• Relias Medical-Surgical Telemetry Competency Exam 2026 | 240+
Exam-Focused Practice Questions with Correct Answers and
Clinical Rationales | Telemetry Monitoring & Rhythm Recognition,
Cardiac Dysrhythmias, Acute Med-Surg Patient Management,
Emergency Cardiac Interventions, Medication Safety, Patient
Assessment, and Evidence-Based Clinical Decision-Making for
RELIAS Nursing Assessments
Question 1:
What is the primary purpose of telemetry monitoring?
• A) To diagnose hypertension
• B) To continuously monitor cardiac rhythms
• C) To evaluate lung function
• D) To assess urinary output
Correct Option: B) To continuously monitor cardiac rhythms
RATIONALE: Telemetry monitoring is primarily utilized to continuously observe and
record a patient's cardiac rhythms. This allows healthcare providers to detect any
abnormalities such as arrhythmias in real-time, which is crucial for timely medical
intervention.
Question 2:
Which of the following is a common indicator of myocardial ischemia on a
telemetry monitor?
• A) Regular sinus rhythm
• B) ST segment elevation
• C) Ventricular fibrillation
• D) Atrial flutter
Correct Option: B) ST segment elevation
RATIONALE: ST segment elevation on a telemetry monitor often indicates myocardial
ischemia, which can signify that the heart muscle is not receiving enough blood flow,
potentially leading to a myocardial infarction. Recognizing these changes promptly is
vital for patient management.
Question 3:
When interpreting telemetry strips, what does a ‘Q wave’ indicate?
, • A) Normal electrical activity
• B) Ongoing myocardial infarction
• C) Prior myocardial infarction
• D) Hyperkalemia
Correct Option: C) Prior myocardial infarction
RATIONALE: The presence of a Q wave on an ECG tracing can indicate a prior
myocardial infarction. It suggests that there has been necrosis of heart tissue due to
lack of blood supply, which can be crucial information when assessing the patient's
cardiac history and current condition.
Question 4:
What is the most appropriate intervention for a patient exhibiting ventricular
tachycardia (VT) without a pulse?
• A) Administer oral beta-blockers
• B) Start CPR and prepare for defibrillation
• C) Monitor vitals every 15 minutes
• D) Administer oxygen via nasal cannula
Correct Option: B) Start CPR and prepare for defibrillation
RATIONALE: In cases of ventricular tachycardia without a pulse, immediate CPR is
necessary to maintain circulation while preparing for defibrillation. This is a life-
threatening condition that requires prompt, aggressive intervention to restore normal
cardiac function.
Question 5:
Which complication is associated with long-term telemetry monitoring?
• A) Hyperglycemia
• B) Skin irritation or breakdown
• C) Deep vein thrombosis
• D) Neurogenic shock
Correct Option: B) Skin irritation or breakdown
RATIONALE: Prolonged telemetry monitoring can lead to skin irritation or breakdown at
the electrode sites due to moisture, friction, or allergic reactions to the adhesive.
,Regular assessment of the skin condition is important to prevent complications and
ensure patient comfort.
Question 6:
Which of the following rhythms is characterized by a narrow QRS complex?
• A) Ventricular tachycardia
• B) Atrial fibrillation
• C) Supraventricular tachycardia
• D) Idioventricular rhythm
Correct Option: C) Supraventricular tachycardia
RATIONALE: Supraventricular tachycardia (SVT) is characterized by a narrow QRS
complex due to the electrical impulse originating above the ventricles, allowing for
normal conduction through the ventricles.
Question 7:
When a patient exhibits bradycardia, what medication is typically administered?
• A) Adenosine
• B) Atropine
• C) Amiodarone
• D) Digoxin
Correct Option: B) Atropine
RATIONALE: Atropine is commonly used to treat bradycardia by blocking the vagal
effects on the heart and increasing heart rate. This is important in symptomatic
bradycardia cases to stabilize the patient.
Question 8:
In telemetry, a 'T-wave inversion' may indicate which of the following?
• A) Hyperkalemia
• B) Hypokalemia
• C) Myocardial ischemia
• D) Atrial enlargement
Correct Option: C) Myocardial ischemia
, RATIONALE: T-wave inversion can suggest myocardial ischemia, indicating that the
heart muscle is not receiving sufficient blood supply, necessitating immediate
attention.
Question 9:
Which telemetry lead placement is typically used to view the heart's inferior wall?
• A) V1
• B) V4
• C) V3
• D) V5
Correct Option: B) V4
RATIONALE: V4 is positioned over the apex of the heart and is used to monitor the
inferior wall, providing important information regarding inferior myocardial function.
Question 10:
What intervention should be taken for a patient experiencing a complete heart
block?
• A) Administer aspirin
• B) Prepare for immediate pacing
• C) Increase IV fluid rate
• D) Conduct a echocardiogram
Correct Option: B) Prepare for immediate pacing
RATIONALE: Complete heart block, resulting in the failure of electrical impulses from
the atria to the ventricles, often necessitates immediate pacing to facilitate adequate
heart rhythm and output.
Question 11:
Which heart sound is often associated with left-sided heart failure?
