BSMH Advanced Arrhythmia Course Exam |
Bon Secours Mercy Health Nursing
Education 2026
Cardiac Anatomy and the Electrophysiology of the Heart (Questions
1-10)
1. The sinoatrial (SA) node is normally the primary pacemaker of the
heart because it:
o A. Is located in the left atrium
o B. Has the slowest rate of spontaneous depolarization
o C. Has the fastest rate of spontaneous depolarization
o D. Is innervated by the parasympathetic nervous system only
o Correct ,,,answer,,,: C. The SA node has the fastest intrinsic
firing rate (60-100 bpm), which allows it to override other
potential pacemaker cells and maintain dominance as the
heart's primary pacemaker.
2. What is the normal intrinsic firing rate of the AV node?
o A. 20-40 bpm
o B. 40-60 bpm
o C. 60-80 bpm
o D. 80-100 bpm
o Correct ,,,answer,,,: B. The AV node acts as a secondary
pacemaker, firing at a rate of 40-60 beats per minute.
3. What is the intrinsic firing rate of Purkinje fibers?
o A. 20-40 bpm
o B. 40-60 bpm
o C. 60-80 bpm
, o D. 80-100 bpm
o Correct ,,,answer,,,: A. Purkinje fibers have the slowest
intrinsic rate (20-40 bpm), serving as a last-resort, or latent,
pacemaker when the SA and AV nodes fail.
4. Which structure is primarily responsible for the physiological
delay of the electrical impulse to allow for proper ventricular
filling?
o A. SA node
o B. Bachmann's bundle
o C. AV node
o D. Purkinje fibers
o Correct ,,,answer,,,: C. The AV node purposely slows down
the conduction velocity, creating a delay that allows the atria
to contract fully and empty blood into the ventricles before
ventricular systole begins.
5. On an ECG, what does the P wave represent?
o A. Ventricular depolarization
o B. Atrial depolarization
o C. Ventricular repolarization
o D. Atrial repolarization
o Correct ,,,answer,,,: B. The P wave represents the electrical
activation (depolarization) of the atria, which is initiated by
the SA node.
6. The QRS complex on an ECG represents:
o A. Atrial depolarization
o B. Atrial repolarization
o C. Ventricular depolarization
o D. Ventricular repolarization
, o Correct ,,,answer,,,: C. The QRS complex represents the
electrical depolarization of the ventricles, which leads to
ventricular contraction.
7. A prolonged PR interval (>0.20 sec) is the hallmark characteristic
of:
o A. First-degree AV block
o B. Hyperkalemia
o C. Junctional rhythm
o D. Ventricular hypertrophy
o Correct ,,,answer,,,: A. First-degree AV block is defined by
a consistent PR interval that exceeds 0.20 seconds, indicating
a delay in conduction through the AV node.
8. Which electrolyte imbalance is most likely to cause peaked
(tented) T waves and a widened QRS complex on an ECG?
o A. Hypokalemia
o B. Hyperkalemia
o C. Hypocalcemia
o D. Hypermagnesemia
o Correct ,,,answer,,,: B. Hyperkalemia, or high potassium
levels, produces distinct ECG changes including tall, peaked
T waves, a widening QRS complex, and potentially a loss of
the P wave.
9. The QT interval is affected by heart rate. How is this typically
corrected (QTc)?
o A. Bazett’s formula
o B. Fick’s equation
o C. Starling’s law
o D. Einthoven’s triangle
Bon Secours Mercy Health Nursing
Education 2026
Cardiac Anatomy and the Electrophysiology of the Heart (Questions
1-10)
1. The sinoatrial (SA) node is normally the primary pacemaker of the
heart because it:
o A. Is located in the left atrium
o B. Has the slowest rate of spontaneous depolarization
o C. Has the fastest rate of spontaneous depolarization
o D. Is innervated by the parasympathetic nervous system only
o Correct ,,,answer,,,: C. The SA node has the fastest intrinsic
firing rate (60-100 bpm), which allows it to override other
potential pacemaker cells and maintain dominance as the
heart's primary pacemaker.
2. What is the normal intrinsic firing rate of the AV node?
o A. 20-40 bpm
o B. 40-60 bpm
o C. 60-80 bpm
o D. 80-100 bpm
o Correct ,,,answer,,,: B. The AV node acts as a secondary
pacemaker, firing at a rate of 40-60 beats per minute.
3. What is the intrinsic firing rate of Purkinje fibers?
o A. 20-40 bpm
o B. 40-60 bpm
o C. 60-80 bpm
, o D. 80-100 bpm
o Correct ,,,answer,,,: A. Purkinje fibers have the slowest
intrinsic rate (20-40 bpm), serving as a last-resort, or latent,
pacemaker when the SA and AV nodes fail.
4. Which structure is primarily responsible for the physiological
delay of the electrical impulse to allow for proper ventricular
filling?
o A. SA node
o B. Bachmann's bundle
o C. AV node
o D. Purkinje fibers
o Correct ,,,answer,,,: C. The AV node purposely slows down
the conduction velocity, creating a delay that allows the atria
to contract fully and empty blood into the ventricles before
ventricular systole begins.
5. On an ECG, what does the P wave represent?
o A. Ventricular depolarization
o B. Atrial depolarization
o C. Ventricular repolarization
o D. Atrial repolarization
o Correct ,,,answer,,,: B. The P wave represents the electrical
activation (depolarization) of the atria, which is initiated by
the SA node.
6. The QRS complex on an ECG represents:
o A. Atrial depolarization
o B. Atrial repolarization
o C. Ventricular depolarization
o D. Ventricular repolarization
, o Correct ,,,answer,,,: C. The QRS complex represents the
electrical depolarization of the ventricles, which leads to
ventricular contraction.
7. A prolonged PR interval (>0.20 sec) is the hallmark characteristic
of:
o A. First-degree AV block
o B. Hyperkalemia
o C. Junctional rhythm
o D. Ventricular hypertrophy
o Correct ,,,answer,,,: A. First-degree AV block is defined by
a consistent PR interval that exceeds 0.20 seconds, indicating
a delay in conduction through the AV node.
8. Which electrolyte imbalance is most likely to cause peaked
(tented) T waves and a widened QRS complex on an ECG?
o A. Hypokalemia
o B. Hyperkalemia
o C. Hypocalcemia
o D. Hypermagnesemia
o Correct ,,,answer,,,: B. Hyperkalemia, or high potassium
levels, produces distinct ECG changes including tall, peaked
T waves, a widening QRS complex, and potentially a loss of
the P wave.
9. The QT interval is affected by heart rate. How is this typically
corrected (QTc)?
o A. Bazett’s formula
o B. Fick’s equation
o C. Starling’s law
o D. Einthoven’s triangle
