BAYLOR SCOTT & WHITE EKG TEST
COMPREHENSIVE 2026/2027 | Questions & Answers
100% Accuracy | Latest Version | Pass Guaranteed -
A+ Graded
Part One: EKG Waveform Components & Normal Values (15
Questions)
Q1: You're reviewing a standard 12-lead EKG on a 45-year-old patient. The PR
interval measures consistently at 0.18 seconds across all leads. How would you
classify this finding?
A. First-degree AV block, requiring immediate intervention
B. Borderline prolonged PR interval, needs cardiology consult
C. Normal PR interval, within expected range of 0.12–0.20 seconds [CORRECT]
D. Short PR interval, suggestive of pre-excitation syndrome
Correct Answer: C
Rationale: The normal PR interval spans 0.12 to 0.20 seconds (3–5 small boxes on
EKG paper). A measurement of 0.18 seconds falls comfortably within this range.
Option A is wrong because first-degree block starts at >0.20 seconds. Option B
incorrectly labels a normal value as borderline. Option D describes a PR <0.12
seconds, which this is not.
Q2: A new nurse on your unit is learning lead placement. She asks you which lead is
placed at the fifth intercostal space, mid-clavicular line on the left side. What's your
answer?
A. Lead V2, positioned at the left sternal border
,B. Lead V4, placed at the fifth intercostal space, mid-axillary line
C. Lead V4, positioned at the fifth intercostal space, mid-clavicular line [CORRECT]
D. Lead V6, placed at the fifth intercostal space, mid-axillary line
Correct Answer: C
Rationale: V4 is correctly placed at the fifth intercostal space in the left mid-
clavicular line. Option A describes V2's location. Option B and D both misplace V4
and V6 respectively—V4 is mid-clavicular, not mid-axillary, and V6 sits at the fifth
intercostal space in the mid-axillary line.
Q3: During a code blue, the team leader asks you to quickly estimate the heart rate
from the rhythm strip. You count approximately 15 large boxes between consecutive
R waves. What is the approximate ventricular rate?
A. 100 beats per minute
B. 75 beats per minute
C. 20 beats per minute [CORRECT]
D. 150 beats per minute
Correct Answer: C
Rationale: The standard "300 method" divides 300 by the number of large boxes
between R waves: 300 ÷ 15 = 20 bpm. Option A would require 3 large boxes. Option
B would need 4 large boxes. Option D would indicate only 2 large boxes. This
extremely slow rate suggests severe bradycardia or asystole approaching.
Q4: You're analyzing a rhythm strip and notice the QRS complexes measure 0.14
seconds in duration. The patient is asymptomatic with normal blood pressure. What
does this QRS width tell you?
A. Normal ventricular depolarization, no action needed
,B. Prolonged QRS, indicating delayed ventricular depolarization [CORRECT]
C. Short QRS, suggestive of accelerated conduction pathway
D. Artifact from loose lead wires, reapply electrodes
Correct Answer: B
Rationale: A normal QRS duration is <0.12 seconds (3 small boxes). A QRS of 0.14
seconds indicates widened QRS, meaning ventricular depolarization is delayed—
possibly from bundle branch block, ventricular rhythm, or aberrant conduction.
Option A is wrong because 0.14 seconds is abnormal. Option C mislabels it as short.
Option D dismisses a real finding as artifact without evidence.
Q5: A patient on telemetry has a QT interval measuring 0.44 seconds at a heart rate
of 60 bpm. Using Bazett's formula, the corrected QT (QTc) calculates to
approximately 0.44 seconds. How do you interpret this?
A. Markedly prolonged QTc, high risk for torsades de pointes
B. Mildly prolonged QTc, requires immediate discontinuation of all QT-prolonging
medications
C. Normal QTc for heart rate, within acceptable limits [CORRECT]
D. Short QTc, associated with sudden cardiac death risk
Correct Answer: C
Rationale: At a heart rate of 60 bpm, the QT and QTc are nearly identical because
the square root of the RR interval (1 second) is 1. A QTc <0.45 seconds in men and
<0.46 seconds in women is generally considered normal. Option A exaggerates the
risk. Option B overreacts to a normal value. Option D describes a completely different
syndrome.
Q6: Your preceptor asks you to identify which EKG wave represents atrial
depolarization. You correctly point to the:
, A. QRS complex, representing ventricular depolarization
B. T wave, representing ventricular repolarization
C. P wave, representing atrial depolarization [CORRECT]
D. U wave, representing Purkinje fiber repolarization
Correct Answer: C
Rationale: The P wave is the electrical signature of atrial depolarization. Option A
describes ventricular depolarization. Option B describes ventricular repolarization.
Option D describes the U wave, which is a small deflection sometimes seen after the
T wave and is not the primary atrial activity.
Q7: A 62-year-old patient has an EKG showing a QRS axis of +90 degrees. You know
that normal electrical axis falls between:
A. -30 degrees and +90 degrees
B. -30 degrees and +105 degrees
C. -30 degrees and +90 degrees [CORRECT]
D. 0 degrees and +180 degrees
Correct Answer: C
Rationale: The normal QRS axis ranges from -30 degrees to +90 degrees. An axis
beyond -30 degrees indicates left axis deviation, while an axis beyond +90 degrees
indicates right axis deviation. Option A is incomplete. Option B extends too far into
right deviation territory. Option D is far too broad and would include abnormal axes.
