Allied Health Patient Care Technician (PCT)
Exam Prep 2026 | 200+ Verified Questions &
Detailed Rationales
ALLIED HEALTH PATIENT CARE TECHNICIAN (PCT) EXAM PREP 2026
200+ Verified Questions & Detailed RATIONALE
Q1. A PCT is monitoring a patient's cardiac rhythm strip and notices a pattern
where the P-R interval progressively lengthens with each beat until a QRS
complex is completely dropped. Which condition does this BEST describe?
A. First-degree AV block
B. Third-degree AV block
C. Atrial fibrillation
D. Ventricular tachycardia
E. Bundle branch block
CORRECT ANSWER: B. Second-degree AV block (Mobitz Type I / Wenckebach)
RATIONALE: Wenckebach (Mobitz Type I) is characterized by a progressively
lengthening PR interval until a QRS complex is dropped entirely, then the cycle repeats.
This distinguishes it from Mobitz Type II where the PR is constant but QRS is randomly
dropped. First-degree AV block only shows a prolonged PR >0.20 seconds. Third-
degree shows complete dissociation between P waves and QRS complexes.
Q2. While performing an EKG, you notice the tracing shows a "sawtooth" pattern
between QRS complexes at a rate of approximately 300 bpm in the atria. The
ventricular rate is 75 bpm. What rhythm is this MOST consistent with?
A. Atrial fibrillation
B. Ventricular flutter
C. Atrial flutter with 4:1 block
D. Sinus tachycardia
E. Supraventricular tachycardia
, CORRECT ANSWER: C. Atrial flutter with 4:1 block
RATIONALE: Atrial flutter is characterized by a "sawtooth" or "picket fence" flutter
wave pattern, typically at an atrial rate of 250–350 bpm. A 4:1 conduction ratio means
for every 4 atrial beats, only 1 is conducted to the ventricles, producing a ventricular rate
of ~75 bpm (300 ÷ 4 = 75). Atrial fibrillation shows an irregularly irregular rhythm with no
discernible P waves.
Q3. A patient's EKG reveals a QRS complex that is wider than 0.12 seconds (3
small boxes), with a "rabbit ear" pattern in lead V1 and a broad S wave in lead V6.
Which condition does this BEST represent?
A. Left bundle branch block
B. Wolff-Parkinson-White syndrome
C. Right bundle branch block
D. First-degree AV block
E. Left anterior fascicular block
CORRECT ANSWER: C. Right bundle branch block (RBBB)
RATIONALE: RBBB is identified by a wide QRS >0.12 sec, rSR' pattern ("rabbit
ears") in V1, and a broad slurred S wave in leads I, aVL, V5, and V6. In LBBB, the
pattern is reversed — broad monophasic R in V5/V6 and a QS or rS in V1. WPW shows
a delta wave and short PR interval rather than a rabbit ear pattern.
Q4. Which of the following EKG changes is MOST associated with hyperkalemia
and should prompt a PCT to immediately notify the nurse?
A. Prolonged QT interval
B. Elevated ST segment
C. Tall, peaked T waves
D. Shortened PR interval
E. Prominent U waves
CORRECT ANSWER: C. Tall, peaked T waves
, RATIONALE: Hyperkalemia (elevated serum potassium) produces progressive
EKG changes beginning with tall, narrow, peaked T waves — often described as
"tented." As K⁺ rises further, the PR interval lengthens, QRS widens, and eventually a
sine wave pattern develops leading to fatal arrhythmias. Prominent U waves are
associated with HYPOkalemia, not hyperkalemia.
Q5. A PCT is applying limb leads for a standard 12-lead EKG. The RIGHT LEG
electrode is placed incorrectly on the left leg. What is the MOST LIKELY result on
the tracing?
A. Artifact in all chest leads
B. Inverted P wave in lead II
C. Lead II and lead III will appear switched
D. No change — the right leg is a ground electrode
E. ST elevation in limb leads
CORRECT ANSWER: D. No change — the right leg is a ground electrode
RATIONALE: The right leg (RL) electrode serves as an electrical ground/reference
in a standard 12-lead EKG and does not contribute to any of the 12 leads. Therefore,
misplacement of the RL electrode typically produces no visible change in the tracing.
However, swapping of arm leads (LA/RA) produces significant changes such as
inverted P waves in lead I and a negative QRS in leads I and aVL.
