between P and QRS
complexes with a slower rate.
QUESTION 5
Which EKG interval is measured from the beginning of the QRS complex to the end
of the T wave?
, A) PR interval
B) QRS duration
C) QT interval
D) ST segment
E) TP interval
CORRECT ANSWER: C) QT interval
RATIONALE: The QT interval represents the total time for ventricular depolarization
and repolarization. It is measured from the beginning of the QRS complex to the
end of the T wave. A prolonged QT interval increases risk for torsades de pointes, a
dangerous ventricular arrhythmia. The PR interval measures from the beginning of
the P wave to the beginning of the QRS. The QRS duration measures only
depolarization. The ST segment is measured from the end of the S wave to the
beginning of the T wave. The TP interval is the baseline between rhythms.
QUESTION 6
A patient presents with a heart rate of 180 bpm, wide QRS complexes, and variable
P waves scattered throughout the rhythm. Blood pressure is 88/52 mmHg. Which
medication would be most appropriate for initial treatment?
A) Adenosine IV
B) Amiodarone IV
C) Atropine IV
D) Metoprolol IV
E) Synchronized cardioversion
CORRECT ANSWER: E) Synchronized cardioversion
RATIONALE: This patient is hemodynamically unstable (hypotensive) with a wide
complex tachycardia and variable P waves consistent with ventricular tachycardia
or atrial fibrillation with rapid ventricular response. In unstable patients with wide
Complete Questions, Verified Answers &
Study Guide
RELIAS DYSRHYTHMIA BASIC A EXAM 2026 | COMPLETE QUESTIONS, VERIFIED
ANSWERS & STUDY GUIDE
• Comprehensive 200-question exam bank covering all dysrhythmia topics with
detailed clinical rationales for deep understanding
• Master rhythm recognition, EKG interpretation, and clinical management through
systematic practice and evidence-based learning strategies
QUESTION 1
A 62-year-old patient presents with sudden onset palpitations. The monitor shows
a regular rhythm at 160 bpm with narrow QRS complexes and no visible P waves.
What is the most likely diagnosis?
A) Atrial Fibrillation
B) Supraventricular Tachycardia
C) Atrial Flutter
D) Sinus Tachycardia
E) Ventricular Tachycardia
CORRECT ANSWER: B) Supraventricular Tachycardia
RATIONALE: SVT typically presents with a regular rhythm at rates between 140-250
bpm with narrow QRS complexes. The P waves are often buried in the T wave or
immediately before the QRS, making them difficult to visualize. Atrial fibrillation
would show an irregular rhythm. Atrial flutter would show a sawtooth pattern.
Sinus tachycardia would have visible P waves and rarely exceeds 150 bpm in adults.
Ventricular tachycardia would present with wide QRS complexes.
QUESTION 2
,Which of the following findings would you expect to see on an EKG of a patient with
normal sinus rhythm?
A) PR interval greater than 0.2 seconds
B) QRS duration of 0.08-0.12 seconds
C) T wave inversion in leads V1-V3
D) ST segment elevation in all leads
E) Heart rate of 40 bpm
CORRECT ANSWER: B) QRS duration of 0.08-0.12 seconds
RATIONALE: In normal sinus rhythm, the QRS duration should measure between
0.08 and 0.12 seconds (2-3 small boxes on standard EKG paper). A PR interval
greater than 0.2 seconds indicates first-degree AV block. T wave inversion in V1-V3
is abnormal. ST segment elevation in all leads would indicate pericarditis or
Takotsubo cardiomyopathy. A heart rate of 40 bpm would be bradycardia. Normal
sinus rhythm ranges from 60-100 bpm.
QUESTION 3
A patient exhibits a rhythm strip showing absent P waves, an irregular ventricular
rhythm, and a ventricular rate between 60-100 bpm. Which dysrhythmia is most
likely?
A) Atrial Fibrillation with slow ventricular response
B) Sinus Arrhythmia
C) Premature Atrial Contractions
D) Wandering Atrial Pacemaker
E) Sick Sinus Syndrome
CORRECT ANSWER: A) Atrial Fibrillation with slow ventricular response
RATIONALE: Atrial fibrillation is characterized by the absence of discernible P waves,
an irregular ventricular rhythm (described as "irregularly irregular"), and a baseline
,that appears wavy due to fibrillation waves. The ventricular rate can range from
slow (under 60) to fast (over 100) depending on AV node conduction. Sinus
arrhythmia would show visible P waves. Premature atrial contractions would show
ectopic P waves. Wandering atrial pacemaker would show varying P wave
morphology. Sick sinus syndrome involves inappropriate sinus node function.
QUESTION 4
A 55-year-old patient is being treated with digoxin for atrial fibrillation. On the
monitor, you observe a regular rhythm at 70 bpm with an irregular PR interval. This
finding is most consistent with which rhythm?
A) Atrial Flutter with fixed AV block
B) Digoxin toxicity with junctional escape rhythm
C) Complete Heart Block
D) Second-degree AV block Type II
E) Sinus Rhythm with PACs
CORRECT ANSWER: B) Digoxin toxicity with junctional escape rhythm
RATIONALE: The combination of a regular rhythm at a normal rate with an irregular
PR interval is characteristic of a junctional rhythm. This can occur with digoxin
toxicity, which increases automaticity of the AV junction. In a junctional rhythm, the
AV junction paces the heart, creating a regular rhythm without visible P waves (they
may be buried in or after the QRS). Digoxin toxicity is a common cause of junctional
rhythms in patients on this medication. Atrial flutter would show a flutter wave
pattern. Complete heart block would show dissociation between P and QRS
complexes with a slower rate.
QUESTION 5
Which EKG interval is measured from the beginning of the QRS complex to the end
of the T wave?
, A) PR interval
B) QRS duration
C) QT interval
D) ST segment
E) TP interval
CORRECT ANSWER: C) QT interval
RATIONALE: The QT interval represents the total time for ventricular depolarization
and repolarization. It is measured from the beginning of the QRS complex to the
end of the T wave. A prolonged QT interval increases risk for torsades de pointes, a
dangerous ventricular arrhythmia. The PR interval measures from the beginning of
the P wave to the beginning of the QRS. The QRS duration measures only
depolarization. The ST segment is measured from the end of the S wave to the
beginning of the T wave. The TP interval is the baseline between rhythms.
QUESTION 6
A patient presents with a heart rate of 180 bpm, wide QRS complexes, and variable
P waves scattered throughout the rhythm. Blood pressure is 88/52 mmHg. Which
medication would be most appropriate for initial treatment?
A) Adenosine IV
B) Amiodarone IV
C) Atropine IV
D) Metoprolol IV
E) Synchronized cardioversion
CORRECT ANSWER: E) Synchronized cardioversion
RATIONALE: This patient is hemodynamically unstable (hypotensive) with a wide
complex tachycardia and variable P waves consistent with ventricular tachycardia
or atrial fibrillation with rapid ventricular response. In unstable patients with wide
