BCMAP — BASIC CARDIAC MONITOR
CERTIFICATION | 250 MCQ REVISION TEST
BANK
Section Topics Questions
A Cardiac Anatomy & Electrophysiology 1–40
B Sinus Node Rhythms 41–60
C Atrial Arrhythmias 61–100
D Junctional & Ventricular Arrhythmias 81–100, 101–115
E Heart Blocks & Bundle Branch Blocks 101–135
F 12-Lead ECG & ST/MI Recognition 116–135
G Pacemakers, Monitoring Equipment & Patient Care 136–205
Cardiac Pharmacology, Emergency Response & Professional
H 156–250
Practice
📘 SECTION A: CARDIAC ANATOMY & ELECTROPHYSIOLOGY (Q1–40)
1. The heart is located in the: A) Right pleural cavity B) Abdominal cavity, behind the stomach
C) Mediastinum, slightly left of the midline (correct answer) D) Superior thoracic aperture
Rationale: The heart lies in the mediastinum (middle compartment of the thoracic cavity)
between the two lungs, slightly tilted to the left. The apex points toward the left lower chest
at approximately the 5th intercostal space.
2. The innermost layer of the heart wall is called the: A) Epicardium B) Myocardium C)
Pericardium D) Endocardium (correct answer)
Rationale: The heart wall has three layers: epicardium (outer), myocardium (middle
muscular layer), and endocardium (inner lining). The endocardium lines the chambers and
covers the valves, forming a smooth surface for blood flow.
,3. The natural pacemaker of the heart is the: A) AV node B) Bundle of His C) Sinoatrial (SA)
node (correct answer) D) Purkinje fibres
Rationale: The SA node, located in the right atrium near the opening of the superior vena
cava, spontaneously depolarises at 60–100 bpm, initiating each cardiac cycle. It is called the
primary pacemaker of the heart.
4. The normal intrinsic rate of the AV node (junctional rate) is: A) 60–100 bpm B) 40–60 bpm
(correct answer) C) 20–40 bpm D) 100–150 bpm
Rationale: If the SA node fails, the AV node takes over as the secondary pacemaker at 40–
60 bpm (junctional rhythm). Ventricular (Purkinje) pacemakers have the slowest intrinsic
rate of 20–40 bpm (idioventricular rhythm).
5. The correct sequence of electrical conduction through the heart is: A) SA node → Bundle of
His → AV node → Purkinje fibres B) AV node → SA node → Bundle branches → Purkinje
fibres C) SA node → AV node → Bundle of His → Bundle branches → Purkinje fibres
(correct answer) D) Purkinje fibres → AV node → SA node → Bundle of His
Rationale: Normal cardiac conduction: SA node (initiates impulse) → AV node (delays
conduction 0.1 sec) → Bundle of His → Left and Right bundle branches → Purkinje fibres
→ ventricular myocardium (contraction).
6. The purpose of the AV node delay in cardiac conduction is to: A) Speed up heart rate during
exercise B) Generate a backup pacemaker rate C) Allow complete atrial contraction before
ventricular filling begins (correct answer) D) Coordinate left and right bundle branch function
Rationale: The AV node delays impulse conduction for approximately 0.1 seconds, allowing
the atria to fully contract and empty blood into the ventricles before ventricular
contraction begins — maximising stroke volume.
7. Depolarisation of the ventricles is represented on the ECG by the: A) P wave B) T wave C) PR
interval D) QRS complex (correct answer)
,Rationale: The QRS complex represents ventricular depolarisation (electrical activation
triggering ventricular contraction). The P wave = atrial depolarisation. The T wave =
ventricular repolarisation. Normal QRS duration is <0.12 sec (3 small squares).
8. Ventricular repolarisation is represented by the: A) P wave B) QRS complex C) PR interval
D) T wave (correct answer)
Rationale: The T wave represents ventricular repolarisation — the electrical recovery of
the ventricles in preparation for the next depolarisation. Peaked, inverted, or flattened T
waves can indicate ischaemia, electrolyte imbalance, or other pathology.
9. The PR interval is measured from: A) Q wave to R wave B) P wave to T wave C) Beginning
of the P wave to beginning of the QRS complex (correct answer) D) End of QRS to
beginning of T wave
Rationale: The PR interval represents the time for the impulse to travel from the SA node
through the atria, AV node, and Bundle of His to the ventricles. Normal PR interval =
0.12–0.20 seconds (3–5 small squares).
10. The normal duration of a QRS complex is: A) 0.20–0.24 seconds B) 0.04–0.08 seconds C)
0.06–0.12 seconds (correct answer) D) 0.14–0.20 seconds
Rationale: Normal QRS duration is 0.06–0.12 seconds (1.5–3 small squares at standard
paper speed of 25 mm/sec). A QRS >0.12 seconds (>3 small squares) is wide and suggests
bundle branch block or ventricular origin.
