ADVENT HEALTH EKG (LATEST 2026
UPDATE) QUESTIONS AND VERIFIED
ANSWERS WITH DIAGRAMS AND
ILLUSTRATIONS| 100% CORRECT
1. Normal Sinus Rhythm (NSR)
Question: Which of the following best describes Normal Sinus Rhythm (NSR)?
Options:
A. Impulse starts in the SA node, rate 60–100, regular rhythm, P wave before each
QRS, PRI 0.12–0.20, QRS 0.04–0.10
B. Impulse starts in the AV node, rate 40–60, irregular rhythm, no P waves, QRS wide
C. Impulse starts in the ventricles, rate 20–40, irregular rhythm, wide QRS
D. Impulse starts in the SA node, rate 100–150, irregular rhythm, no P waves
Correct Answer: A
Rationale:
Normal Sinus Rhythm originates in the SA node, producing atrial and ventricular rates
between 60 and 100 bpm. The rhythm is regular, with consistent P-P and R-R intervals.
Each P wave precedes a QRS complex, showing normal atrial depolarization followed
by ventricular depolarization. PR interval is normal (0.12–0.20 s), and QRS is narrow
(0.04–0.10 s). This represents normal cardiac electrical activity.
2. Sinus Tachycardia
Question: Sinus Tachycardia is characterized by:
Options:
A. Rate 60–100, regular rhythm, P wave before each QRS
B. Rate >150, irregular rhythm, no P waves
C. Rate 100–150, regular rhythm, P wave before each QRS
D. Rate <60, regular rhythm, P wave before each QRS
Correct Answer: C
Rationale:
Sinus Tachycardia follows NSR criteria except for rate (100–150 bpm). Impulse
originates in the SA node, rhythm remains regular, and each P wave is followed by a
QRS. It can be physiological (exercise, fever, anxiety) or pathological
,(hyperthyroidism, hypovolemia). Distinguishing sinus tachycardia from SVT or atrial
tachyarrhythmias is essential for correct management.
3. Sinus Bradycardia
Question: What defines Sinus Bradycardia?
Options:
A. Rate >100, regular rhythm, P wave before each QRS
B. Rate <60, regular rhythm, P wave before each QRS
C. Rate 60–100, irregular rhythm, no P waves
D. Wide QRS, rate <40, irregular rhythm
Correct Answer: B
Rationale:
Sinus Bradycardia originates in the SA node with all NSR features intact except a
slower rate (<60 bpm). Rhythm is regular, and each P wave precedes a QRS complex.
Causes include high vagal tone, medications, hypothyroidism, or athletic conditioning.
Symptomatic bradycardia may cause dizziness, hypotension, or syncope.
4. Sinus Arrhythmia
Question: Which statement correctly describes Sinus Arrhythmia?
Options:
A. SA node impulse varies with respiration, rate 60–100, rhythm irregular, normal P
wave, PRI and QRS normal
B. Rate >150, regular rhythm, no P waves
C. Ventricular origin, wide QRS, irregular rhythm
D. SA node impulse fixed, regular rhythm, P wave before QRS
Correct Answer: A
Rationale:
Sinus Arrhythmia is a normal variation of NSR, with rate fluctuating during respiration
—faster with inspiration and slower with expiration. Rhythm is irregular due to varying
,P-P and R-R intervals, but P waves, PR interval, and QRS remain normal. Common in
young healthy adults, it is generally benign and requires no treatment.
5. Sinus Pause / Arrest
Question: Sinus Pause or Sinus Arrest is identified when:
Options:
A. Underlying rhythm is not sinus, wide QRS
B. Missed beat(s) or pause in underlying sinus rhythm
C. Rate >150, regular rhythm
D. Ventricular origin, no P waves
Correct Answer: B
Rationale:
Sinus Pause/Arrest occurs when the SA node temporarily stops firing. The underlying
rhythm must first be sinus. The pause may result in a missed P wave and QRS
complex, leading to transient drop in cardiac output. Causes include increased vagal
tone, ischemia, medications, or SA node disease. Prolonged pauses can cause
dizziness or syncope.
