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RELIAS – Dysrhythmia Basic B Exam ACTUAL EXAM
COMPLETE 200 QUESTIONS AND VERIFIED SOLUTIONS
LATEST UPDATE THIS YEAR
EXAM COVERAGE
RELIAS – Dysrhythmia Basic B Exam
• Cardiac conduction system: SA node, AV node, bundle branches, Purkinje fibers
• Normal sinus rhythm and variations
• Common arrhythmias:
o Atrial: PAC, atrial flutter, atrial fibrillation
o Junctional rhythms: junctional escape, accelerated junctional
o Ventricular: PVCs, ventricular tachycardia, ventricular fibrillation
• Heart blocks:
o First-degree AV block
o Second-degree (Type I & II) AV block
o Third-degree (complete) AV block
• Bradycardia and tachycardia recognition
• Electrocardiogram (ECG) interpretation basics
• Rhythm identification steps (rate, rhythm, P wave, PR interval, QRS complex)
• Clinical significance of dysrhythmias
• Basic interventions and emergency responses (CPR, defibrillation basics)
• Documentation and reporting of dysrhythmias
1. The electrical impulse normally originates from which structure of the heart?
A. AV node
B. Bundle of His
C. SA node
D. Purkinje fibers
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Answer: C. SA node
Rationale: The sinoatrial (SA) node is the heart’s primary pacemaker. It initiates electrical
impulses that travel through the atria, causing atrial contraction before reaching the AV node.
2. Which ECG component represents ventricular depolarization?
A. P wave
B. PR interval
C. QRS complex
D. T wave
Answer: C. QRS complex
Rationale: The QRS complex reflects ventricular depolarization. It is normally narrow (0.06–0.10
seconds). A widened QRS may indicate a ventricular origin or conduction delay.
3. A rhythm strip shows a regular rhythm, heart rate of 68 bpm, upright P waves before every
QRS, and a PR interval of 0.16 seconds. This rhythm is:
A. Sinus bradycardia
B. Normal sinus rhythm
C. Atrial fibrillation
D. First-degree AV block
Answer: B. Normal sinus rhythm
Rationale: The rate is within normal range (60–100 bpm), rhythm is regular, P waves precede
each QRS, and the PR interval is normal (0.12–0.20 seconds). These findings indicate normal
sinus rhythm.
4. What is the normal intrinsic firing rate of the SA node?
A. 20–40 bpm
B. 40–60 bpm
C. 60–100 bpm
D. 100–150 bpm
Answer: C. 60–100 bpm
Rationale: The SA node normally fires at 60–100 beats per minute. If it fails, lower pacemakers
(AV node or ventricles) may take over at slower rates.
1. The SA node is located in the:
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A. Left atrium
B. Right atrium
C. Left ventricle
D. Right ventricle
Answer: B
Rationale: The SA node sits in the right atrium near the superior vena cava and serves as the
heart’s natural pacemaker.
2. Normal SA node intrinsic rate is:
A. 20–40 bpm
B. 40–60 bpm
C. 60–100 bpm
D. 100–150 bpm
Answer: C
Rationale: The SA node normally fires between 60–100 bpm.
3. Normal PR interval:
A. 0.06–0.10 sec
B. 0.10–0.12 sec
C. 0.12–0.20 sec
D. 0.20–0.30 sec
Answer: C
Rationale: Represents atrial depolarization and AV conduction.
4. Normal QRS duration:
A. 0.04–0.08 sec
B. 0.06–0.10 sec
C. 0.10–0.14 sec
D. 0.14–0.18 sec
Answer: B
Rationale: Ventricular depolarization should be narrow (<0.12 sec).
5. Heart rate if R-R = 0.5 sec:
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A. 60
B. 75
C. 100
D. 120
Answer: D
Rationale: 60 ÷ 0.5 = 120 bpm.
6. Atrial depolarization is represented by:
A. QRS
B. T wave
C. P wave
D. U wave
Answer: C
Rationale: P wave = atrial depolarization.
7. Sinus bradycardia rate is:
A. <50
B. <60
C. <70
D. <80
Answer: B
Rationale: Sinus rhythm below 60 bpm.
8. Sinus tachycardia rate is:
A. >90
B. >100
C. >110
D. >120
Answer: B
Rationale: Above 100 bpm from SA node.
