RELIAS ADVANCED DYSRHYTHMIA EXAM B QUESTIONS
AND CORRECT ANSWERS WITH RATIONALES GRADED A+
LATEST
Question 1
A patient with atrial fibrillation has an irregularly irregular rhythm with no
discernible P waves. Which mechanism best explains this dysrhythmia?
A. Reentry circuit within the AV node
B. Multiple ectopic atrial foci firing chaotically
C. Delayed ventricular repolarization
D. SA node automaticity suppression
Correct Answer: B
Rationale: Atrial fibrillation is caused by multiple ectopic atrial foci firing
simultaneously, resulting in chaotic atrial activity and loss of organized P waves.
Question 2
Which ECG finding is most consistent with second-degree AV block type II
(Mobitz II)?
A. Progressive PR interval prolongation before a dropped QRS
B. Constant PR intervals with intermittent dropped QRS complexes
C. Absence of P waves
D. Wide QRS complexes with premature beats
Correct Answer: B
Rationale: Mobitz II is characterized by fixed PR intervals with sudden dropped
QRS complexes, reflecting conduction failure below the AV node.
,Question 3
A wide-complex tachycardia at 180 bpm with AV dissociation is most likely:
A. Supraventricular tachycardia with aberrancy
B. Ventricular tachycardia
C. Atrial flutter
D. Junctional tachycardia
Correct Answer: B
Rationale: AV dissociation strongly suggests ventricular tachycardia, especially in
the presence of a wide-complex tachycardia.
Question 4
Which electrolyte abnormality most commonly predisposes a patient to torsades de
pointes?
A. Hyperkalemia
B. Hypokalemia
C. Hypercalcemia
D. Hyponatremia
Correct Answer: B
Rationale: Hypokalemia prolongs ventricular repolarization, increasing the risk of
QT prolongation and torsades de pointes.
Question 5
A patient with sinus bradycardia becomes hypotensive and altered. Which
intervention is most appropriate?
A. Immediate synchronized cardioversion
B. Atropine administration
C. Adenosine IV push
D. Amiodarone infusion
,Correct Answer: B
Rationale: Atropine is first-line therapy for symptomatic sinus bradycardia to
increase heart rate by blocking vagal tone.
Question 6
Which rhythm is associated with a sawtooth pattern of flutter waves?
A. Atrial fibrillation
B. Atrial flutter
C. Multifocal atrial tachycardia
D. Junctional rhythm
Correct Answer: B
Rationale: Atrial flutter produces organized atrial activity with characteristic
sawtooth flutter waves, usually at 250–350 bpm.
Question 7
A prolonged PR interval (>0.20 seconds) with a 1:1 P-to-QRS ratio indicates:
A. Second-degree AV block type I
B. First-degree AV block
C. Junctional rhythm
D. Complete heart block
Correct Answer: B
Rationale: First-degree AV block is defined by consistent conduction with a
prolonged PR interval.
, Question 8
Which rhythm carries the highest immediate risk for sudden cardiac death?
A. Sinus tachycardia
B. Atrial flutter
C. Ventricular fibrillation
D. Junctional rhythm
Correct Answer: C
Rationale: Ventricular fibrillation results in no effective cardiac output and is
immediately life-threatening without defibrillation.
Question 9
In ventricular tachycardia, the QRS complex is typically:
A. Narrow and regular
B. Wide and bizarre
C. Narrow and irregular
D. Absent
Correct Answer: B
Rationale: Ventricular rhythms originate below the AV node, producing wide and
abnormal QRS complexes.
Question 10
Which medication is most appropriate for stable monomorphic ventricular
tachycardia?
A. Adenosine
B. Amiodarone
C. Atropine
D. Digoxin
AND CORRECT ANSWERS WITH RATIONALES GRADED A+
LATEST
Question 1
A patient with atrial fibrillation has an irregularly irregular rhythm with no
discernible P waves. Which mechanism best explains this dysrhythmia?
A. Reentry circuit within the AV node
B. Multiple ectopic atrial foci firing chaotically
C. Delayed ventricular repolarization
D. SA node automaticity suppression
Correct Answer: B
Rationale: Atrial fibrillation is caused by multiple ectopic atrial foci firing
simultaneously, resulting in chaotic atrial activity and loss of organized P waves.
Question 2
Which ECG finding is most consistent with second-degree AV block type II
(Mobitz II)?
A. Progressive PR interval prolongation before a dropped QRS
B. Constant PR intervals with intermittent dropped QRS complexes
C. Absence of P waves
D. Wide QRS complexes with premature beats
Correct Answer: B
Rationale: Mobitz II is characterized by fixed PR intervals with sudden dropped
QRS complexes, reflecting conduction failure below the AV node.
,Question 3
A wide-complex tachycardia at 180 bpm with AV dissociation is most likely:
A. Supraventricular tachycardia with aberrancy
B. Ventricular tachycardia
C. Atrial flutter
D. Junctional tachycardia
Correct Answer: B
Rationale: AV dissociation strongly suggests ventricular tachycardia, especially in
the presence of a wide-complex tachycardia.
Question 4
Which electrolyte abnormality most commonly predisposes a patient to torsades de
pointes?
A. Hyperkalemia
B. Hypokalemia
C. Hypercalcemia
D. Hyponatremia
Correct Answer: B
Rationale: Hypokalemia prolongs ventricular repolarization, increasing the risk of
QT prolongation and torsades de pointes.
Question 5
A patient with sinus bradycardia becomes hypotensive and altered. Which
intervention is most appropriate?
A. Immediate synchronized cardioversion
B. Atropine administration
C. Adenosine IV push
D. Amiodarone infusion
,Correct Answer: B
Rationale: Atropine is first-line therapy for symptomatic sinus bradycardia to
increase heart rate by blocking vagal tone.
Question 6
Which rhythm is associated with a sawtooth pattern of flutter waves?
A. Atrial fibrillation
B. Atrial flutter
C. Multifocal atrial tachycardia
D. Junctional rhythm
Correct Answer: B
Rationale: Atrial flutter produces organized atrial activity with characteristic
sawtooth flutter waves, usually at 250–350 bpm.
Question 7
A prolonged PR interval (>0.20 seconds) with a 1:1 P-to-QRS ratio indicates:
A. Second-degree AV block type I
B. First-degree AV block
C. Junctional rhythm
D. Complete heart block
Correct Answer: B
Rationale: First-degree AV block is defined by consistent conduction with a
prolonged PR interval.
, Question 8
Which rhythm carries the highest immediate risk for sudden cardiac death?
A. Sinus tachycardia
B. Atrial flutter
C. Ventricular fibrillation
D. Junctional rhythm
Correct Answer: C
Rationale: Ventricular fibrillation results in no effective cardiac output and is
immediately life-threatening without defibrillation.
Question 9
In ventricular tachycardia, the QRS complex is typically:
A. Narrow and regular
B. Wide and bizarre
C. Narrow and irregular
D. Absent
Correct Answer: B
Rationale: Ventricular rhythms originate below the AV node, producing wide and
abnormal QRS complexes.
Question 10
Which medication is most appropriate for stable monomorphic ventricular
tachycardia?
A. Adenosine
B. Amiodarone
C. Atropine
D. Digoxin