Q6. Which of the following BEST describes the function of the SA node in cardiac
physiology?
A. It receives electrical impulses from the AV node and distributes them to the Purkinje
fibers
B. It is located in the interventricular septum and delays conduction
C. It serves as the primary pacemaker, initiating impulses at 60–100 bpm
D. It is responsible for ventricular repolarization
E. It conducts impulses only during episodes of bradycardia
CORRECT ANSWER: C. It serves as the primary pacemaker, initiating
impulses at 60–100 bpm
, RATIONALE: The sinoatrial (SA) node, located in the right atrium near the
superior vena cava, is the heart's natural pacemaker with an intrinsic rate of 60–100
bpm. It initiates electrical impulses that travel through the atria to the AV node, bundle of
His, bundle branches, and Purkinje fibers. If the SA node fails, the AV node takes over
at 40–60 bpm, and the ventricles can pace at 20–40 bpm as a last resort.
Q7. A PCT observes that a patient's cardiac monitor shows no P waves, an
irregularly irregular ventricular rhythm, and a ventricular rate of 110 bpm. The
MOST likely rhythm is:
A. Sinus arrhythmia
B. Atrial flutter
C. Atrial fibrillation
D. Junctional tachycardia
E. Multifocal atrial tachycardia
CORRECT ANSWER: C. Atrial fibrillation
RATIONALE: Atrial fibrillation (A-fib) is characterized by the absence of distinct P
waves (replaced by chaotic fibrillatory baseline), an irregularly irregular ventricular
rhythm, and variable ventricular rate. MAT also shows no regular P waves but has at
least 3 different P wave morphologies. Atrial flutter has a regular sawtooth pattern.
Sinus arrhythmia is regularly irregular and associated with respiration.
Q8. During telemetry monitoring, a PCT observes a patient suddenly go into a
rhythm showing wide, bizarre QRS complexes at a rate of 180 bpm with no
discernible P waves. The patient is unresponsive. What is the PRIORITY action?
A. Administer amiodarone immediately
B. Perform a 12-lead EKG
C. Call for help and initiate the emergency response system
D. Check lead placement for artifact
E. Reposition the patient and reassess
CORRECT ANSWER: C. Call for help and initiate the emergency response
system
Exam Prep 2026 | 200+ Verified Questions &
Detailed Rationales
ALLIED HEALTH PATIENT CARE TECHNICIAN (PCT) EXAM PREP 2026
200+ Verified Questions & Detailed RATIONALE
Q1. A PCT is monitoring a patient's cardiac rhythm strip and notices a pattern
where the P-R interval progressively lengthens with each beat until a QRS
complex is completely dropped. Which condition does this BEST describe?
A. First-degree AV block
B. Third-degree AV block
C. Atrial fibrillation
D. Ventricular tachycardia
E. Bundle branch block
CORRECT ANSWER: B. Second-degree AV block (Mobitz Type I / Wenckebach)
RATIONALE: Wenckebach (Mobitz Type I) is characterized by a progressively
lengthening PR interval until a QRS complex is dropped entirely, then the cycle repeats.
This distinguishes it from Mobitz Type II where the PR is constant but QRS is randomly
dropped. First-degree AV block only shows a prolonged PR >0.20 seconds. Third-
degree shows complete dissociation between P waves and QRS complexes.
Q2. While performing an EKG, you notice the tracing shows a "sawtooth" pattern
between QRS complexes at a rate of approximately 300 bpm in the atria. The
ventricular rate is 75 bpm. What rhythm is this MOST consistent with?
A. Atrial fibrillation
B. Ventricular flutter
C. Atrial flutter with 4:1 block
D. Sinus tachycardia
E. Supraventricular tachycardia
, CORRECT ANSWER: C. Atrial flutter with 4:1 block
RATIONALE: Atrial flutter is characterized by a "sawtooth" or "picket fence" flutter
wave pattern, typically at an atrial rate of 250–350 bpm. A 4:1 conduction ratio means
for every 4 atrial beats, only 1 is conducted to the ventricles, producing a ventricular rate
of ~75 bpm (300 ÷ 4 = 75). Atrial fibrillation shows an irregularly irregular rhythm with no
discernible P waves.
Q3. A patient's EKG reveals a QRS complex that is wider than 0.12 seconds (3
small boxes), with a "rabbit ear" pattern in lead V1 and a broad S wave in lead V6.