• A) S1
• B) S2
• C) S3
Exam-Focused Practice Questions with Correct Answers and
Clinical Rationales | Telemetry Monitoring & Rhythm Recognition,
Cardiac Dysrhythmias, Acute Med-Surg Patient Management,
Emergency Cardiac Interventions, Medication Safety, Patient
Assessment, and Evidence-Based Clinical Decision-Making for
RELIAS Nursing Assessments
Question 1:
What is the primary purpose of telemetry monitoring?
• A) To diagnose hypertension
• B) To continuously monitor cardiac rhythms
• C) To evaluate lung function
• D) To assess urinary output
Correct Option: B) To continuously monitor cardiac rhythms
RATIONALE: Telemetry monitoring is primarily utilized to continuously observe and
record a patient's cardiac rhythms. This allows healthcare providers to detect any
abnormalities such as arrhythmias in real-time, which is crucial for timely medical
intervention.
Question 2:
Which of the following is a common indicator of myocardial ischemia on a
telemetry monitor?
• A) Regular sinus rhythm
• B) ST segment elevation
• C) Ventricular fibrillation
• D) Atrial flutter
Correct Option: B) ST segment elevation
RATIONALE: ST segment elevation on a telemetry monitor often indicates myocardial
ischemia, which can signify that the heart muscle is not receiving enough blood flow,
potentially leading to a myocardial infarction. Recognizing these changes promptly is
vital for patient management.
Question 3:
When interpreting telemetry strips, what does a ‘Q wave’ indicate?
, • A) Normal electrical activity
• B) Ongoing myocardial infarction
• C) Prior myocardial infarction
• D) Hyperkalemia
Correct Option: C) Prior myocardial infarction
RATIONALE: The presence of a Q wave on an ECG tracing can indicate a prior
myocardial infarction. It suggests that there has been necrosis of heart tissue due to
lack of blood supply, which can be crucial information when assessing the patient's
cardiac history and current condition.
Question 4:
What is the most appropriate intervention for a patient exhibiting ventricular
tachycardia (VT) without a pulse?
• A) Administer oral beta-blockers
• B) Start CPR and prepare for defibrillation
• C) Monitor vitals every 15 minutes
• D) Administer oxygen via nasal cannula
Correct Option: B) Start CPR and prepare for defibrillation
RATIONALE: In cases of ventricular tachycardia without a pulse, immediate CPR is
necessary to maintain circulation while preparing for defibrillation. This is a life-
threatening condition that requires prompt, aggressive intervention to restore normal
cardiac function.
Question 5:
Which complication is associated with long-term telemetry monitoring?
• A) Hyperglycemia
• B) Skin irritation or breakdown
• C) Deep vein thrombosis
• D) Neurogenic shock
Correct Option: B) Skin irritation or breakdown
RATIONALE: Prolonged telemetry monitoring can lead to skin irritation or breakdown at
the electrode sites due to moisture, friction, or allergic reactions to the adhesive.
,Regular assessment of the skin condition is important to prevent complications and
ensure patient comfort.
Question 6:
Which of the following rhythms is characterized by a narrow QRS complex?
• A) Ventricular tachycardia
• B) Atrial fibrillation
• C) Supraventricular tachycardia
• D) Idioventricular rhythm
Correct Option: C) Supraventricular tachycardia
RATIONALE: Supraventricular tachycardia (SVT) is characterized by a narrow QRS
complex due to the electrical impulse originating above the ventricles, allowing for
normal conduction through the ventricles.
Question 7:
When a patient exhibits bradycardia, what medication is typically administered?
• A) Adenosine
• B) Atropine
• C) Amiodarone
• D) Digoxin
Correct Option: B) Atropine
RATIONALE: Atropine is commonly used to treat bradycardia by blocking the vagal
effects on the heart and increasing heart rate. This is important in symptomatic
bradycardia cases to stabilize the patient.
Question 8:
In telemetry, a 'T-wave inversion' may indicate which of the following?
• A) Hyperkalemia
• B) Hypokalemia
• C) Myocardial ischemia
• D) Atrial enlargement
Correct Option: C) Myocardial ischemia
, RATIONALE: T-wave inversion can suggest myocardial ischemia, indicating that the
heart muscle is not receiving sufficient blood supply, necessitating immediate
attention.
Question 9:
Which telemetry lead placement is typically used to view the heart's inferior wall?
• A) V1
• B) V4
• C) V3
• D) V5
Correct Option: B) V4
RATIONALE: V4 is positioned over the apex of the heart and is used to monitor the
inferior wall, providing important information regarding inferior myocardial function.
Question 10:
What intervention should be taken for a patient experiencing a complete heart
block?
• A) Administer aspirin
• B) Prepare for immediate pacing
• C) Increase IV fluid rate
• D) Conduct a echocardiogram
Correct Option: B) Prepare for immediate pacing
RATIONALE: Complete heart block, resulting in the failure of electrical impulses from
the atria to the ventricles, often necessitates immediate pacing to facilitate adequate
heart rhythm and output.
Question 11:
Which heart sound is often associated with left-sided heart failure?
• A) S1
• B) S2
• C) S3
