Page 1 of 77
UCLA EKG ACTUAL EXAM QUESTIONS AND CORRECT VERIFIED
SOLUTIONS LATEST UPDATE THIS YEAR – JUST RELEASED
EXAM COVERAGE — UCLA EKG EXAM
The UCLA EKG Examination tests the ability to interpret electrocardiogram tracings, identify
arrhythmias, recognize ischemic changes, and understand cardiac electrophysiology. Key
content areas include:
Normal EKG Components — P wave (atrial depolarization), PR interval (atrial to ventricular
conduction), QRS complex (ventricular depolarization), ST segment (early repolarization), T
wave (ventricular repolarization), QT interval (total ventricular activity), U wave (hypokalemia,
bradycardia) .
Rate & Rhythm Analysis — Normal sinus rhythm (60-100 bpm, regular, P before each QRS),
sinus tachycardia (>100 bpm), sinus bradycardia (<60 bpm), sinus arrhythmia (P-P variation with
respiration) .
Supraventricular Arrhythmias — Atrial fibrillation (irregularly irregular, no P waves), atrial
flutter (sawtooth F waves), SVT (narrow QRS, rate >150), multifocal atrial tachycardia (MAT,
three or more P wave morphologies), wandering atrial pacemaker (P wave changes, rate <100) .
Ventricular Arrhythmias — Premature ventricular complexes (PVCs: wide QRS, no preceding P
wave, full compensatory pause), ventricular tachycardia (VT: wide QRS, rate >100,
monomorphic or polymorphic), ventricular fibrillation (VF: chaotic, no organized rhythm),
torsade de pointes (twisting points, prolonged QT) .
Conduction Blocks — First-degree AV block (PR >0.20 seconds), second-degree type I (Mobitz
I/Wenckebach: progressive PR prolongation then dropped QRS), second-degree type II (Mobitz
II: constant PR with intermittent dropped QRS), third-degree AV block (complete heart block: P
waves and QRS dissociated) .
Ischemia & Infarction — ST elevation (STEMI), ST depression (ischemia, reciprocal changes), T
wave inversion (ischemia, strain), Q waves (infarction), hyperacute T waves (early infarction),
Wellens' syndrome (biphasic/T-wave inversions in V2-V3) .
Axis & Hypertrophy — Left axis deviation (normal -30° to +90°, LAD beyond -30°), right axis
deviation (>+90°), left ventricular hypertrophy (LVH: tall R in V5/V6 + deep S in V1/V2), right
ventricular hypertrophy (RVH: tall R in V1, right axis deviation) .
Electrolyte & Drug Effects — Hyperkalemia (peaked T waves, wide QRS, sine wave),
hypokalemia (U waves, ST depression), hypercalcemia (short QT), hypocalcemia (prolonged QT),
digoxin effect (scooped ST, PR prolongation) .
, Page 2 of 77
Pacemaker Rhythms — Pacing spikes, capture (QRS after spike), failure to capture (spike
without QRS), failure to sense (spike in refractory period) .
UCLA EKG EXAM — 200 RANDOMIZED SCENARIO-BASED MCQS
1. A 45-year-old presents with palpitations. EKG shows rate 150, regular, narrow QRS, no visible
P waves. What is the rhythm?
A) Atrial fibrillation
B) Atrial flutter
C) Sinus tachycardia
D) Supraventricular tachycardia (SVT)
Answer: D
*RATIONALE: SVT presents with regular, narrow QRS tachycardia at 150-250 bpm with no visible
P waves due to AV nodal reentry or accessory pathway .*
2. A patient has an EKG with irregularly irregular rhythm, no P waves, and ventricular rate 110.
What is the diagnosis?
A) Atrial flutter
B) Multifocal atrial tachycardia
C) Atrial fibrillation
D) Wandering atrial pacemaker
Answer: C
RATIONALE: Atrial fibrillation is characterized by irregularly irregular rhythm with no discernible
P waves and variable ventricular response .