Which condition does this BEST represent?
A. Left bundle branch block
B. Wolff-Parkinson-White syndrome
C. Right bundle branch block
D. First-degree AV block
E. Left anterior fascicular block
CORRECT ANSWER: C. Right bundle branch block (RBBB)
RATIONALE: RBBB is identified by a wide QRS >0.12 sec, rSR' pattern ("rabbit
ears") in V1, and a broad slurred S wave in leads I, aVL, V5, and V6. In LBBB, the
pattern is reversed — broad monophasic R in V5/V6 and a QS or rS in V1. WPW shows
a delta wave and short PR interval rather than a rabbit ear pattern.
Q4. Which of the following EKG changes is MOST associated with hyperkalemia
and should prompt a PCT to immediately notify the nurse?
A. Prolonged QT interval
B. Elevated ST segment
C. Tall, peaked T waves
D. Shortened PR interval
E. Prominent U waves
CORRECT ANSWER: C. Tall, peaked T waves
, RATIONALE: Hyperkalemia (elevated serum potassium) produces progressive
EKG changes beginning with tall, narrow, peaked T waves — often described as
"tented." As K⁺ rises further, the PR interval lengthens, QRS widens, and eventually a
sine wave pattern develops leading to fatal arrhythmias. Prominent U waves are
associated with HYPOkalemia, not hyperkalemia.
Q5. A PCT is applying limb leads for a standard 12-lead EKG. The RIGHT LEG
electrode is placed incorrectly on the left leg. What is the MOST LIKELY result on
the tracing?
A. Artifact in all chest leads
B. Inverted P wave in lead II
C. Lead II and lead III will appear switched
D. No change — the right leg is a ground electrode
E. ST elevation in limb leads
CORRECT ANSWER: D. No change — the right leg is a ground electrode
RATIONALE: The right leg (RL) electrode serves as an electrical ground/reference
in a standard 12-lead EKG and does not contribute to any of the 12 leads. Therefore,
misplacement of the RL electrode typically produces no visible change in the tracing.
However, swapping of arm leads (LA/RA) produces significant changes such as
inverted P waves in lead I and a negative QRS in leads I and aVL.
Q6. Which of the following BEST describes the function of the SA node in cardiac
physiology?
A. It receives electrical impulses from the AV node and distributes them to the Purkinje
fibers
B. It is located in the interventricular septum and delays conduction
C. It serves as the primary pacemaker, initiating impulses at 60–100 bpm
D. It is responsible for ventricular repolarization
E. It conducts impulses only during episodes of bradycardia
CORRECT ANSWER: C. It serves as the primary pacemaker, initiating
impulses at 60–100 bpm
, RATIONALE: The sinoatrial (SA) node, located in the right atrium near the
superior vena cava, is the heart's natural pacemaker with an intrinsic rate of 60–100
bpm. It initiates electrical impulses that travel through the atria to the AV node, bundle of
His, bundle branches, and Purkinje fibers. If the SA node fails, the AV node takes over
at 40–60 bpm, and the ventricles can pace at 20–40 bpm as a last resort.
Q7. A PCT observes that a patient's cardiac monitor shows no P waves, an
irregularly irregular ventricular rhythm, and a ventricular rate of 110 bpm. The
MOST likely rhythm is:
A. Sinus arrhythmia
B. Atrial flutter
C. Atrial fibrillation
D. Junctional tachycardia
E. Multifocal atrial tachycardia
CORRECT ANSWER: C. Atrial fibrillation
RATIONALE: Atrial fibrillation (A-fib) is characterized by the absence of distinct P
waves (replaced by chaotic fibrillatory baseline), an irregularly irregular ventricular
rhythm, and variable ventricular rate. MAT also shows no regular P waves but has at
least 3 different P wave morphologies. Atrial flutter has a regular sawtooth pattern.
Sinus arrhythmia is regularly irregular and associated with respiration.
Q8. During telemetry monitoring, a PCT observes a patient suddenly go into a
rhythm showing wide, bizarre QRS complexes at a rate of 180 bpm with no
discernible P waves. The patient is unresponsive. What is the PRIORITY action?
A. Administer amiodarone immediately
B. Perform a 12-lead EKG
C. Call for help and initiate the emergency response system
D. Check lead placement for artifact
E. Reposition the patient and reassess
CORRECT ANSWER: C. Call for help and initiate the emergency response
system
