RELIAS DYSRHYTHMIA BASIC TEST A 2026/2027 | Questions
& Verified Answers | A+ Rated Solution Guide | Pass
Guaranteed - A+ Graded
[Section 1: Normal Sinus Rhythm & Sinus Node Dysrhythmias
(Questions 1-12)]
Question 1
A telemetry nurse is reviewing an ECG strip. The rhythm is regular, the rate is 72 bpm,
there is an upright P wave in lead II before each QRS complex, the PR interval measures
0.16 seconds, and the QRS duration is 0.08 seconds. What is the correct interpretation?
A. Sinus Bradycardia
B. Normal Sinus Rhythm
C. First-Degree AV Block
D. Sinus Tachycardia
Correct Answer: B. Normal Sinus Rhythm [CORRECT]
Rationale: This strip meets all criteria for Normal Sinus Rhythm (NSR): regular rhythm,
rate 60-100 bpm, upright P wave in lead II preceding each QRS, PR interval 0.12-0.20
seconds (3-5 small boxes), and QRS duration <0.12 seconds. Option A is incorrect
,because the rate is not <60 bpm. Option C is incorrect because the PR interval is not
prolonged >0.20 seconds. Option D is incorrect because the rate is not >100 bpm. Per
Relias Dysrhythmia Basic A competency standards and AHA ACLS Guidelines, NSR is
the foundation rhythm from which all dysrhythmias are compared.
Question 2
A 68-year-old patient presents with a heart rate of 52 bpm on the monitor. The rhythm is
regular with upright P waves before each QRS, PR interval 0.18 seconds, and QRS 0.10
seconds. The patient is asymptomatic. What is the priority nursing action?
A. Prepare for immediate transcutaneous pacing
B. Administer atropine 0.5 mg IV push
C. Continue monitoring and document findings
D. Initiate synchronized cardioversion
Correct Answer: C. Continue monitoring and document findings [CORRECT]
Rationale: This is Sinus Bradycardia (rate <60 bpm with normal P waves, PR interval, and
QRS duration). In asymptomatic patients, no treatment is required—only monitoring and
documentation. Option A is incorrect because pacing is reserved for symptomatic
bradycardia unresponsive to atropine. Option B is incorrect because atropine is
indicated only for symptomatic bradycardia (hypotension, altered mental status, chest
pain, heart failure). Option D is incorrect because cardioversion is used for
tachyarrhythmias, not bradycardia. Per AHA ACLS Guidelines and Relias competency,
treat the patient, not just the monitor.
,Question 3
Which of the following is NOT a common cause of Sinus Bradycardia?
A. Beta-blocker therapy
B. Hyperthyroidism
C. Increased intracranial pressure
D. Hypothermia
Correct Answer: B. Hyperthyroidism [CORRECT]
Rationale: Hyperthyroidism causes Sinus Tachycardia, not bradycardia, due to increased
metabolic demand and catecholamine sensitivity. Options A, C, and D are all established
causes of Sinus Bradycardia: beta-blockers block SA node automaticity, increased ICP
stimulates vagal tone via the Cushing reflex, and hypothermia slows all metabolic
processes including cardiac conduction. Per Relias Dysrhythmia Basic A standards and
AHA ACLS, understanding causative factors is essential for targeted treatment.
Question 4
A patient with Sinus Bradycardia at 48 bpm develops acute hypotension (BP 82/50
mmHg) and altered mental status. What is the first-line pharmacological intervention
per AHA ACLS Guidelines?
A. Dopamine infusion 5-20 mcg/kg/min
, B. Atropine 0.5 mg IV every 3-5 minutes (maximum 3 mg)
C. Epinephrine infusion 2-10 mcg/min
D. Transcutaneous pacing at 60 bpm
Correct Answer: B. Atropine 0.5 mg IV every 3-5 minutes (maximum 3 mg) [CORRECT]
Rationale: Atropine is the first-line treatment for symptomatic bradycardia per AHA
ACLS Guidelines. It blocks parasympathetic (vagal) tone, increasing SA node firing and
AV nodal conduction. Option A is a second-line agent if atropine fails. Option C is also
second-line or used during pacing preparation. Option D is indicated if pharmacological
therapy is ineffective. Per Relias competency, the algorithm sequence is critical:
atropine first, then pacing or catecholamines if needed.
Question 5
A marathon runner has a resting heart rate of 54 bpm during a routine physical. The
ECG shows regular rhythm, upright P waves, normal PR interval, and narrow QRS. The
patient denies dizziness, syncope, or chest pain. What is the most appropriate action?