9. Irregularly irregular rhythm without P waves:
A. Atrial flutter
B. Atrial fibrillation
RELIAS – Dysrhythmia Basic B Exam ACTUAL EXAM
COMPLETE 200 QUESTIONS AND VERIFIED SOLUTIONS
LATEST UPDATE THIS YEAR
EXAM COVERAGE
RELIAS – Dysrhythmia Basic B Exam
• Cardiac conduction system: SA node, AV node, bundle branches, Purkinje fibers
• Normal sinus rhythm and variations
• Common arrhythmias:
o Atrial: PAC, atrial flutter, atrial fibrillation
o Junctional rhythms: junctional escape, accelerated junctional
o Ventricular: PVCs, ventricular tachycardia, ventricular fibrillation
• Heart blocks:
o First-degree AV block
o Second-degree (Type I & II) AV block
o Third-degree (complete) AV block
• Bradycardia and tachycardia recognition
• Electrocardiogram (ECG) interpretation basics
• Rhythm identification steps (rate, rhythm, P wave, PR interval, QRS complex)
• Clinical significance of dysrhythmias
• Basic interventions and emergency responses (CPR, defibrillation basics)
• Documentation and reporting of dysrhythmias
1. The electrical impulse normally originates from which structure of the heart?
A. AV node
B. Bundle of His
C. SA node
D. Purkinje fibers
,Page 2 of 42
Answer: C. SA node
Rationale: The sinoatrial (SA) node is the heart’s primary pacemaker. It initiates electrical
impulses that travel through the atria, causing atrial contraction before reaching the AV node.
2. Which ECG component represents ventricular depolarization?
A. P wave
B. PR interval
C. QRS complex
D. T wave
Answer: C. QRS complex
Rationale: The QRS complex reflects ventricular depolarization. It is normally narrow (0.06–0.10
seconds). A widened QRS may indicate a ventricular origin or conduction delay.
3. A rhythm strip shows a regular rhythm, heart rate of 68 bpm, upright P waves before every
QRS, and a PR interval of 0.16 seconds. This rhythm is:
A. Sinus bradycardia
B. Normal sinus rhythm
C. Atrial fibrillation
D. First-degree AV block
Answer: B. Normal sinus rhythm
Rationale: The rate is within normal range (60–100 bpm), rhythm is regular, P waves precede
each QRS, and the PR interval is normal (0.12–0.20 seconds). These findings indicate normal
sinus rhythm.
4. What is the normal intrinsic firing rate of the SA node?
A. 20–40 bpm
B. 40–60 bpm
C. 60–100 bpm
D. 100–150 bpm
Answer: C. 60–100 bpm
Rationale: The SA node normally fires at 60–100 beats per minute. If it fails, lower pacemakers
(AV node or ventricles) may take over at slower rates.
1. The SA node is located in the:
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A. Left atrium
B. Right atrium
C. Left ventricle
D. Right ventricle
Answer: B
Rationale: The SA node sits in the right atrium near the superior vena cava and serves as the
heart’s natural pacemaker.
2. Normal SA node intrinsic rate is:
A. 20–40 bpm
B. 40–60 bpm
C. 60–100 bpm
D. 100–150 bpm
Answer: C
Rationale: The SA node normally fires between 60–100 bpm.
3. Normal PR interval:
A. 0.06–0.10 sec
B. 0.10–0.12 sec
C. 0.12–0.20 sec
D. 0.20–0.30 sec
Answer: C
Rationale: Represents atrial depolarization and AV conduction.
4. Normal QRS duration:
A. 0.04–0.08 sec
B. 0.06–0.10 sec
C. 0.10–0.14 sec
D. 0.14–0.18 sec
Answer: B
Rationale: Ventricular depolarization should be narrow (<0.12 sec).
5. Heart rate if R-R = 0.5 sec:
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A. 60
B. 75
C. 100
D. 120
Answer: D
Rationale: 60 ÷ 0.5 = 120 bpm.
6. Atrial depolarization is represented by:
A. QRS
B. T wave
C. P wave
D. U wave
Answer: C
Rationale: P wave = atrial depolarization.
7. Sinus bradycardia rate is:
A. <50
B. <60
C. <70
D. <80
Answer: B
Rationale: Sinus rhythm below 60 bpm.
8. Sinus tachycardia rate is:
A. >90
B. >100
C. >110
D. >120
Answer: B
Rationale: Above 100 bpm from SA node.
9. Irregularly irregular rhythm without P waves:
A. Atrial flutter
B. Atrial fibrillation