6. Narrow Complex Supraventricular Tachycardia (NCSVT)
Question: Which is true about Narrow Complex SVT?
Options:
A. Impulse originates in the ventricles, QRS >0.12 s
B. Ventricular rate >150, QRS 0.04–0.10, P waves often buried in T waves
C. Rate <60, regular rhythm, P waves visible
D. Atrial flutter with saw-tooth waves
Correct Answer: B
Rationale:
NCSVT arises above the ventricles (atria or AV node). Ventricular rate exceeds 150
bpm, QRS is narrow (0.04–0.10 s). P waves may be present but are often hidden within
, T waves, making atrial activity hard to measure. This rhythm is usually regular and
may cause palpitations, dizziness, or hypotension.
7. Atrial Flutter
Question: Atrial Flutter is characterized by:
Options:
A. Atrial rate 250–350 bpm, saw-tooth waves, variable ventricular response, QRS
normal
B. Ventricular origin, wide QRS, irregular rhythm
C. Rate <60, P wave before QRS, regular rhythm
D. Impulse from AV node, P waves absent, QRS narrow
Correct Answer: A
Rationale:
Atrial Flutter originates in the atria with a rapid atrial rate (250–350 bpm).
Characteristic saw-tooth flutter waves are seen on EKG. Ventricular rhythm may be
regular or irregular depending on conduction ratio. PR interval is non-measurable due
to rapid atrial depolarization, but QRS remains narrow if no bundle branch block exists.
Rate control and anticoagulation are important clinical considerations.
8. Atrial Fibrillation
Question: Which feature is typical of Atrial Fibrillation (AFib)?
Options:
A. Regular rhythm, P waves before QRS, PR interval normal
B. Irregularly irregular rhythm, no discrete P waves, fibrillatory baseline, narrow QRS
C. Ventricular origin, wide QRS, rate <40
D. SA node impulse, rate 60–100, regular rhythm
Correct Answer: B
Rationale:
AFib originates in the atria with chaotic electrical activity. It is characterized by an
irregularly irregular ventricular rhythm, absence of discrete P waves, and a fibrillatory
UPDATE) QUESTIONS AND VERIFIED
ANSWERS WITH DIAGRAMS AND
ILLUSTRATIONS| 100% CORRECT
1. Normal Sinus Rhythm (NSR)
Question: Which of the following best describes Normal Sinus Rhythm (NSR)?
Options:
A. Impulse starts in the SA node, rate 60–100, regular rhythm, P wave before each
QRS, PRI 0.12–0.20, QRS 0.04–0.10
B. Impulse starts in the AV node, rate 40–60, irregular rhythm, no P waves, QRS wide
C. Impulse starts in the ventricles, rate 20–40, irregular rhythm, wide QRS
D. Impulse starts in the SA node, rate 100–150, irregular rhythm, no P waves
Correct Answer: A
Rationale:
Normal Sinus Rhythm originates in the SA node, producing atrial and ventricular rates
between 60 and 100 bpm. The rhythm is regular, with consistent P-P and R-R intervals.
Each P wave precedes a QRS complex, showing normal atrial depolarization followed
by ventricular depolarization. PR interval is normal (0.12–0.20 s), and QRS is narrow
(0.04–0.10 s). This represents normal cardiac electrical activity.
2. Sinus Tachycardia
Question: Sinus Tachycardia is characterized by:
Options:
A. Rate 60–100, regular rhythm, P wave before each QRS
B. Rate >150, irregular rhythm, no P waves
C. Rate 100–150, regular rhythm, P wave before each QRS
D. Rate <60, regular rhythm, P wave before each QRS
Correct Answer: C
Rationale:
Sinus Tachycardia follows NSR criteria except for rate (100–150 bpm). Impulse
originates in the SA node, rhythm remains regular, and each P wave is followed by a
QRS. It can be physiological (exercise, fever, anxiety) or pathological
,(hyperthyroidism, hypovolemia). Distinguishing sinus tachycardia from SVT or atrial
tachyarrhythmias is essential for correct management.
3. Sinus Bradycardia
Question: What defines Sinus Bradycardia?