11. On ECG graph paper, one small square represents: A) 0.20 seconds in time and 0.5 mV in
voltage B) 0.04 seconds in time and 0.1 mV in voltage (correct answer) C) 0.10 seconds in
time and 0.5 mV in voltage D) 0.02 seconds in time and 0.1 mV in voltage
Rationale: Standard ECG paper: small squares = 1 mm wide × 1 mm tall. Horizontally: 1
small square = 0.04 sec (at 25 mm/sec). Vertically: 1 small square = 0.1 mV. One large
square (5 small squares) = 0.20 sec.
, 12. The QT interval represents: A) Time for the P wave and QRS complex only B) Time for
atrial depolarisation and repolarisation C) Total time for ventricular depolarisation and
repolarisation (correct answer) D) Time for SA node firing
Rationale: The QT interval (from start of Q to end of T wave) represents the total duration
of ventricular electrical activity. Normal corrected QT (QTc) is <0.44 sec in men and <0.46
sec in women. Prolonged QT increases risk of torsades de pointes.
13. A standard 12-lead ECG uses how many electrodes/leads? A) 8 electrodes, 8 leads B) 6
electrodes, 12 leads C) 10 electrodes, 12 leads (correct answer) D) 12 electrodes, 12 leads
Rationale: A 12-lead ECG uses 10 electrodes: 4 limb electrodes (RA, LA, RL, LL) and 6
precordial (chest) electrodes (V1–V6). These 10 electrodes generate 12 different "views"
(leads) of the heart's electrical activity.
14. Leads II, III, and aVF "look at" which surface of the heart? A) Anterior wall B) Lateral wall
C) Posterior wall D) Inferior wall (correct answer)
Rationale: Inferior leads (II, III, aVF) view the inferior (diaphragmatic) surface of the left
ventricle, supplied by the right coronary artery (RCA). ST elevation in these leads =
inferior STEMI.
15. The precordial lead that lies directly over the right side of the interventricular septum is: A)
V4 B) V6 C) V3 D) V1 (correct answer)
Rationale: V1 is placed at the 4th intercostal space, right sternal border — overlying the
right ventricle and interventricular septum. It typically shows a predominantly negative
(rS) QRS pattern due to away-directed ventricular forces.
16. Which of the following correctly describes the cardiac action potential Phase 0? A) Slow
repolarisation via potassium efflux B) Resting membrane potential maintained C) Rapid
depolarisation due to fast sodium channel opening (correct answer) D) Calcium channel
slow depolarisation
Rationale: Phase 0 of the fast-response cardiac action potential involves rapid Na⁺ influx
through fast sodium channels, causing rapid depolarisation. This phase corresponds to the
upstroke of the action potential and ventricular activation.
CERTIFICATION | 250 MCQ REVISION TEST
BANK
Section Topics Questions
A Cardiac Anatomy & Electrophysiology 1–40
B Sinus Node Rhythms 41–60
C Atrial Arrhythmias 61–100
D Junctional & Ventricular Arrhythmias 81–100, 101–115
E Heart Blocks & Bundle Branch Blocks 101–135
F 12-Lead ECG & ST/MI Recognition 116–135
G Pacemakers, Monitoring Equipment & Patient Care 136–205
Cardiac Pharmacology, Emergency Response & Professional
H 156–250
Practice
📘 SECTION A: CARDIAC ANATOMY & ELECTROPHYSIOLOGY (Q1–40)
1. The heart is located in the: A) Right pleural cavity B) Abdominal cavity, behind the stomach
C) Mediastinum, slightly left of the midline (correct answer) D) Superior thoracic aperture
Rationale: The heart lies in the mediastinum (middle compartment of the thoracic cavity)
between the two lungs, slightly tilted to the left. The apex points toward the left lower chest
at approximately the 5th intercostal space.
2. The innermost layer of the heart wall is called the: A) Epicardium B) Myocardium C)
Pericardium D) Endocardium (correct answer)
Rationale: The heart wall has three layers: epicardium (outer), myocardium (middle
muscular layer), and endocardium (inner lining). The endocardium lines the chambers and
covers the valves, forming a smooth surface for blood flow.
,3. The natural pacemaker of the heart is the: A) AV node B) Bundle of His C) Sinoatrial (SA)
node (correct answer) D) Purkinje fibres
Rationale: The SA node, located in the right atrium near the opening of the superior vena
cava, spontaneously depolarises at 60–100 bpm, initiating each cardiac cycle. It is called the
primary pacemaker of the heart.
4. The normal intrinsic rate of the AV node (junctional rate) is: A) 60–100 bpm B) 40–60 bpm
(correct answer) C) 20–40 bpm D) 100–150 bpm
Rationale: If the SA node fails, the AV node takes over as the secondary pacemaker at 40–
60 bpm (junctional rhythm). Ventricular (Purkinje) pacemakers have the slowest intrinsic
rate of 20–40 bpm (idioventricular rhythm).
