RELIAS ADVANCED DYSRHYTHMIA EXAM B
QUESTIONS AND CORRECT ANSWERS WITH
RATIONALES GRADED A+ LATEST
Question 1
A patient with atrial fibrillation has an irregularly irregular rhythm with no discernible P waves.
Which mechanism best explains this dysrhythmia?
A. Reentry circuit within the AV node
B. Multiple ectopic atrial foci firing chaotically
C. Delayed ventricular repolarization
D. SA node automaticity suppression
Correct Answer: B
Rationale: Atrial fibrillation is caused by multiple ectopic atrial foci firing simultaneously, resulting
in chaotic atrial activity and loss of organized P waves.
Question 2
Which ECG finding is most consistent with second-degree AV block type II (Mobitz II)?
A. Progressive PR interval prolongation before a dropped QRS
B. Constant PR intervals with intermittent dropped QRS complexes
C. Absence of P waves
D. Wide QRS complexes with premature beats
Correct Answer: B
Rationale: Mobitz II is characterized by fixed PR intervals with sudden dropped QRS complexes,
reflecting conduction failure below the AV node.
,Question 3
A wide-complex tachycardia at 180 bpm with AV dissociation is most likely:
A. Supraventricular tachycardia with aberrancy
B. Ventricular tachycardia
C. Atrial flutter
D. Junctional tachycardia
Correct Answer: B
Rationale: AV dissociation strongly suggests ventricular tachycardia, especially in the presence of
a wide-complex tachycardia.
Question 4
Which electrolyte abnormality most commonly predisposes a patient to torsades de pointes?
A. Hyperkalemia
B. Hypokalemia
C. Hypercalcemia
D. Hyponatremia
Correct Answer: B
Rationale: Hypokalemia prolongs ventricular repolarization, increasing the risk of QT prolongation
and torsades de pointes.
Question 5
A patient with sinus bradycardia becomes hypotensive and altered. Which intervention is most
appropriate?
A. Immediate synchronized cardioversion
B. Atropine administration
C. Adenosine IV push
D. Amiodarone infusion
,Correct Answer: B
Rationale: Atropine is first-line therapy for symptomatic sinus bradycardia to increase heart rate
by blocking vagal tone.
Question 6
Which rhythm is associated with a sawtooth pattern of flutter waves?
A. Atrial fibrillation
B. Atrial flutter
C. Multifocal atrial tachycardia
D. Junctional rhythm
Correct Answer: B
Rationale: Atrial flutter produces organized atrial activity with characteristic sawtooth flutter
waves, usually at 250–350 bpm.
Question 7
A prolonged PR interval (>0.20 seconds) with a 1:1 P-to-QRS ratio indicates:
A. Second-degree AV block type I
B. First-degree AV block
C. Junctional rhythm
D. Complete heart block
Correct Answer: B
Rationale: First-degree AV block is defined by consistent conduction with a prolonged PR interval.
, Question 8
Which rhythm carries the highest immediate risk for sudden cardiac death?
A. Sinus tachycardia
B. Atrial flutter
C. Ventricular fibrillation
D. Junctional rhythm
Correct Answer: C
Rationale: Ventricular fibrillation results in no effective cardiac output and is immediately life-
threatening without defibrillation.
Question 9
In ventricular tachycardia, the QRS complex is typically:
A. Narrow and regular
B. Wide and bizarre
C. Narrow and irregular
D. Absent
Correct Answer: B
Rationale: Ventricular rhythms originate below the AV node, producing wide and abnormal QRS
complexes.
Question 10
Which medication is most appropriate for stable monomorphic ventricular tachycardia?
A. Adenosine
B. Amiodarone
C. Atropine
D. Digoxin
QUESTIONS AND CORRECT ANSWERS WITH
RATIONALES GRADED A+ LATEST
Question 1
A patient with atrial fibrillation has an irregularly irregular rhythm with no discernible P waves.
Which mechanism best explains this dysrhythmia?
A. Reentry circuit within the AV node
B. Multiple ectopic atrial foci firing chaotically
C. Delayed ventricular repolarization
D. SA node automaticity suppression
Correct Answer: B
Rationale: Atrial fibrillation is caused by multiple ectopic atrial foci firing simultaneously, resulting
in chaotic atrial activity and loss of organized P waves.
Question 2
Which ECG finding is most consistent with second-degree AV block type II (Mobitz II)?
A. Progressive PR interval prolongation before a dropped QRS
B. Constant PR intervals with intermittent dropped QRS complexes
C. Absence of P waves
D. Wide QRS complexes with premature beats
Correct Answer: B
Rationale: Mobitz II is characterized by fixed PR intervals with sudden dropped QRS complexes,
reflecting conduction failure below the AV node.
,Question 3
A wide-complex tachycardia at 180 bpm with AV dissociation is most likely:
A. Supraventricular tachycardia with aberrancy
B. Ventricular tachycardia
C. Atrial flutter
D. Junctional tachycardia
Correct Answer: B
Rationale: AV dissociation strongly suggests ventricular tachycardia, especially in the presence of
a wide-complex tachycardia.
Question 4
Which electrolyte abnormality most commonly predisposes a patient to torsades de pointes?
A. Hyperkalemia
B. Hypokalemia
C. Hypercalcemia
D. Hyponatremia
Correct Answer: B
Rationale: Hypokalemia prolongs ventricular repolarization, increasing the risk of QT prolongation
and torsades de pointes.
Question 5
A patient with sinus bradycardia becomes hypotensive and altered. Which intervention is most
appropriate?
A. Immediate synchronized cardioversion
B. Atropine administration
C. Adenosine IV push
D. Amiodarone infusion
,Correct Answer: B
Rationale: Atropine is first-line therapy for symptomatic sinus bradycardia to increase heart rate
by blocking vagal tone.
Question 6
Which rhythm is associated with a sawtooth pattern of flutter waves?
A. Atrial fibrillation
B. Atrial flutter
C. Multifocal atrial tachycardia
D. Junctional rhythm
Correct Answer: B
Rationale: Atrial flutter produces organized atrial activity with characteristic sawtooth flutter
waves, usually at 250–350 bpm.
Question 7
A prolonged PR interval (>0.20 seconds) with a 1:1 P-to-QRS ratio indicates:
A. Second-degree AV block type I
B. First-degree AV block
C. Junctional rhythm
D. Complete heart block
Correct Answer: B
Rationale: First-degree AV block is defined by consistent conduction with a prolonged PR interval.
, Question 8
Which rhythm carries the highest immediate risk for sudden cardiac death?
A. Sinus tachycardia
B. Atrial flutter
C. Ventricular fibrillation
D. Junctional rhythm
Correct Answer: C
Rationale: Ventricular fibrillation results in no effective cardiac output and is immediately life-
threatening without defibrillation.
Question 9
In ventricular tachycardia, the QRS complex is typically:
A. Narrow and regular
B. Wide and bizarre
C. Narrow and irregular
D. Absent
Correct Answer: B
Rationale: Ventricular rhythms originate below the AV node, producing wide and abnormal QRS
complexes.
Question 10
Which medication is most appropriate for stable monomorphic ventricular tachycardia?
A. Adenosine
B. Amiodarone
C. Atropine
D. Digoxin
