RELIAS MEDICAL SURGICAL TELEMETRY EXAM, MOST RECENT EXAM 2025-2026
ACTUAL COMPLETE REAL EXAM QUESTIONS AND CORRECT ANSWERS (VERIFIED
ANSWERS)
.
Cardiac Anatomy & Physiology (Questions 1–15)
Question 1
Which of the following structures is the primary pacemaker of the heart?
A) Atrioventricular (AV) node
B) Purkinje fibers
C) Bundle of His
D) Sinoatrial (SA) node
Answer: D
Rationale: The sinoatrial (SA) node is the natural pacemaker because it has the
fastest intrinsic firing rate (60-100 bpm). The AV node (40-60 bpm) and Purkinje
fibers (15-40 bpm) serve as backup pacemakers if the SA node fails.
Question 2
What is the correct sequence of electrical conduction through the heart?
,A) SA node → Purkinje fibers → AV node → bundle of His
B) SA node → AV node → bundle of His → bundle branches → Purkinje fibers
C) AV node → SA node → bundle of His → Purkinje fibers
D) Bundle of His → SA node → AV node → Purkinje fibers
Answer: B
Rationale: The electrical impulse originates in the SA node, travels to the AV node,
then through the bundle of His, right and left bundle branches, and finally to the
Purkinje fibers, which distribute the impulse to the ventricular myocardium.
Question 3
On an ECG, the P wave represents:
A) Ventricular depolarization
B) Ventricular repolarization
C) Atrial depolarization
D) Atrial repolarization
Answer: C
Rationale: The P wave represents atrial depolarization (contraction). The QRS
complex represents ventricular depolarization, and the T wave represents
,ventricular repolarization. Atrial repolarization is not visible on a normal ECG as it
is masked by the QRS complex.
Question 4
The QRS complex on an ECG represents:
A) Atrial depolarization
B) Ventricular depolarization
C) Ventricular repolarization
D) Atrial repolarization
Answer: B
Rationale: The QRS complex represents ventricular depolarization (contraction). It
is normally narrow (<0.12 seconds) because conduction through the Purkinje
fibers is rapid.
Question 5
The T wave on an ECG represents:
A) Atrial depolarization
B) Ventricular depolarization
C) Ventricular repolarization
, D) Atrial repolarization
Answer: C
Rationale: The T wave represents ventricular repolarization (recovery). It follows
the QRS complex and precedes the next P wave.
Question 6
Which of the following correctly describes the cardiac cycle during ventricular
systole?
A) The atria contract
B) The AV valves open
C) The semilunar valves open
D) Blood flows into the ventricles
Answer: C
Rationale: During ventricular systole, the ventricles contract, increasing pressure.
The AV valves (tricuspid and mitral) close to prevent backflow, and the semilunar
valves (aortic and pulmonary) open to allow blood ejection into the aorta and
pulmonary artery.
ACTUAL COMPLETE REAL EXAM QUESTIONS AND CORRECT ANSWERS (VERIFIED
ANSWERS)
.
Cardiac Anatomy & Physiology (Questions 1–15)
Question 1
Which of the following structures is the primary pacemaker of the heart?
A) Atrioventricular (AV) node
B) Purkinje fibers
C) Bundle of His
D) Sinoatrial (SA) node
Answer: D
Rationale: The sinoatrial (SA) node is the natural pacemaker because it has the
fastest intrinsic firing rate (60-100 bpm). The AV node (40-60 bpm) and Purkinje
fibers (15-40 bpm) serve as backup pacemakers if the SA node fails.
Question 2
What is the correct sequence of electrical conduction through the heart?
,A) SA node → Purkinje fibers → AV node → bundle of His
B) SA node → AV node → bundle of His → bundle branches → Purkinje fibers
C) AV node → SA node → bundle of His → Purkinje fibers
D) Bundle of His → SA node → AV node → Purkinje fibers
Answer: B
Rationale: The electrical impulse originates in the SA node, travels to the AV node,
then through the bundle of His, right and left bundle branches, and finally to the
Purkinje fibers, which distribute the impulse to the ventricular myocardium.
Question 3
On an ECG, the P wave represents:
A) Ventricular depolarization
B) Ventricular repolarization
C) Atrial depolarization
D) Atrial repolarization
Answer: C
Rationale: The P wave represents atrial depolarization (contraction). The QRS
complex represents ventricular depolarization, and the T wave represents
,ventricular repolarization. Atrial repolarization is not visible on a normal ECG as it
is masked by the QRS complex.
Question 4
The QRS complex on an ECG represents:
A) Atrial depolarization
B) Ventricular depolarization
C) Ventricular repolarization
D) Atrial repolarization
Answer: B
Rationale: The QRS complex represents ventricular depolarization (contraction). It
is normally narrow (<0.12 seconds) because conduction through the Purkinje
fibers is rapid.
Question 5
The T wave on an ECG represents:
A) Atrial depolarization
B) Ventricular depolarization
C) Ventricular repolarization
, D) Atrial repolarization
Answer: C
Rationale: The T wave represents ventricular repolarization (recovery). It follows
the QRS complex and precedes the next P wave.
Question 6
Which of the following correctly describes the cardiac cycle during ventricular
systole?
A) The atria contract
B) The AV valves open
C) The semilunar valves open
D) Blood flows into the ventricles
Answer: C
Rationale: During ventricular systole, the ventricles contract, increasing pressure.
The AV valves (tricuspid and mitral) close to prevent backflow, and the semilunar
valves (aortic and pulmonary) open to allow blood ejection into the aorta and
pulmonary artery.
