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RELIAS MEDICAL SURGICAL TELEMETRY
EXAM 2026 |ORIGINAL 100Qs&As
|ALREADY GRADED A+
Question 1
A patient's telemetry strip shows a regular rhythm with a rate of
42 bpm, no P waves visible, wide QRS complexes (>0.12
seconds), and a regular R-R interval. What is the rhythm?
A) Sinus bradycardia
B) Junctional rhythm
C) Idioventricular rhythm
D) First-degree AV block
Answer: C) Idioventricular rhythm
Rationale: Idioventricular rhythm originates from the Purkinje
fibers, typically at a rate of 20-40 bpm. The absence of P
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waves and wide QRS complexes (>0.12 sec) confirms ventricular
origin. Sinus bradycardia would have P waves; junctional rhythm
has narrow QRS (<0.12 sec) and rates 40-60 bpm.
Question 2
A 72-year-old male with history of CHF presents with telemetry
showing an irregularly irregular rhythm with no discernible P
waves and a ventricular rate of 118 bpm. What is the most
appropriate initial intervention?
A) Immediate synchronized cardioversion
B) Metoprolol 5 mg IV push
C) Digoxin 0.25 mg PO daily
D) Diltiazem bolus followed by continuous infusion
Answer: D) Diltiazem bolus followed by continuous infusion
Rationale: This rhythm is atrial fibrillation with rapid ventricular
response. For stable patients with RVR, rate control is first-line
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therapy. Diltiazem (calcium channel blocker) is preferred for
rapid rate control. Synchronized cardioversion is for unstable
patients. Metoprolol could be used but diltiazem works faster.
Digoxin is for chronic rate control.
Question 3
A patient's monitor alarms with a rhythm showing wide QRS
complexes at 180 bpm, regular, with no P waves visible. The
patient is unconscious with no palpable pulse. What is your
immediate action?
A) Administer amiodarone 300 mg IV push
B) Perform synchronized cardioversion
C) Defibrillate at 200 J biphasic
D) Start chest compressions
Answer: D) Start chest compressions
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Rationale: This is pulseless ventricular tachycardia. High-quality
CPR should be initiated immediately while preparing for
defibrillation. According to ACLS guidelines, CPR first, then
defibrillation as soon as available. Defibrillation is the definitive
treatment, but chest compressions should not be delayed.
Question 4
A telemetry strip shows a regular rhythm with a rate of 68 bpm,
normal P waves preceding each QRS, PR interval 0.28 seconds,
and QRS duration 0.10 seconds. What is this rhythm?
A) Normal sinus rhythm
B) First-degree AV block
C) Second-degree AV block type I
D) Second-degree AV block type II
Answer: B) First-degree AV block
RELIAS MEDICAL SURGICAL TELEMETRY
EXAM 2026 |ORIGINAL 100Qs&As
|ALREADY GRADED A+
Question 1
A patient's telemetry strip shows a regular rhythm with a rate of
42 bpm, no P waves visible, wide QRS complexes (>0.12
seconds), and a regular R-R interval. What is the rhythm?
A) Sinus bradycardia
B) Junctional rhythm
C) Idioventricular rhythm
D) First-degree AV block
Answer: C) Idioventricular rhythm
Rationale: Idioventricular rhythm originates from the Purkinje
fibers, typically at a rate of 20-40 bpm. The absence of P
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waves and wide QRS complexes (>0.12 sec) confirms ventricular
origin. Sinus bradycardia would have P waves; junctional rhythm
has narrow QRS (<0.12 sec) and rates 40-60 bpm.
Question 2
A 72-year-old male with history of CHF presents with telemetry
showing an irregularly irregular rhythm with no discernible P
waves and a ventricular rate of 118 bpm. What is the most
appropriate initial intervention?
A) Immediate synchronized cardioversion
B) Metoprolol 5 mg IV push
C) Digoxin 0.25 mg PO daily
D) Diltiazem bolus followed by continuous infusion
Answer: D) Diltiazem bolus followed by continuous infusion
Rationale: This rhythm is atrial fibrillation with rapid ventricular
response. For stable patients with RVR, rate control is first-line
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therapy. Diltiazem (calcium channel blocker) is preferred for
rapid rate control. Synchronized cardioversion is for unstable
patients. Metoprolol could be used but diltiazem works faster.
Digoxin is for chronic rate control.
Question 3
A patient's monitor alarms with a rhythm showing wide QRS
complexes at 180 bpm, regular, with no P waves visible. The
patient is unconscious with no palpable pulse. What is your
immediate action?
A) Administer amiodarone 300 mg IV push
B) Perform synchronized cardioversion
C) Defibrillate at 200 J biphasic
D) Start chest compressions
Answer: D) Start chest compressions
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Rationale: This is pulseless ventricular tachycardia. High-quality
CPR should be initiated immediately while preparing for
defibrillation. According to ACLS guidelines, CPR first, then
defibrillation as soon as available. Defibrillation is the definitive
treatment, but chest compressions should not be delayed.
Question 4
A telemetry strip shows a regular rhythm with a rate of 68 bpm,
normal P waves preceding each QRS, PR interval 0.28 seconds,
and QRS duration 0.10 seconds. What is this rhythm?
A) Normal sinus rhythm
B) First-degree AV block
C) Second-degree AV block type I
D) Second-degree AV block type II
Answer: B) First-degree AV block