Options:
A. Rate >100, regular rhythm, P wave before each QRS
B. Rate <60, regular rhythm, P wave before each QRS
C. Rate 60–100, irregular rhythm, no P waves
D. Wide QRS, rate <40, irregular rhythm
Correct Answer: B
Rationale:
Sinus Bradycardia originates in the SA node with all NSR features intact except a
slower rate (<60 bpm). Rhythm is regular, and each P wave precedes a QRS complex.
Causes include high vagal tone, medications, hypothyroidism, or athletic conditioning.
Symptomatic bradycardia may cause dizziness, hypotension, or syncope.
4. Sinus Arrhythmia
Question: Which statement correctly describes Sinus Arrhythmia?
Options:
A. SA node impulse varies with respiration, rate 60–100, rhythm irregular, normal P
wave, PRI and QRS normal
B. Rate >150, regular rhythm, no P waves
C. Ventricular origin, wide QRS, irregular rhythm
D. SA node impulse fixed, regular rhythm, P wave before QRS
Correct Answer: A
Rationale:
Sinus Arrhythmia is a normal variation of NSR, with rate fluctuating during respiration
—faster with inspiration and slower with expiration. Rhythm is irregular due to varying
,P-P and R-R intervals, but P waves, PR interval, and QRS remain normal. Common in
young healthy adults, it is generally benign and requires no treatment.
5. Sinus Pause / Arrest
Question: Sinus Pause or Sinus Arrest is identified when:
Options:
A. Underlying rhythm is not sinus, wide QRS
B. Missed beat(s) or pause in underlying sinus rhythm
C. Rate >150, regular rhythm
D. Ventricular origin, no P waves
Correct Answer: B
Rationale:
Sinus Pause/Arrest occurs when the SA node temporarily stops firing. The underlying
rhythm must first be sinus. The pause may result in a missed P wave and QRS
complex, leading to transient drop in cardiac output. Causes include increased vagal
tone, ischemia, medications, or SA node disease. Prolonged pauses can cause
dizziness or syncope.
6. Narrow Complex Supraventricular Tachycardia (NCSVT)
Question: Which is true about Narrow Complex SVT?
Options:
A. Impulse originates in the ventricles, QRS >0.12 s
B. Ventricular rate >150, QRS 0.04–0.10, P waves often buried in T waves
C. Rate <60, regular rhythm, P waves visible
D. Atrial flutter with saw-tooth waves
Correct Answer: B
Rationale:
NCSVT arises above the ventricles (atria or AV node). Ventricular rate exceeds 150
bpm, QRS is narrow (0.04–0.10 s). P waves may be present but are often hidden within
, T waves, making atrial activity hard to measure. This rhythm is usually regular and
may cause palpitations, dizziness, or hypotension.
7. Atrial Flutter
Question: Atrial Flutter is characterized by:
Options:
A. Atrial rate 250–350 bpm, saw-tooth waves, variable ventricular response, QRS
normal
B. Ventricular origin, wide QRS, irregular rhythm
C. Rate <60, P wave before QRS, regular rhythm
D. Impulse from AV node, P waves absent, QRS narrow
Correct Answer: A
Rationale:
Atrial Flutter originates in the atria with a rapid atrial rate (250–350 bpm).
Characteristic saw-tooth flutter waves are seen on EKG. Ventricular rhythm may be
regular or irregular depending on conduction ratio. PR interval is non-measurable due
to rapid atrial depolarization, but QRS remains narrow if no bundle branch block exists.
Rate control and anticoagulation are important clinical considerations.
8. Atrial Fibrillation
Question: Which feature is typical of Atrial Fibrillation (AFib)?
Options:
A. Regular rhythm, P waves before QRS, PR interval normal
B. Irregularly irregular rhythm, no discrete P waves, fibrillatory baseline, narrow QRS
C. Ventricular origin, wide QRS, rate <40
D. SA node impulse, rate 60–100, regular rhythm
Correct Answer: B
Rationale:
AFib originates in the atria with chaotic electrical activity. It is characterized by an
irregularly irregular ventricular rhythm, absence of discrete P waves, and a fibrillatory
