Relias Advanced Dysrhythmia Exam A |
2025–2026 Edition
52 Questions with Step-by-Step Answers | Cardiology & Critical Care | 100% Verified |
A+ Graded Review
Introduction
This advanced cardiology resource includes all 52 questions from the Relias Advanced
Dysrhythmia Exam A, updated for 2025–2026. Each question features a step-by-step
explanation for interpreting EKG rhythms and selecting the correct intervention or diagnosis.
Ideal for ICU, telemetry, emergency, and cardiac nurses preparing for certification or clinical
validation.
Topics Covered
• Advanced EKG Interpretation
• Atrial, Junctional, and Ventricular Rhythms
• Heart Blocks (1st, 2nd, 3rd degree)
• Paced Rhythms & Malfunction Recognition
• ACLS-Tied Clinical Decision Making
• Symptom Recognition & Treatment Priorities
• Pharmacologic and Electrical Interventions
• Rhythm Strip Analysis Step-by-Step
All correct answers are highlighted in bold and green. Each response includes a clear, step-
by-step breakdown of the rhythm analysis process — rate, rhythm, P waves, PR interval,
QRS duration, and interpretation logic.
Exam Questions and Answers
Question 1: A rhythm strip shows a rate of 88 bpm, regular rhythm, normal P waves, PR
interval 0.16 seconds, QRS 0.08 seconds. What is the rhythm?
A) Atrial fibrillation
B) Normal sinus rhythm
C) Sinus tachycardia
D) Sinus bradycardia
Rationale: Rate 60–100 bpm, regular rhythm, normal P waves, PR 0.12–0.20 s, QRS <0.12 s
indicate normal sinus rhythm.
Question 2: A patient has a rhythm with no identifiable P waves, irregular rhythm, and QRS
0.10 seconds. What is the rhythm?
A) Atrial fibrillation
B) Sinus arrhythmia
C) Junctional rhythm
D) Ventricular tachycardia
Rationale: Absent P waves and irregular rhythm are hallmarks of atrial fibrillation; normal
QRS rules out ventricular rhythms.
, Question 3: A rhythm shows a rate of 50 bpm, regular rhythm, P waves before each QRS,
PR interval 0.24 seconds, QRS 0.10 seconds. What is the rhythm?
A) First-degree heart block
B) Second-degree heart block Type I
C) Sinus tachycardia
D) Third-degree heart block
Rationale: Prolonged PR interval (>0.20 s) with consistent P waves and QRS indicates first-
degree heart block.
Question 4: A patient with chest pain has a rhythm with wide QRS (>0.12 s), rate 160 bpm,
and no visible P waves. What is the priority action?
A) Administer amiodarone
B) Prepare for synchronized cardioversion
C) Start CPR
D) Monitor vitals
Rationale: Ventricular tachycardia (wide QRS, fast rate) with symptoms requires immediate
cardioversion per ACLS.
Question 5: A rhythm strip shows dropped QRS complexes after every third P wave, with
PR intervals lengthening progressively. What is the rhythm?
A) First-degree heart block
B) Second-degree heart block Type I (Wenckebach)
C) Second-degree heart block Type II
D) Third-degree heart block
Rationale: Progressive PR lengthening with dropped QRS is characteristic of Wenckebach.
Question 6: A patient with a pacemaker has no pacer spikes and irregular rhythm. What is
this?
A) Normal paced rhythm
B) Pacemaker failure to capture
C) Pacemaker oversensing
D) Pacemaker failure to sense
Question 7: A rhythm shows a rate of 120 bpm, regular rhythm, P waves present, PR interval
0.18 seconds, QRS 0.08 seconds. What is the rhythm?
A) Atrial flutter
B) Sinus tachycardia
C) Supraventricular tachycardia
D) Junctional rhythm
Rationale: Rate >100 bpm, regular rhythm, normal PR and QRS indicate sinus tachycardia.
Question 8: A patient has a rhythm with sawtooth P waves and a rate of 150 bpm. What is
the rhythm?
A) Atrial flutter
B) Atrial fibrillation
C) Sinus tachycardia
D) Ventricular fibrillation
Question 9: A rhythm strip shows no correlation between P waves and QRS complexes, rate
40 bpm, QRS 0.14 seconds. What is the rhythm?
