Relias Advanced Dysrhythmia Exam B Actual
Exam 2026/2027 | 52 Questions with Verified
Answers | 100% Correct | Pass Guaranteed
SECTION 1: Complex Atrial & Junctional Dysrhythmias (12 Questions)
Q1: EKG Description: Rhythm: Irregularly irregular with no pattern. Rate: 110-130 bpm. P
waves: Present but at least 3 different morphologies. PR interval: Varies. QRS: Narrow
(0.08s). ST/T: Normal.
A. Atrial fibrillation
B. Multifocal atrial tachycardia (MAT)
C. Sinus arrhythmia
D. Atrial flutter with variable conduction
Correct Answer: B
Rationale: Step-by-Step Analysis:
1. Rhythm: Irregularly irregular (but MAT can be irregular).
2. Rate: 110-130 bpm (>100 bpm is key for MAT vs WAP).
3. P waves: At least 3 different morphologies - hallmark of MAT or WAP.
4. PR interval: Varies - expected with changing pacemaker site.
5. QRS: Normal.
6. Interpretation: Multifocal Atrial Tachycardia - criteria met: irregular, rate >100, ≥3
P morphologies.
7. Clinical Significance: Often seen in COPD patients. Treat underlying cause, not
the rhythm itself.
Differentiation from WAP: Wandering Atrial Pacemaker has same features but
rate <100 bpm.
,Q2: EKG Description: Rhythm: Regular. Rate: 50 bpm. P waves: Absent. QRS: Narrow
(0.08s). ST/T: Normal.
A. Sinus bradycardia
B. Junctional rhythm
C. 2:1 AV block
D. Idioventricular rhythm
Correct Answer: B
Rationale: Step-by-Step Analysis:
1. Rhythm: Regular.
2. Rate: 50 bpm (40-60 = junctional escape range).
3. P waves: Absent (or may be retrograde, hidden in QRS).
4. PR interval: Not measurable.
5. QRS: Narrow (0.08s) - key differentiator from ventricular rhythm.
6. Interpretation: Junctional rhythm - regular, narrow QRS, rate 40-60, no visible P
waves.
7. Clinical Action: Assess perfusion, consider atropine if symptomatic.
Q3: EKG Description: Rhythm: Regular. Rate: 140 bpm. P waves: Inverted in II, III, aVF;
upright in aVR. PR interval: 0.06s. QRS: Narrow (0.08s). ST/T: Normal.
A. Sinus tachycardia
B. Junctional tachycardia
C. Atrial tachycardia
D. AVNRT
,Correct Answer: B
Rationale: Step-by-Step Analysis:
1. Rhythm: Regular.
2. Rate: 140 bpm (>60 = junctional tachycardia).
3. P waves: Inverted in inferior leads - indicates retrograde atrial activation.
4. PR interval: Short (0.06s) - near-simultaneous atrial/ventricular activation.
5. QRS: Narrow.
6. Interpretation: Junctional tachycardia - retrograde P waves, short PR, narrow
QRS, rate >60.
7. Clinical Action: Vagal maneuvers may slow; adenosine if unstable.
Q4: EKG Description: Rhythm: Irregular. Rate: 90-110 bpm. P waves: Present, 3 distinct
morphologies. PR interval: Varies 0.12-0.20s. QRS: Narrow (0.08s). ST/T: Normal.
A. MAT
B. Atrial fibrillation
C. Wandering atrial pacemaker (WAP)
D. Sinus arrhythmia
Correct Answer: C
Rationale: Step-by-Step Analysis:
1. Rhythm: Irregular.
2. Rate: 90-110 bpm (<100 bpm differentiates from MAT).
3. P waves: 3 distinct morphologies - hallmark of WAP/MAT.
4. PR interval: Varies with changing pacemaker site.
5. QRS: Narrow.
6. Interpretation: Wandering Atrial Pacemaker - same as MAT but rate <100 bpm.
7. Clinical Significance: Usually benign, no treatment needed.
, Q5: EKG Description: Rhythm: Regular. Rate: 160 bpm. P waves: Hidden within T waves.
PR interval: Not measurable. QRS: Narrow (0.08s). ST/T: T waves distorted.
A. Sinus tachycardia
B. Atrial flutter with 2:1 conduction
C. Paroxysmal atrial tachycardia (PAT)
D. Junctional tachycardia
Correct Answer: C
Rationale: Step-by-Step Analysis:
1. Rhythm: Regular.
2. Rate: 160 bpm (typical for PAT).
3. P waves: Buried in T waves - difficult to identify.
4. PR interval: Not measurable due to hidden P waves.
5. QRS: Narrow.
6. Interpretation: Paroxysmal Atrial Tachycardia - sudden onset, regular narrow
tachycardia.
7. Clinical Action: Vagal maneuvers, adenosine if unstable.
Q6: EKG Description: Rhythm: Irregular. Rate: 70-90 bpm. P waves: Present, morphology
changes gradually. PR interval: Varies gradually. QRS: Narrow (0.08s). ST/T: Normal.