Q8: During a morning huddle, your charge nurse quizzes the team: "What's the
normal duration of the QRS complex in a healthy adult?" You answer:
A. 0.04 to 0.10 seconds
B. 0.06 to 0.10 seconds
COMPREHENSIVE 2026/2027 | Questions & Answers
100% Accuracy | Latest Version | Pass Guaranteed -
A+ Graded
Part One: EKG Waveform Components & Normal Values (15
Questions)
Q1: You're reviewing a standard 12-lead EKG on a 45-year-old patient. The PR
interval measures consistently at 0.18 seconds across all leads. How would you
classify this finding?
A. First-degree AV block, requiring immediate intervention
B. Borderline prolonged PR interval, needs cardiology consult
C. Normal PR interval, within expected range of 0.12–0.20 seconds [CORRECT]
D. Short PR interval, suggestive of pre-excitation syndrome
Correct Answer: C
Rationale: The normal PR interval spans 0.12 to 0.20 seconds (3–5 small boxes on
EKG paper). A measurement of 0.18 seconds falls comfortably within this range.
Option A is wrong because first-degree block starts at >0.20 seconds. Option B
incorrectly labels a normal value as borderline. Option D describes a PR <0.12
seconds, which this is not.
Q2: A new nurse on your unit is learning lead placement. She asks you which lead is
placed at the fifth intercostal space, mid-clavicular line on the left side. What's your
answer?
A. Lead V2, positioned at the left sternal border
,B. Lead V4, placed at the fifth intercostal space, mid-axillary line
C. Lead V4, positioned at the fifth intercostal space, mid-clavicular line [CORRECT]
D. Lead V6, placed at the fifth intercostal space, mid-axillary line
Correct Answer: C
Rationale: V4 is correctly placed at the fifth intercostal space in the left mid-
clavicular line. Option A describes V2's location. Option B and D both misplace V4
and V6 respectively—V4 is mid-clavicular, not mid-axillary, and V6 sits at the fifth
intercostal space in the mid-axillary line.
Q3: During a code blue, the team leader asks you to quickly estimate the heart rate
from the rhythm strip. You count approximately 15 large boxes between consecutive
R waves. What is the approximate ventricular rate?
A. 100 beats per minute
B. 75 beats per minute
C. 20 beats per minute [CORRECT]
D. 150 beats per minute
Correct Answer: C
Rationale: The standard "300 method" divides 300 by the number of large boxes
between R waves: 300 ÷ 15 = 20 bpm. Option A would require 3 large boxes. Option
B would need 4 large boxes. Option D would indicate only 2 large boxes. This
extremely slow rate suggests severe bradycardia or asystole approaching.
Q4: You're analyzing a rhythm strip and notice the QRS complexes measure 0.14
seconds in duration. The patient is asymptomatic with normal blood pressure. What
does this QRS width tell you?
A. Normal ventricular depolarization, no action needed
,B. Prolonged QRS, indicating delayed ventricular depolarization [CORRECT]
C. Short QRS, suggestive of accelerated conduction pathway
D. Artifact from loose lead wires, reapply electrodes
Correct Answer: B
Rationale: A normal QRS duration is <0.12 seconds (3 small boxes). A QRS of 0.14
seconds indicates widened QRS, meaning ventricular depolarization is delayed—
possibly from bundle branch block, ventricular rhythm, or aberrant conduction.
Option A is wrong because 0.14 seconds is abnormal. Option C mislabels it as short.
Option D dismisses a real finding as artifact without evidence.
Q5: A patient on telemetry has a QT interval measuring 0.44 seconds at a heart rate
of 60 bpm. Using Bazett's formula, the corrected QT (QTc) calculates to
approximately 0.44 seconds. How do you interpret this?
A. Markedly prolonged QTc, high risk for torsades de pointes
B. Mildly prolonged QTc, requires immediate discontinuation of all QT-prolonging
medications
C. Normal QTc for heart rate, within acceptable limits [CORRECT]
D. Short QTc, associated with sudden cardiac death risk
Correct Answer: C
Rationale: At a heart rate of 60 bpm, the QT and QTc are nearly identical because
the square root of the RR interval (1 second) is 1. A QTc <0.45 seconds in men and
<0.46 seconds in women is generally considered normal. Option A exaggerates the
risk. Option B overreacts to a normal value. Option D describes a completely different
syndrome.
Q6: Your preceptor asks you to identify which EKG wave represents atrial
depolarization. You correctly point to the:
, A. QRS complex, representing ventricular depolarization
B. T wave, representing ventricular repolarization
C. P wave, representing atrial depolarization [CORRECT]
D. U wave, representing Purkinje fiber repolarization
Correct Answer: C
Rationale: The P wave is the electrical signature of atrial depolarization. Option A
describes ventricular depolarization. Option B describes ventricular repolarization.
Option D describes the U wave, which is a small deflection sometimes seen after the
T wave and is not the primary atrial activity.
Q7: A 62-year-old patient has an EKG showing a QRS axis of +90 degrees. You know
that normal electrical axis falls between:
A. -30 degrees and +90 degrees
B. -30 degrees and +105 degrees
C. -30 degrees and +90 degrees [CORRECT]
D. 0 degrees and +180 degrees
Correct Answer: C
Rationale: The normal QRS axis ranges from -30 degrees to +90 degrees. An axis
beyond -30 degrees indicates left axis deviation, while an axis beyond +90 degrees
indicates right axis deviation. Option A is incomplete. Option B extends too far into
right deviation territory. Option D is far too broad and would include abnormal axes.
Q8: During a morning huddle, your charge nurse quizzes the team: "What's the
normal duration of the QRS complex in a healthy adult?" You answer:
A. 0.04 to 0.10 seconds
B. 0.06 to 0.10 seconds
