BSMH ADVANCED ARRHYTHMIA PRACTICE EXAM
LATEST 2026 UPDATE 100 QUESTIONS AND
DETAILED VERIFIED ANSWERS FROM ACTUAL
EXAMS TEST GRADE A+
1. A patient has a rhythm strip showing irregularly irregular rhythm with no
discernible P waves. What is the rhythm?
A. Atrial flutter
B. Atrial fibrillation
C. Sinus tachycardia
D. Ventricular tachycardia
Answer: B. ATRIAL FIBRILLATION
Rationale: Atrial fibrillation is characterized by irregularly irregular rhythm and
absence of identifiable P waves due to chaotic atrial activity.
2. First-line medication for stable narrow-complex SVT is:
A. Amiodarone
B. Adenosine
C. Atropine
D. Lidocaine
Answer: B. ADENOSINE
Rationale: Adenosine temporarily blocks AV node conduction and is first-line for
terminating stable SVT.
3. A patient has a ventricular rate of 180, wide QRS, and regular rhythm. What is
most likely?
,A. SVT with aberrancy
B. Ventricular tachycardia
C. Atrial fibrillation
D. Sinus tachycardia
Answer: B. VENTRICULAR TACHYCARDIA
Rationale: Wide-complex tachycardia with regular rhythm is ventricular
tachycardia until proven otherwise.
4. The most appropriate immediate treatment for pulseless ventricular
tachycardia is:
A. Adenosine
B. Synchronized cardioversion
C. Defibrillation
D. Atropine
Answer: C. DEFIBRILLATION
Rationale: Pulseless VT is a shockable rhythm requiring immediate defibrillation.
5. Which rhythm is most associated with sawtooth flutter waves?
A. Atrial fibrillation
B. Atrial flutter
C. Ventricular fibrillation
D. Junctional rhythm
Answer: B. ATRIAL FLUTTER
Rationale: Atrial flutter produces characteristic sawtooth flutter waves.
6. Sinus bradycardia is defined as:
A. HR >100
B. HR <60 with P waves
,C. Irregular rhythm
D. Wide QRS complex
Answer: B. HR <60 WITH P WAVES
Rationale: Sinus bradycardia is a normal rhythm with slow rate originating from
SA node.
7. A patient in torsades de pointes should receive:
A. Lidocaine
B. Magnesium sulfate
C. Adenosine
D. Atropine
Answer: B. MAGNESIUM SULFATE
Rationale: Magnesium is first-line treatment for torsades de pointes.
8. The most common cause of pulseless electrical activity (PEA) includes:
A. Hypovolemia
B. Hyperventilation
C. Hyperglycemia
D. Hypertension
Answer: A. HYPOVOLEMIA
Rationale: Hypovolemia is a reversible cause of PEA (H’s and T’s).
9. Which drug is used for symptomatic bradycardia?
A. Adenosine
B. Atropine
C. Amiodarone
D. Dopamine blocker
, Answer: B. ATROPINE
Rationale: Atropine increases heart rate by blocking vagal tone.
10. Ventricular fibrillation appears as:
A. Organized rhythm
B. Flat line
C. Chaotic irregular waveform
D. Sawtooth pattern
Answer: C. CHAOTIC IRREGULAR WAVEFORM
Rationale: VF is disorganized electrical activity without effective contraction.
11. A widened QRS (>0.12 sec) suggests:
A. Normal conduction
B. Delayed ventricular conduction
C. Sinus rhythm
D. Atrial contraction only
Answer: B. DELAYED VENTRICULAR CONDUCTION
Rationale: Wide QRS indicates abnormal ventricular depolarization.
12. The primary pacemaker of the heart is:
A. AV node
B. SA node
C. Bundle of His
D. Purkinje fibers
Answer: B. SA NODE
Rationale: The SA node initiates normal sinus rhythm.
LATEST 2026 UPDATE 100 QUESTIONS AND
DETAILED VERIFIED ANSWERS FROM ACTUAL
EXAMS TEST GRADE A+
1. A patient has a rhythm strip showing irregularly irregular rhythm with no
discernible P waves. What is the rhythm?
A. Atrial flutter
B. Atrial fibrillation
C. Sinus tachycardia
D. Ventricular tachycardia
Answer: B. ATRIAL FIBRILLATION
Rationale: Atrial fibrillation is characterized by irregularly irregular rhythm and
absence of identifiable P waves due to chaotic atrial activity.
2. First-line medication for stable narrow-complex SVT is:
A. Amiodarone
B. Adenosine
C. Atropine
D. Lidocaine
Answer: B. ADENOSINE
Rationale: Adenosine temporarily blocks AV node conduction and is first-line for
terminating stable SVT.
3. A patient has a ventricular rate of 180, wide QRS, and regular rhythm. What is
most likely?
,A. SVT with aberrancy
B. Ventricular tachycardia
C. Atrial fibrillation
D. Sinus tachycardia
Answer: B. VENTRICULAR TACHYCARDIA
Rationale: Wide-complex tachycardia with regular rhythm is ventricular
tachycardia until proven otherwise.
4. The most appropriate immediate treatment for pulseless ventricular
tachycardia is:
A. Adenosine
B. Synchronized cardioversion
C. Defibrillation
D. Atropine
Answer: C. DEFIBRILLATION
Rationale: Pulseless VT is a shockable rhythm requiring immediate defibrillation.
5. Which rhythm is most associated with sawtooth flutter waves?
A. Atrial fibrillation
B. Atrial flutter
C. Ventricular fibrillation
D. Junctional rhythm
Answer: B. ATRIAL FLUTTER
Rationale: Atrial flutter produces characteristic sawtooth flutter waves.
6. Sinus bradycardia is defined as:
A. HR >100
B. HR <60 with P waves
,C. Irregular rhythm
D. Wide QRS complex
Answer: B. HR <60 WITH P WAVES
Rationale: Sinus bradycardia is a normal rhythm with slow rate originating from
SA node.
7. A patient in torsades de pointes should receive:
A. Lidocaine
B. Magnesium sulfate
C. Adenosine
D. Atropine
Answer: B. MAGNESIUM SULFATE
Rationale: Magnesium is first-line treatment for torsades de pointes.
8. The most common cause of pulseless electrical activity (PEA) includes:
A. Hypovolemia
B. Hyperventilation
C. Hyperglycemia
D. Hypertension
Answer: A. HYPOVOLEMIA
Rationale: Hypovolemia is a reversible cause of PEA (H’s and T’s).
9. Which drug is used for symptomatic bradycardia?
A. Adenosine
B. Atropine
C. Amiodarone
D. Dopamine blocker
, Answer: B. ATROPINE
Rationale: Atropine increases heart rate by blocking vagal tone.
10. Ventricular fibrillation appears as:
A. Organized rhythm
B. Flat line
C. Chaotic irregular waveform
D. Sawtooth pattern
Answer: C. CHAOTIC IRREGULAR WAVEFORM
Rationale: VF is disorganized electrical activity without effective contraction.
11. A widened QRS (>0.12 sec) suggests:
A. Normal conduction
B. Delayed ventricular conduction
C. Sinus rhythm
D. Atrial contraction only
Answer: B. DELAYED VENTRICULAR CONDUCTION
Rationale: Wide QRS indicates abnormal ventricular depolarization.
12. The primary pacemaker of the heart is:
A. AV node
B. SA node
C. Bundle of His
D. Purkinje fibers
Answer: B. SA NODE
Rationale: The SA node initiates normal sinus rhythm.