A. Immediate cardiology referral for pacemaker evaluation
B. Discontinue all exercise and place on bed rest
C. Reassurance that this is a normal physiological adaptation
D. Initiate telemetry monitoring for 48 hours
Correct Answer: C. Reassurance that this is a normal physiological adaptation
[CORRECT]
& Verified Answers | A+ Rated Solution Guide | Pass
Guaranteed - A+ Graded
[Section 1: Normal Sinus Rhythm & Sinus Node Dysrhythmias
(Questions 1-12)]
Question 1
A telemetry nurse is reviewing an ECG strip. The rhythm is regular, the rate is 72 bpm,
there is an upright P wave in lead II before each QRS complex, the PR interval measures
0.16 seconds, and the QRS duration is 0.08 seconds. What is the correct interpretation?
A. Sinus Bradycardia
B. Normal Sinus Rhythm
C. First-Degree AV Block
D. Sinus Tachycardia
Correct Answer: B. Normal Sinus Rhythm [CORRECT]
Rationale: This strip meets all criteria for Normal Sinus Rhythm (NSR): regular rhythm,
rate 60-100 bpm, upright P wave in lead II preceding each QRS, PR interval 0.12-0.20
seconds (3-5 small boxes), and QRS duration <0.12 seconds. Option A is incorrect
,because the rate is not <60 bpm. Option C is incorrect because the PR interval is not
prolonged >0.20 seconds. Option D is incorrect because the rate is not >100 bpm. Per
Relias Dysrhythmia Basic A competency standards and AHA ACLS Guidelines, NSR is
the foundation rhythm from which all dysrhythmias are compared.
Question 2
A 68-year-old patient presents with a heart rate of 52 bpm on the monitor. The rhythm is
regular with upright P waves before each QRS, PR interval 0.18 seconds, and QRS 0.10
seconds. The patient is asymptomatic. What is the priority nursing action?
A. Prepare for immediate transcutaneous pacing
B. Administer atropine 0.5 mg IV push
C. Continue monitoring and document findings
D. Initiate synchronized cardioversion
Correct Answer: C. Continue monitoring and document findings [CORRECT]
Rationale: This is Sinus Bradycardia (rate <60 bpm with normal P waves, PR interval, and
QRS duration). In asymptomatic patients, no treatment is required—only monitoring and
documentation. Option A is incorrect because pacing is reserved for symptomatic
bradycardia unresponsive to atropine. Option B is incorrect because atropine is
indicated only for symptomatic bradycardia (hypotension, altered mental status, chest
pain, heart failure). Option D is incorrect because cardioversion is used for
tachyarrhythmias, not bradycardia. Per AHA ACLS Guidelines and Relias competency,
treat the patient, not just the monitor.
,Question 3
Which of the following is NOT a common cause of Sinus Bradycardia?
A. Beta-blocker therapy
B. Hyperthyroidism
C. Increased intracranial pressure
D. Hypothermia
Correct Answer: B. Hyperthyroidism [CORRECT]
Rationale: Hyperthyroidism causes Sinus Tachycardia, not bradycardia, due to increased
metabolic demand and catecholamine sensitivity. Options A, C, and D are all established
causes of Sinus Bradycardia: beta-blockers block SA node automaticity, increased ICP
stimulates vagal tone via the Cushing reflex, and hypothermia slows all metabolic
processes including cardiac conduction. Per Relias Dysrhythmia Basic A standards and
AHA ACLS, understanding causative factors is essential for targeted treatment.
Question 4
A patient with Sinus Bradycardia at 48 bpm develops acute hypotension (BP 82/50
mmHg) and altered mental status. What is the first-line pharmacological intervention
per AHA ACLS Guidelines?
A. Dopamine infusion 5-20 mcg/kg/min
, B. Atropine 0.5 mg IV every 3-5 minutes (maximum 3 mg)
C. Epinephrine infusion 2-10 mcg/min
D. Transcutaneous pacing at 60 bpm
Correct Answer: B. Atropine 0.5 mg IV every 3-5 minutes (maximum 3 mg) [CORRECT]
Rationale: Atropine is the first-line treatment for symptomatic bradycardia per AHA
ACLS Guidelines. It blocks parasympathetic (vagal) tone, increasing SA node firing and
AV nodal conduction. Option A is a second-line agent if atropine fails. Option C is also
second-line or used during pacing preparation. Option D is indicated if pharmacological
therapy is ineffective. Per Relias competency, the algorithm sequence is critical:
atropine first, then pacing or catecholamines if needed.
Question 5
A marathon runner has a resting heart rate of 54 bpm during a routine physical. The
ECG shows regular rhythm, upright P waves, normal PR interval, and narrow QRS. The
patient denies dizziness, syncope, or chest pain. What is the most appropriate action?
A. Immediate cardiology referral for pacemaker evaluation
B. Discontinue all exercise and place on bed rest
C. Reassurance that this is a normal physiological adaptation
D. Initiate telemetry monitoring for 48 hours
Correct Answer: C. Reassurance that this is a normal physiological adaptation
[CORRECT]