A. MAT
B. Wandering atrial pacemaker
C. Sinus arrhythmia
D. Atrial fibrillation
Correct Answer: B
Exam 2026/2027 | 52 Questions with Verified
Answers | 100% Correct | Pass Guaranteed
SECTION 1: Complex Atrial & Junctional Dysrhythmias (12 Questions)
Q1: EKG Description: Rhythm: Irregularly irregular with no pattern. Rate: 110-130 bpm. P
waves: Present but at least 3 different morphologies. PR interval: Varies. QRS: Narrow
(0.08s). ST/T: Normal.
A. Atrial fibrillation
B. Multifocal atrial tachycardia (MAT)
C. Sinus arrhythmia
D. Atrial flutter with variable conduction
Correct Answer: B
Rationale: Step-by-Step Analysis:
1. Rhythm: Irregularly irregular (but MAT can be irregular).
2. Rate: 110-130 bpm (>100 bpm is key for MAT vs WAP).
3. P waves: At least 3 different morphologies - hallmark of MAT or WAP.
4. PR interval: Varies - expected with changing pacemaker site.
5. QRS: Normal.
6. Interpretation: Multifocal Atrial Tachycardia - criteria met: irregular, rate >100, ≥3
P morphologies.
7. Clinical Significance: Often seen in COPD patients. Treat underlying cause, not
the rhythm itself.
Differentiation from WAP: Wandering Atrial Pacemaker has same features but
rate <100 bpm.
,Q2: EKG Description: Rhythm: Regular. Rate: 50 bpm. P waves: Absent. QRS: Narrow
(0.08s). ST/T: Normal.
A. Sinus bradycardia
B. Junctional rhythm
C. 2:1 AV block
D. Idioventricular rhythm
Correct Answer: B
Rationale: Step-by-Step Analysis:
1. Rhythm: Regular.
2. Rate: 50 bpm (40-60 = junctional escape range).
3. P waves: Absent (or may be retrograde, hidden in QRS).
4. PR interval: Not measurable.
5. QRS: Narrow (0.08s) - key differentiator from ventricular rhythm.
6. Interpretation: Junctional rhythm - regular, narrow QRS, rate 40-60, no visible P
waves.
7. Clinical Action: Assess perfusion, consider atropine if symptomatic.
Q3: EKG Description: Rhythm: Regular. Rate: 140 bpm. P waves: Inverted in II, III, aVF;
upright in aVR. PR interval: 0.06s. QRS: Narrow (0.08s). ST/T: Normal.
A. Sinus tachycardia
B. Junctional tachycardia
C. Atrial tachycardia
D. AVNRT
,Correct Answer: B
Rationale: Step-by-Step Analysis:
1. Rhythm: Regular.
2. Rate: 140 bpm (>60 = junctional tachycardia).
3. P waves: Inverted in inferior leads - indicates retrograde atrial activation.
4. PR interval: Short (0.06s) - near-simultaneous atrial/ventricular activation.
5. QRS: Narrow.
6. Interpretation: Junctional tachycardia - retrograde P waves, short PR, narrow
QRS, rate >60.
7. Clinical Action: Vagal maneuvers may slow; adenosine if unstable.
Q4: EKG Description: Rhythm: Irregular. Rate: 90-110 bpm. P waves: Present, 3 distinct
morphologies. PR interval: Varies 0.12-0.20s. QRS: Narrow (0.08s). ST/T: Normal.
A. MAT
B. Atrial fibrillation
C. Wandering atrial pacemaker (WAP)
D. Sinus arrhythmia
Correct Answer: C
Rationale: Step-by-Step Analysis:
1. Rhythm: Irregular.
2. Rate: 90-110 bpm (<100 bpm differentiates from MAT).
3. P waves: 3 distinct morphologies - hallmark of WAP/MAT.
4. PR interval: Varies with changing pacemaker site.
5. QRS: Narrow.
6. Interpretation: Wandering Atrial Pacemaker - same as MAT but rate <100 bpm.
7. Clinical Significance: Usually benign, no treatment needed.
, Q5: EKG Description: Rhythm: Regular. Rate: 160 bpm. P waves: Hidden within T waves.
PR interval: Not measurable. QRS: Narrow (0.08s). ST/T: T waves distorted.
A. Sinus tachycardia
B. Atrial flutter with 2:1 conduction
C. Paroxysmal atrial tachycardia (PAT)
D. Junctional tachycardia
Correct Answer: C
Rationale: Step-by-Step Analysis:
1. Rhythm: Regular.
2. Rate: 160 bpm (typical for PAT).
3. P waves: Buried in T waves - difficult to identify.
4. PR interval: Not measurable due to hidden P waves.
5. QRS: Narrow.
6. Interpretation: Paroxysmal Atrial Tachycardia - sudden onset, regular narrow
tachycardia.
7. Clinical Action: Vagal maneuvers, adenosine if unstable.
Q6: EKG Description: Rhythm: Irregular. Rate: 70-90 bpm. P waves: Present, morphology
changes gradually. PR interval: Varies gradually. QRS: Narrow (0.08s). ST/T: Normal.
A. MAT
B. Wandering atrial pacemaker
C. Sinus arrhythmia
D. Atrial fibrillation
Correct Answer: B