, Page 3 of 77
3. Which EKG finding is most suggestive of left ventricular hypertrophy (LVH)?
A) Tall R wave in V1 and deep S in V6
B) Deep S wave in V1 and tall R wave in V5 or V6
C) Peaked T waves in precordial leads
D) Q waves in leads II, III, aVF
Answer: B
*RATIONALE: LVH criteria include deep S in V1 plus tall R in V5/V6 (e.g., S in V1 + R in V5 >35
mm) .*
4. A patient's EKG shows PR interval 0.28 seconds with constant PR and 1:1 conduction. What is
the rhythm?
A) First-degree AV block
B) Second-degree AV block type I
C) Second-degree AV block type II
D) Third-degree AV block
Answer: A
*RATIONALE: First-degree AV block is defined by PR interval >0.20 seconds with consistent
conduction .*
5. A 68-year-old reports dizziness. EKG shows rate 38, regular, wide QRS, and P waves not
related to QRS complexes. What is the rhythm?
A) Sinus bradycardia with first-degree block
B) Second-degree AV block type I
, Page 4 of 77
C) Second-degree AV block type II
D) Third-degree AV block
Answer: D
RATIONALE: Complete heart block (third-degree) has atria and ventricles beating independently
with no relationship between P waves and QRS .
6. Which electrolyte abnormality produces tall, peaked T waves and widening of the QRS
complex?
A) Hypokalemia
B) Hyperkalemia
C) Hypocalcemia
D) Hypercalcemia
Answer: B
RATIONALE: Hyperkalemia causes tall, peaked, symmetrical T waves, PR prolongation, wide QRS,
and eventual sine wave pattern .
7. A patient with chest pain has ST segment elevation in leads V1-V4. Which coronary artery is
most likely occluded?
A) Right coronary artery
B) Left circumflex artery
C) Left anterior descending artery
D) Posterior descending artery
Answer: C
UCLA EKG ACTUAL EXAM QUESTIONS AND CORRECT VERIFIED
SOLUTIONS LATEST UPDATE THIS YEAR – JUST RELEASED
EXAM COVERAGE — UCLA EKG EXAM
The UCLA EKG Examination tests the ability to interpret electrocardiogram tracings, identify
arrhythmias, recognize ischemic changes, and understand cardiac electrophysiology. Key
content areas include:
Normal EKG Components — P wave (atrial depolarization), PR interval (atrial to ventricular
conduction), QRS complex (ventricular depolarization), ST segment (early repolarization), T
wave (ventricular repolarization), QT interval (total ventricular activity), U wave (hypokalemia,
bradycardia) .
Rate & Rhythm Analysis — Normal sinus rhythm (60-100 bpm, regular, P before each QRS),
sinus tachycardia (>100 bpm), sinus bradycardia (<60 bpm), sinus arrhythmia (P-P variation with
respiration) .
Supraventricular Arrhythmias — Atrial fibrillation (irregularly irregular, no P waves), atrial
flutter (sawtooth F waves), SVT (narrow QRS, rate >150), multifocal atrial tachycardia (MAT,
three or more P wave morphologies), wandering atrial pacemaker (P wave changes, rate <100) .
Ventricular Arrhythmias — Premature ventricular complexes (PVCs: wide QRS, no preceding P
wave, full compensatory pause), ventricular tachycardia (VT: wide QRS, rate >100,
monomorphic or polymorphic), ventricular fibrillation (VF: chaotic, no organized rhythm),
torsade de pointes (twisting points, prolonged QT) .
Conduction Blocks — First-degree AV block (PR >0.20 seconds), second-degree type I (Mobitz
I/Wenckebach: progressive PR prolongation then dropped QRS), second-degree type II (Mobitz
II: constant PR with intermittent dropped QRS), third-degree AV block (complete heart block: P
waves and QRS dissociated) .
