Prophecy Med-Surg Telemetry Exam | 2026–2027
Prophecy Med-Surgical Telemetry
Exam
2026–2027 Comprehensive Q&A Mastery Guide
100% Solved Question Bank with Clinical Rationales
Department: Cardiac & Telemetry Nursing Education
Institution: Prophecy Healthcare Assessment Services
Program: Medical-Surgical Telemetry Nursing Certification
Date: April 2026
1
, Prophecy Med-Surg Telemetry Exam | 2026–2027
Abstract
This Prophecy Med-Surgical Telemetry Exam Mastery Guide for the 2026–2027 assessment
cycle provides a comprehensive, evidence-based question bank designed to prepare nursing professionals
for telemetry certification and competency evaluation. The examination encompasses ten critical
domains: cardiac rhythm interpretation spanning sinus, atrial, junctional, ventricular, and heart block
dysrhythmias; 12-lead electrocardiogram (ECG) analysis; telemetry monitoring and lead placement
techniques; ischemia and infarction recognition; antiarrhythmic pharmacology; hemodynamic monitoring
parameters; post-myocardial infarction complications; pacemaker function assessment; defibrillation and
cardioversion protocols; and clinical decision-making frameworks essential for med-surg telemetry
nursing practice. Each question is accompanied by a detailed rationale grounded in current American
Heart Association (AHA) guidelines, Advanced Cardiac Life Support (ACLS) algorithms, and peer-
reviewed nursing literature. This guide emphasizes the identification of life-threatening dysrhythmias,
appropriate nursing interventions, medication administration safety, and systematic clinical reasoning in
acute cardiac care environments.
Keywords: telemetry nursing, cardiac dysrhythmia interpretation, 12-lead ECG, antiarrhythmic
pharmacology, hemodynamic monitoring, ACLS, pacemaker management, myocardial infarction,
Prophecy exam preparation, med-surg competency
Examination Score Summary
Domain Questions Points Each Total Points
1. Cardiac Rhythm 1–10 1 10
Interpretation
2. 12-Lead ECG Analysis 11–20 1 10
3. Telemetry Monitoring 21–30 1 10
& Lead Placement
4. Ischemia & Infarction 31–40 1 10
Recognition
5. Antiarrhythmic 41–50 1 10
Pharmacology
6. Hemodynamic 51–60 1 10
2
, Prophecy Med-Surg Telemetry Exam | 2026–2027
Monitoring
7. Post-MI Complications 61–70 1 10
8. Pacemaker Function 71–80 1 10
9. Defibrillation & 81–90 1 10
Cardioversion
10. Clinical Decision- 91–100 1 10
Making
Total Examination: 100 Questions | 100 Points | Passing Score: 75%
3
, Prophecy Med-Surg Telemetry Exam | 2026–2027
Domain 1: Cardiac Rhythm Interpretation (Sinus, Atrial, Junctional,
Ventricular, Heart Blocks)
1. A patient's telemetry monitor displays a regular rhythm with a rate of 88 bpm, a P wave
preceding each QRS complex, and a PR interval of 0.16 seconds. The nurse correctly
identifies this rhythm as:
A) Sinus bradycardia
B) Normal sinus rhythm
C) Sinus tachycardia
D) Sinus arrhythmia
Rationale: Normal sinus rhythm (NSR) is characterized by a regular rhythm, rate 60–100 bpm, a P wave before
every QRS, a normal PR interval (0.12–0.20 seconds), and a narrow QRS complex. All parameters in this
scenario fall within NSR ranges.
2. A patient on telemetry demonstrates an irregular rhythm with no discernible P waves, a
wavy baseline, and a ventricular rate of 150 bpm. The nurse recognizes this as which
dysrhythmia?
A) Atrial flutter
B) Atrial fibrillation
C) Ventricular tachycardia
D) Supraventricular tachycardia
Rationale: Atrial fibrillation (A-fib) is identified by an irregularly irregular rhythm, absence of distinct P waves
(replaced by chaotic fibrillatory waves producing a wavy baseline), and a variable ventricular rate often
exceeding 100 bpm in untreated patients.
3. Which ECG characteristic is most consistent with second-degree AV block Type I
(Mobitz I / Wenckebach)?
A) Constant PR interval with occasional dropped QRS
B) Progressively lengthening PR intervals until a QRS is dropped
C) PR interval remains constant; P waves outnumber QRS complexes in a 2:1 or 3:1 ratio
D) P waves and QRS complexes are completely dissociated
Rationale: Mobitz I (Wenckebach) is defined by progressively prolonging PR intervals until a QRS complex is
not conducted (dropped beat). After the dropped beat, the PR interval resets and the cycle repeats. It is usually
benign and often asymptomatic.
