HCA Healthcare Telemetry ECG Interpretation 2026/2027 | Verified Questions & Answers | HCA Telemetry ECG Exam Prep

HCA Healthcare Telemetry ECG
Interpretation 2026/2027 | Verified
Questions & Answers | HCA Telemetry ECG
Exam Prep
HCA HEALTHCARE TELEMETRY ECG INTERPRETATION 2026/2027 | VERIFIED
QUESTIONS & ANSWERS

• This comprehensive exam preparation material contains verified practice
questions designed to reinforce critical ECG interpretation skills required for HCA
telemetry nursing certification, covering all major arrhythmias, conduction
abnormalities, and acute coronary patterns.

• Study this material by working through questions systematically, focusing on
pattern recognition and clinical correlation; review rationales carefully to
strengthen your understanding of ECG pathophysiology and practice managing
your time for exam-paced conditions.



QUESTION 1: A 68-year-old male presents with chest pain. The ECG shows ST
elevation in leads II, III, and aVF with reciprocal changes in I and aVL. What is
the likely location of the acute myocardial infarction?

A) Anterior wall

B) Lateral wall

C) Inferior wall

D) Posterior wall

E) Right ventricle

CORRECT ANSWER: C) Inferior wall

RATIONALE: ST elevation in the inferior leads (II, III, aVF) with reciprocal ST
depression in I and aVL indicates inferior wall myocardial infarction. The inferior
wall is supplied by the right coronary artery in most patients (80% of cases).
Reciprocal changes in the lateral leads help confirm the location and are
characteristic of this type of acute MI. The posterior wall would show different lead
involvement (V8-V9), and anterior MI presents with ST elevation in V1-V4.

,QUESTION 2: Which of the following ECG findings is most consistent with
hyperkalemia?

A) Flattened T waves and ST depression

B) Peaked T waves and shortened QT interval

C) Prolonged PR interval and wide QRS

D) Tall U waves and prolonged QT

E) Delta waves and short PR interval

CORRECT ANSWER: B) Peaked T waves and shortened QT interval

RATIONALE: Hyperkalemia characteristically produces peaked (tented) T waves
that are narrow and symmetrical, particularly visible in the precordial leads. As
potassium levels rise further, the QT interval shortens and the PR interval
lengthens. Eventually, the QRS complex widens. The peaked T waves typically
appear when potassium exceeds 5.5-6.0 mEq/L. Flattened T waves and U waves are
characteristic of hypokalemia. Delta waves suggest Wolff-Parkinson-White
syndrome.



QUESTION 3: A patient in the intensive care unit is noted to have an ECG
showing an absent P wave, a regular rhythm at 140 beats per minute, and a
narrow QRS complex. What is the most likely diagnosis?

A) Atrial flutter with 2:1 AV conduction

B) Atrial fibrillation

C) Sinus tachycardia

D) Atrioventricular nodal reentrant tachycardia

E) Atrial tachycardia

CORRECT ANSWER: A) Atrial flutter with 2:1 AV conduction

,RATIONALE: Atrial flutter with 2:1 AV conduction presents with a regular ventricular
rhythm at approximately 150 bpm (though often appears as 140 when rounded).
The P wave is absent because the flutter waves are buried in or replace the T
waves. The atrial rate is typically 280-320 bpm, and with 2:1 conduction, every other
atrial impulse conducts, resulting in a ventricular rate of 140-160 bpm. If the flutter
waves were visible, they would have a characteristic sawtooth appearance in leads
II, III, and aVF. AVNRT would show retrograde P waves shortly after the QRS.



QUESTION 4: A 55-year-old patient presents with palpitations. The ECG shows
a rhythm with a rate of 180 bpm, narrow QRS complexes, and visible P waves
that appear to be retrograde (inverted and occurring shortly after the QRS
complex). What is the most likely diagnosis?

A) Atrial tachycardia

B) Atrial flutter

C) Atrioventricular nodal reentrant tachycardia

D) Orthodromic atrioventricular reentrant tachycardia

E) Sinus tachycardia

CORRECT ANSWER: C) Atrioventricular nodal reentrant tachycardia

RATIONALE: AVNRT is the most common paroxysmal supraventricular tachycardia
and presents with narrow QRS complexes, a rapid regular rate (typically 140-250
bpm), and retrograde P waves that may be superimposed on the QRS complex or
buried in the ST segment. The retrograde P wave occurs shortly after the QRS
because the atrial activation happens nearly simultaneously with ventricular
activation in the reentrant circuit. The mechanism involves dual pathways (fast and
slow) within the AV node. Atrial tachycardia would show upright P waves before the
QRS, and AVRT would involve an accessory pathway outside the AV node.

, QUESTION 5: An ECG shows a QRS duration of 120 milliseconds with a broad
base and peaked appearance, particularly in lead V1. What conduction
abnormality is most likely?

A) Right bundle branch block

B) Left bundle branch block

C) Bifascicular block

D) First-degree AV block

E) Wolff-Parkinson-White syndrome

CORRECT ANSWER: A) Right bundle branch block

RATIONALE: Right bundle branch block presents with a QRS duration ≥120
milliseconds and a characteristic RSR' pattern (M-shaped or "rabbit ears") in the
right precordial leads (V1-V2). The terminal forces are directed anteriorly and to the
right. The broad, peaked appearance in V1 with the RSR' configuration is
pathognomonic for RBBB. LBBB would show broad, notched complexes in the
lateral leads (V5-V6, I, aVL) with a broad R wave. WPW would show a delta wave and
short PR interval.



QUESTION 6: A patient's ECG reveals a prolonged PR interval of 240
milliseconds with normal AV conduction on the previous beat. No dropped
beats are noted. What type of AV block is present?

A) First-degree AV block

B) Second-degree AV block, Mobitz I

C) Second-degree AV block, Mobitz II

D) Third-degree AV block

E) Wolff-Parkinson-White syndrome

CORRECT ANSWER: A) First-degree AV block