Relias Dysrhythmia Basic B Exam
Cardiac Rhythm Interpretation
ACTUAL EXAM 2026/2027 | Relias Basic
B Dysrhythmia | Verified Q&A | Pass
Guaranteed - A+ Graded
Section 1 – Normal Sinus Rhythm & Sinus Dysrhythmias (Questions 1–10)
Q1: A cardiac rhythm strip shows a regular rhythm with a heart rate of 52 beats per minute. There is a P
wave before every QRS complex, PR interval measures 0.16 seconds, and QRS duration is 0.08 seconds.
What is this rhythm?
A. Sinus tachycardia
B. Sinus bradycardia [CORRECT]
C. Normal sinus rhythm
D. Sinus arrhythmia
Correct Answer: B
Rationale: Rate below 60 bpm (52) with normal upright P waves, normal PR interval (0.16 sec), and
narrow QRS (0.08 sec) defines sinus bradycardia, indicating the SA node is firing slowly but conducting
normally through the heart.
Q2: A rhythm strip demonstrates a regular rhythm at 110 bpm with upright P waves preceding each
QRS, PR interval 0.14 seconds, and QRS 0.10 seconds. What is this rhythm?
A. Normal sinus rhythm
B. Sinus bradycardia
C. Sinus tachycardia [CORRECT]
D. Atrial flutter
Correct Answer: C
Rationale: Rate above 100 bpm (110) with normal sinus P waves, normal PR interval, and narrow QRS
complexes defines sinus tachycardia, where the SA node accelerates firing in response to physiologic
demands such as exercise, fever, or stress.
,Q3: A rhythm strip shows a rhythm that is irregular, with R-R intervals varying by more than 0.12
seconds. The rate increases during inspiration and decreases during expiration. P waves are normal and
precede each QRS. What is this rhythm?
A. Sinus bradycardia
B. Sinus tachycardia
C. Sinus arrhythmia [CORRECT]
D. Atrial fibrillation
Correct Answer: C
Rationale: Sinus arrhythmia is characterized by a phasic variation in heart rate with respiration
(inspiration increases rate, expiration decreases rate) with normal P waves and normal conduction,
reflecting normal autonomic nervous system influence on the SA node.
Q4: A rhythm strip shows a pause in the rhythm where one complete PQRST complex is missing. The
pause is not a multiple of the preceding R-R interval. What is this rhythm?
A. Sinus block
B. Sinus arrest (sinus pause) [CORRECT]
C. Second-degree AV block Type I
D. Junctional escape beat
Correct Answer: B
Rationale: Sinus arrest (sinus pause) occurs when the SA node fails to fire, producing a pause that is not
a multiple of the baseline R-R interval because the SA node has reset its timing rather than being
blocked; this distinguishes it from sinus block where the pause is a multiple of the R-R interval.
Q5: Using the 300 method, a rhythm strip shows 2 large squares between R waves. What is the heart
rate?
A. 75 bpm
B. 100 bpm
C. 150 bpm [CORRECT]
D. 300 bpm
Correct Answer: C
Rationale: The 300 method calculates rate by dividing 300 by the number of large squares between R
waves; 300 ÷ 2 = 150 bpm, which is consistent with a rapid supraventricular or ventricular rhythm
requiring immediate assessment.
, Q6: A rhythm strip shows a regular rhythm at 68 bpm with upright P waves, PR 0.18 seconds, and QRS
0.09 seconds. What is this rhythm?
A. Sinus bradycardia
B. Normal sinus rhythm [CORRECT]
C. Junctional rhythm
D. First-degree AV block
Correct Answer: B
Rationale: Normal sinus rhythm is defined by a regular rhythm with rate 60-100 bpm, upright P waves
before each QRS, PR interval 0.12-0.20 seconds, and QRS duration <0.12 seconds, indicating normal SA
node initiation and AV nodal conduction.
Q7: A patient has a sinus rhythm at 45 bpm. They are asymptomatic with blood pressure 118/72. What
is the appropriate initial nursing action?
A. Prepare for immediate transcutaneous pacing
B. Continue monitoring and document [CORRECT]
C. Administer atropine 1 mg IV push
D. Begin CPR
Correct Answer: B
Rationale: Asymptomatic sinus bradycardia with normal blood pressure does not require immediate
intervention; the nurse should continue monitoring, assess for symptoms, and document, reserving
atropine or pacing for symptomatic bradycardia per ACLS guidelines.
Q8: A rhythm strip shows a sinus rhythm at 140 bpm following a postoperative patient's blood
transfusion. What is the most likely cause?
A. Hypovolemia
B. Compensatory response to volume expansion [CORRECT]
C. Hyperkalemia
D. Digoxin toxicity
Correct Answer: B
Rationale: Sinus tachycardia following blood transfusion commonly reflects the body's compensatory
response to increased circulatory volume, increased metabolic demand, or mild febrile reaction; other
causes such as hemorrhage or transfusion reaction should also be assessed.