2025–2026 Edition
52 Questions with Step-by-Step Answers | Cardiology & Critical Care | 100% Verified |
A+ Graded Review
Introduction
This advanced cardiology resource includes all 52 questions from the Relias Advanced
Dysrhythmia Exam A, updated for 2025–2026. Each question features a step-by-step
explanation for interpreting EKG rhythms and selecting the correct intervention or diagnosis.
Ideal for ICU, telemetry, emergency, and cardiac nurses preparing for certification or clinical
validation.
Topics Covered
• Advanced EKG Interpretation
• Atrial, Junctional, and Ventricular Rhythms
• Heart Blocks (1st, 2nd, 3rd degree)
• Paced Rhythms & Malfunction Recognition
• ACLS-Tied Clinical Decision Making
• Symptom Recognition & Treatment Priorities
• Pharmacologic and Electrical Interventions
• Rhythm Strip Analysis Step-by-Step
All correct answers are highlighted in bold and green. Each response includes a clear, step-
by-step breakdown of the rhythm analysis process — rate, rhythm, P waves, PR interval,
QRS duration, and interpretation logic.
Exam Questions and Answers
Question 1: A rhythm strip shows a rate of 88 bpm, regular rhythm, normal P waves, PR
interval 0.16 seconds, QRS 0.08 seconds. What is the rhythm?
A) Atrial fibrillation
B) Normal sinus rhythm
C) Sinus tachycardia
D) Sinus bradycardia
Rationale: Rate 60–100 bpm, regular rhythm, normal P waves, PR 0.12–0.20 s, QRS <0.12 s
indicate normal sinus rhythm.
Question 2: A patient has a rhythm with no identifiable P waves, irregular rhythm, and QRS
0.10 seconds. What is the rhythm?
A) Atrial fibrillation
B) Sinus arrhythmia
C) Junctional rhythm
D) Ventricular tachycardia
Rationale: Absent P waves and irregular rhythm are hallmarks of atrial fibrillation; normal
QRS rules out ventricular rhythms.
, Question 3: A rhythm shows a rate of 50 bpm, regular rhythm, P waves before each QRS,
PR interval 0.24 seconds, QRS 0.10 seconds. What is the rhythm?
A) First-degree heart block
B) Second-degree heart block Type I
C) Sinus tachycardia
D) Third-degree heart block
Rationale: Prolonged PR interval (>0.20 s) with consistent P waves and QRS indicates first-
degree heart block.
Question 4: A patient with chest pain has a rhythm with wide QRS (>0.12 s), rate 160 bpm,
and no visible P waves. What is the priority action?
A) Administer amiodarone
B) Prepare for synchronized cardioversion
C) Start CPR
D) Monitor vitals
Rationale: Ventricular tachycardia (wide QRS, fast rate) with symptoms requires immediate
cardioversion per ACLS.
Question 5: A rhythm strip shows dropped QRS complexes after every third P wave, with
PR intervals lengthening progressively. What is the rhythm?
A) First-degree heart block
B) Second-degree heart block Type I (Wenckebach)
C) Second-degree heart block Type II
D) Third-degree heart block
Rationale: Progressive PR lengthening with dropped QRS is characteristic of Wenckebach.
Question 6: A patient with a pacemaker has no pacer spikes and irregular rhythm. What is
this?
A) Normal paced rhythm
B) Pacemaker failure to capture
C) Pacemaker oversensing
D) Pacemaker failure to sense
Question 7: A rhythm shows a rate of 120 bpm, regular rhythm, P waves present, PR interval
0.18 seconds, QRS 0.08 seconds. What is the rhythm?
A) Atrial flutter
B) Sinus tachycardia
C) Supraventricular tachycardia
D) Junctional rhythm
Rationale: Rate >100 bpm, regular rhythm, normal PR and QRS indicate sinus tachycardia.
Question 8: A patient has a rhythm with sawtooth P waves and a rate of 150 bpm. What is
the rhythm?
A) Atrial flutter
B) Atrial fibrillation
C) Sinus tachycardia
D) Ventricular fibrillation
Question 9: A rhythm strip shows no correlation between P waves and QRS complexes, rate
40 bpm, QRS 0.14 seconds. What is the rhythm?