4
Prophecy Med-Surgical Telemetry
Exam
2026–2027 Comprehensive Q&A Mastery Guide
100% Solved Question Bank with Clinical Rationales
Department: Cardiac & Telemetry Nursing Education
Institution: Prophecy Healthcare Assessment Services
Program: Medical-Surgical Telemetry Nursing Certification
Date: April 2026
1
, Prophecy Med-Surg Telemetry Exam | 2026–2027
Abstract
This Prophecy Med-Surgical Telemetry Exam Mastery Guide for the 2026–2027 assessment
cycle provides a comprehensive, evidence-based question bank designed to prepare nursing professionals
for telemetry certification and competency evaluation. The examination encompasses ten critical
domains: cardiac rhythm interpretation spanning sinus, atrial, junctional, ventricular, and heart block
dysrhythmias; 12-lead electrocardiogram (ECG) analysis; telemetry monitoring and lead placement
techniques; ischemia and infarction recognition; antiarrhythmic pharmacology; hemodynamic monitoring
parameters; post-myocardial infarction complications; pacemaker function assessment; defibrillation and
cardioversion protocols; and clinical decision-making frameworks essential for med-surg telemetry
nursing practice. Each question is accompanied by a detailed rationale grounded in current American
Heart Association (AHA) guidelines, Advanced Cardiac Life Support (ACLS) algorithms, and peer-
reviewed nursing literature. This guide emphasizes the identification of life-threatening dysrhythmias,
appropriate nursing interventions, medication administration safety, and systematic clinical reasoning in
acute cardiac care environments.
Keywords: telemetry nursing, cardiac dysrhythmia interpretation, 12-lead ECG, antiarrhythmic
pharmacology, hemodynamic monitoring, ACLS, pacemaker management, myocardial infarction,
Prophecy exam preparation, med-surg competency
Examination Score Summary
Domain Questions Points Each Total Points
1. Cardiac Rhythm 1–10 1 10
Interpretation
2. 12-Lead ECG Analysis 11–20 1 10
3. Telemetry Monitoring 21–30 1 10
& Lead Placement
4. Ischemia & Infarction 31–40 1 10
Recognition
5. Antiarrhythmic 41–50 1 10
Pharmacology
6. Hemodynamic 51–60 1 10
2
, Prophecy Med-Surg Telemetry Exam | 2026–2027
Monitoring
7. Post-MI Complications 61–70 1 10
8. Pacemaker Function 71–80 1 10
9. Defibrillation & 81–90 1 10
Cardioversion
10. Clinical Decision- 91–100 1 10
Making
Total Examination: 100 Questions | 100 Points | Passing Score: 75%
3
, Prophecy Med-Surg Telemetry Exam | 2026–2027
Domain 1: Cardiac Rhythm Interpretation (Sinus, Atrial, Junctional,
Ventricular, Heart Blocks)
1. A patient's telemetry monitor displays a regular rhythm with a rate of 88 bpm, a P wave
preceding each QRS complex, and a PR interval of 0.16 seconds. The nurse correctly
identifies this rhythm as:
A) Sinus bradycardia
B) Normal sinus rhythm
C) Sinus tachycardia
D) Sinus arrhythmia
Rationale: Normal sinus rhythm (NSR) is characterized by a regular rhythm, rate 60–100 bpm, a P wave before
every QRS, a normal PR interval (0.12–0.20 seconds), and a narrow QRS complex. All parameters in this
scenario fall within NSR ranges.
2. A patient on telemetry demonstrates an irregular rhythm with no discernible P waves, a
wavy baseline, and a ventricular rate of 150 bpm. The nurse recognizes this as which
dysrhythmia?
A) Atrial flutter
B) Atrial fibrillation
C) Ventricular tachycardia
D) Supraventricular tachycardia
Rationale: Atrial fibrillation (A-fib) is identified by an irregularly irregular rhythm, absence of distinct P waves
(replaced by chaotic fibrillatory waves producing a wavy baseline), and a variable ventricular rate often
exceeding 100 bpm in untreated patients.
3. Which ECG characteristic is most consistent with second-degree AV block Type I
(Mobitz I / Wenckebach)?
A) Constant PR interval with occasional dropped QRS
B) Progressively lengthening PR intervals until a QRS is dropped
C) PR interval remains constant; P waves outnumber QRS complexes in a 2:1 or 3:1 ratio
D) P waves and QRS complexes are completely dissociated
Rationale: Mobitz I (Wenckebach) is defined by progressively prolonging PR intervals until a QRS complex is
not conducted (dropped beat). After the dropped beat, the PR interval resets and the cycle repeats. It is usually
benign and often asymptomatic.
4