Cardiac Rhythm Interpretation
ACTUAL EXAM 2026/2027 | Relias Basic
B Dysrhythmia | Verified Q&A | Pass
Guaranteed - A+ Graded
Section 1 – Normal Sinus Rhythm & Sinus Dysrhythmias (Questions 1–10)
Q1: A cardiac rhythm strip shows a regular rhythm with a heart rate of 52 beats per minute. There is a P
wave before every QRS complex, PR interval measures 0.16 seconds, and QRS duration is 0.08 seconds.
What is this rhythm?
A. Sinus tachycardia
B. Sinus bradycardia [CORRECT]
C. Normal sinus rhythm
D. Sinus arrhythmia
Correct Answer: B
Rationale: Rate below 60 bpm (52) with normal upright P waves, normal PR interval (0.16 sec), and
narrow QRS (0.08 sec) defines sinus bradycardia, indicating the SA node is firing slowly but conducting
normally through the heart.
Q2: A rhythm strip demonstrates a regular rhythm at 110 bpm with upright P waves preceding each
QRS, PR interval 0.14 seconds, and QRS 0.10 seconds. What is this rhythm?
A. Normal sinus rhythm
B. Sinus bradycardia
C. Sinus tachycardia [CORRECT]
D. Atrial flutter
Correct Answer: C
Rationale: Rate above 100 bpm (110) with normal sinus P waves, normal PR interval, and narrow QRS
complexes defines sinus tachycardia, where the SA node accelerates firing in response to physiologic
demands such as exercise, fever, or stress.
,Q3: A rhythm strip shows a rhythm that is irregular, with R-R intervals varying by more than 0.12
seconds. The rate increases during inspiration and decreases during expiration. P waves are normal and
precede each QRS. What is this rhythm?
A. Sinus bradycardia
B. Sinus tachycardia
C. Sinus arrhythmia [CORRECT]
D. Atrial fibrillation
Correct Answer: C
Rationale: Sinus arrhythmia is characterized by a phasic variation in heart rate with respiration
(inspiration increases rate, expiration decreases rate) with normal P waves and normal conduction,
reflecting normal autonomic nervous system influence on the SA node.
Q4: A rhythm strip shows a pause in the rhythm where one complete PQRST complex is missing. The
pause is not a multiple of the preceding R-R interval. What is this rhythm?
A. Sinus block
B. Sinus arrest (sinus pause) [CORRECT]
C. Second-degree AV block Type I
D. Junctional escape beat
Correct Answer: B
Rationale: Sinus arrest (sinus pause) occurs when the SA node fails to fire, producing a pause that is not
a multiple of the baseline R-R interval because the SA node has reset its timing rather than being
blocked; this distinguishes it from sinus block where the pause is a multiple of the R-R interval.
Q5: Using the 300 method, a rhythm strip shows 2 large squares between R waves. What is the heart
rate?
A. 75 bpm
B. 100 bpm
C. 150 bpm [CORRECT]
D. 300 bpm
Correct Answer: C
Rationale: The 300 method calculates rate by dividing 300 by the number of large squares between R
waves; 300 ÷ 2 = 150 bpm, which is consistent with a rapid supraventricular or ventricular rhythm
requiring immediate assessment.
, Q6: A rhythm strip shows a regular rhythm at 68 bpm with upright P waves, PR 0.18 seconds, and QRS
0.09 seconds. What is this rhythm?
A. Sinus bradycardia
B. Normal sinus rhythm [CORRECT]
C. Junctional rhythm
D. First-degree AV block
Correct Answer: B
Rationale: Normal sinus rhythm is defined by a regular rhythm with rate 60-100 bpm, upright P waves
before each QRS, PR interval 0.12-0.20 seconds, and QRS duration <0.12 seconds, indicating normal SA
node initiation and AV nodal conduction.
Q7: A patient has a sinus rhythm at 45 bpm. They are asymptomatic with blood pressure 118/72. What
is the appropriate initial nursing action?
A. Prepare for immediate transcutaneous pacing
B. Continue monitoring and document [CORRECT]
C. Administer atropine 1 mg IV push
D. Begin CPR
Correct Answer: B
Rationale: Asymptomatic sinus bradycardia with normal blood pressure does not require immediate
intervention; the nurse should continue monitoring, assess for symptoms, and document, reserving
atropine or pacing for symptomatic bradycardia per ACLS guidelines.
Q8: A rhythm strip shows a sinus rhythm at 140 bpm following a postoperative patient's blood
transfusion. What is the most likely cause?
A. Hypovolemia
B. Compensatory response to volume expansion [CORRECT]
C. Hyperkalemia
D. Digoxin toxicity
Correct Answer: B
Rationale: Sinus tachycardia following blood transfusion commonly reflects the body's compensatory
response to increased circulatory volume, increased metabolic demand, or mild febrile reaction; other
causes such as hemorrhage or transfusion reaction should also be assessed.