5. The correct sequence of electrical conduction through the heart is: A) SA node → Bundle of
His → AV node → Purkinje fibres B) AV node → SA node → Bundle branches → Purkinje
fibres C) SA node → AV node → Bundle of His → Bundle branches → Purkinje fibres
(correct answer) D) Purkinje fibres → AV node → SA node → Bundle of His
Rationale: Normal cardiac conduction: SA node (initiates impulse) → AV node (delays
conduction 0.1 sec) → Bundle of His → Left and Right bundle branches → Purkinje fibres
→ ventricular myocardium (contraction).
6. The purpose of the AV node delay in cardiac conduction is to: A) Speed up heart rate during
exercise B) Generate a backup pacemaker rate C) Allow complete atrial contraction before
ventricular filling begins (correct answer) D) Coordinate left and right bundle branch function
Rationale: The AV node delays impulse conduction for approximately 0.1 seconds, allowing
the atria to fully contract and empty blood into the ventricles before ventricular
contraction begins — maximising stroke volume.
7. Depolarisation of the ventricles is represented on the ECG by the: A) P wave B) T wave C) PR
interval D) QRS complex (correct answer)
,Rationale: The QRS complex represents ventricular depolarisation (electrical activation
triggering ventricular contraction). The P wave = atrial depolarisation. The T wave =
ventricular repolarisation. Normal QRS duration is <0.12 sec (3 small squares).
8. Ventricular repolarisation is represented by the: A) P wave B) QRS complex C) PR interval
D) T wave (correct answer)
Rationale: The T wave represents ventricular repolarisation — the electrical recovery of
the ventricles in preparation for the next depolarisation. Peaked, inverted, or flattened T
waves can indicate ischaemia, electrolyte imbalance, or other pathology.
9. The PR interval is measured from: A) Q wave to R wave B) P wave to T wave C) Beginning
of the P wave to beginning of the QRS complex (correct answer) D) End of QRS to
beginning of T wave
Rationale: The PR interval represents the time for the impulse to travel from the SA node
through the atria, AV node, and Bundle of His to the ventricles. Normal PR interval =
0.12–0.20 seconds (3–5 small squares).
10. The normal duration of a QRS complex is: A) 0.20–0.24 seconds B) 0.04–0.08 seconds C)
0.06–0.12 seconds (correct answer) D) 0.14–0.20 seconds
Rationale: Normal QRS duration is 0.06–0.12 seconds (1.5–3 small squares at standard
paper speed of 25 mm/sec). A QRS >0.12 seconds (>3 small squares) is wide and suggests
bundle branch block or ventricular origin.
11. On ECG graph paper, one small square represents: A) 0.20 seconds in time and 0.5 mV in
voltage B) 0.04 seconds in time and 0.1 mV in voltage (correct answer) C) 0.10 seconds in
time and 0.5 mV in voltage D) 0.02 seconds in time and 0.1 mV in voltage
Rationale: Standard ECG paper: small squares = 1 mm wide × 1 mm tall. Horizontally: 1
small square = 0.04 sec (at 25 mm/sec). Vertically: 1 small square = 0.1 mV. One large
square (5 small squares) = 0.20 sec.
, 12. The QT interval represents: A) Time for the P wave and QRS complex only B) Time for
atrial depolarisation and repolarisation C) Total time for ventricular depolarisation and
repolarisation (correct answer) D) Time for SA node firing
Rationale: The QT interval (from start of Q to end of T wave) represents the total duration
of ventricular electrical activity. Normal corrected QT (QTc) is <0.44 sec in men and <0.46
sec in women. Prolonged QT increases risk of torsades de pointes.
13. A standard 12-lead ECG uses how many electrodes/leads? A) 8 electrodes, 8 leads B) 6
electrodes, 12 leads C) 10 electrodes, 12 leads (correct answer) D) 12 electrodes, 12 leads
Rationale: A 12-lead ECG uses 10 electrodes: 4 limb electrodes (RA, LA, RL, LL) and 6
precordial (chest) electrodes (V1–V6). These 10 electrodes generate 12 different "views"
(leads) of the heart's electrical activity.
14. Leads II, III, and aVF "look at" which surface of the heart? A) Anterior wall B) Lateral wall
C) Posterior wall D) Inferior wall (correct answer)
Rationale: Inferior leads (II, III, aVF) view the inferior (diaphragmatic) surface of the left
ventricle, supplied by the right coronary artery (RCA). ST elevation in these leads =
inferior STEMI.
15. The precordial lead that lies directly over the right side of the interventricular septum is: A)
V4 B) V6 C) V3 D) V1 (correct answer)
Rationale: V1 is placed at the 4th intercostal space, right sternal border — overlying the
right ventricle and interventricular septum. It typically shows a predominantly negative
(rS) QRS pattern due to away-directed ventricular forces.
16. Which of the following correctly describes the cardiac action potential Phase 0? A) Slow
repolarisation via potassium efflux B) Resting membrane potential maintained C) Rapid
depolarisation due to fast sodium channel opening (correct answer) D) Calcium channel
slow depolarisation
Rationale: Phase 0 of the fast-response cardiac action potential involves rapid Na⁺ influx
through fast sodium channels, causing rapid depolarisation. This phase corresponds to the
upstroke of the action potential and ventricular activation.