Ischemia & Infarction — ST elevation (STEMI), ST depression (ischemia, reciprocal changes), T
wave inversion (ischemia, strain), Q waves (infarction), hyperacute T waves (early infarction),
Wellens' syndrome (biphasic/T-wave inversions in V2-V3) .
Axis & Hypertrophy — Left axis deviation (normal -30° to +90°, LAD beyond -30°), right axis
deviation (>+90°), left ventricular hypertrophy (LVH: tall R in V5/V6 + deep S in V1/V2), right
ventricular hypertrophy (RVH: tall R in V1, right axis deviation) .
Electrolyte & Drug Effects — Hyperkalemia (peaked T waves, wide QRS, sine wave),
hypokalemia (U waves, ST depression), hypercalcemia (short QT), hypocalcemia (prolonged QT),
digoxin effect (scooped ST, PR prolongation) .
, Page 2 of 77
Pacemaker Rhythms — Pacing spikes, capture (QRS after spike), failure to capture (spike
without QRS), failure to sense (spike in refractory period) .
UCLA EKG EXAM — 200 RANDOMIZED SCENARIO-BASED MCQS
1. A 45-year-old presents with palpitations. EKG shows rate 150, regular, narrow QRS, no visible
P waves. What is the rhythm?
A) Atrial fibrillation
B) Atrial flutter
C) Sinus tachycardia
D) Supraventricular tachycardia (SVT)
Answer: D
*RATIONALE: SVT presents with regular, narrow QRS tachycardia at 150-250 bpm with no visible
P waves due to AV nodal reentry or accessory pathway .*
2. A patient has an EKG with irregularly irregular rhythm, no P waves, and ventricular rate 110.
What is the diagnosis?
A) Atrial flutter
B) Multifocal atrial tachycardia
C) Atrial fibrillation
D) Wandering atrial pacemaker
Answer: C
RATIONALE: Atrial fibrillation is characterized by irregularly irregular rhythm with no discernible
P waves and variable ventricular response .
, Page 3 of 77
3. Which EKG finding is most suggestive of left ventricular hypertrophy (LVH)?
A) Tall R wave in V1 and deep S in V6
B) Deep S wave in V1 and tall R wave in V5 or V6
C) Peaked T waves in precordial leads
D) Q waves in leads II, III, aVF
Answer: B
*RATIONALE: LVH criteria include deep S in V1 plus tall R in V5/V6 (e.g., S in V1 + R in V5 >35
mm) .*
4. A patient's EKG shows PR interval 0.28 seconds with constant PR and 1:1 conduction. What is
the rhythm?
A) First-degree AV block
B) Second-degree AV block type I
C) Second-degree AV block type II
D) Third-degree AV block
Answer: A
*RATIONALE: First-degree AV block is defined by PR interval >0.20 seconds with consistent
conduction .*
5. A 68-year-old reports dizziness. EKG shows rate 38, regular, wide QRS, and P waves not
related to QRS complexes. What is the rhythm?
A) Sinus bradycardia with first-degree block
B) Second-degree AV block type I
, Page 4 of 77
C) Second-degree AV block type II
D) Third-degree AV block
Answer: D
RATIONALE: Complete heart block (third-degree) has atria and ventricles beating independently
with no relationship between P waves and QRS .
6. Which electrolyte abnormality produces tall, peaked T waves and widening of the QRS
complex?
A) Hypokalemia
B) Hyperkalemia
C) Hypocalcemia
D) Hypercalcemia
Answer: B
RATIONALE: Hyperkalemia causes tall, peaked, symmetrical T waves, PR prolongation, wide QRS,
and eventual sine wave pattern .
7. A patient with chest pain has ST segment elevation in leads V1-V4. Which coronary artery is
most likely occluded?
A) Right coronary artery
B) Left circumflex artery
C) Left anterior descending artery
D) Posterior descending artery
Answer: C
