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APEX EKG 2026 TEST EXAM LEVEL 3 COMPLETE
(150) CURRENT TESTING QUESTIONS AND
CORRECT ANSWERS WITH DETAILED
EXPLANATIONS|GUARANTEED PASS.
APEX
Prepare for the APEX EKG Test Exam Level 3 with practice questions
covering advanced ECG rhythm interpretation, cardiac conduction
abnormalities, arrhythmias, patient monitoring, emergency cardiac
response, and EKG analysis techniques. This study guide helps
reinforce essential electrocardiography concepts and supports
effective exam preparation. Designed to improve rhythm recognition
skills and boost confidence in advanced cardiac patient care. Suitable
for nursing, allied health, and healthcare professionals.
MULTIPLE CHOICE.
Section 1: Rhythm Recognition – Narrow Complex (20
questions)
1. A 45-year-old presents with palpitations. ECG shows HR 180 bpm, regular, narrow
QRS, no visible P waves. What is the most likely rhythm?
• Answer: AV nodal reentrant tachycardia (AVNRT)
• Rationale: Regular narrow-complex tachycardia at 150–250 bpm without visible P
waves suggests AVNRT (P waves buried in QRS).
2. Rhythm is irregularly irregular, no P waves, narrow QRS, HR 110–140 bpm.
• Answer: Atrial fibrillation
• Rationale: Irregularly irregular narrow-complex rhythm with absent P waves is
classic for AFib.
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3. Sawtooth flutter waves at 300 bpm, ventricular rate 150 bpm, narrow QRS.
• Answer: Atrial flutter with 2:1 conduction
• Rationale: Flutter waves (often best seen in V1) at ~300 bpm with 2:1 block =
ventricular rate ~150.
•
4. HR 75 bpm, regular, normal P wave before each QRS, PR 0.28 sec, QRS 0.08 sec.
• Answer: First-degree AV block
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• Rationale: PR >0.20 sec with all conducted = first-degree AV block.
5. P waves normal but intermittent non-conducted P waves (e.g., 3:2 block), QRS narrow.
• Answer: Second-degree AV block Mobitz I (Wenckebach)
• Rationale: Progressive PR prolongation then dropped beat.
6. P waves normal, constant PR, sudden dropped QRS without preceding PR change.
• Answer: Second-degree AV block Mobitz II
• Rationale: Fixed PR interval with intermittent non-conducted P waves.
7. No relationship between P waves and QRS, atrial rate 100, ventricular rate 40, QRS
narrow.
• Answer: Complete heart block (third-degree AV block) with junctional escape
• Rationale: AV dissociation with narrow QRS suggests block at AV node with
junctional pacemaker.
8. HR 55, regular, P wave inverted after QRS, RP interval 0.16 sec.
• Answer: Junctional rhythm (retrograde P)
• Rationale: Inverted P after QRS (RP < PR) = junctional focus.
9. Irregular narrow-complex rhythm with early P waves different from sinus.
• Answer: Premature atrial complexes (PACs)
• Rationale: Early, abnormal P wave morphology preceding a narrow QRS.
10. Rhythm irregular, no P waves, narrow QRS, HR 80 bpm, fibrillatory baseline.
• Answer: Atrial fibrillation (controlled)
• Rationale: No P waves, irregular baseline, variable RR.
11. Regular, narrow QRS, HR 110, every other P is non-conducted (2:1 block).
APEX EKG 2026 TEST EXAM LEVEL 3 COMPLETE
(150) CURRENT TESTING QUESTIONS AND
CORRECT ANSWERS WITH DETAILED
EXPLANATIONS|GUARANTEED PASS.
APEX
Prepare for the APEX EKG Test Exam Level 3 with practice questions
covering advanced ECG rhythm interpretation, cardiac conduction
abnormalities, arrhythmias, patient monitoring, emergency cardiac
response, and EKG analysis techniques. This study guide helps
reinforce essential electrocardiography concepts and supports
effective exam preparation. Designed to improve rhythm recognition
skills and boost confidence in advanced cardiac patient care. Suitable
for nursing, allied health, and healthcare professionals.
MULTIPLE CHOICE.
Section 1: Rhythm Recognition – Narrow Complex (20
questions)
1. A 45-year-old presents with palpitations. ECG shows HR 180 bpm, regular, narrow
QRS, no visible P waves. What is the most likely rhythm?
• Answer: AV nodal reentrant tachycardia (AVNRT)
• Rationale: Regular narrow-complex tachycardia at 150–250 bpm without visible P
waves suggests AVNRT (P waves buried in QRS).
2. Rhythm is irregularly irregular, no P waves, narrow QRS, HR 110–140 bpm.
• Answer: Atrial fibrillation
• Rationale: Irregularly irregular narrow-complex rhythm with absent P waves is
classic for AFib.
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3. Sawtooth flutter waves at 300 bpm, ventricular rate 150 bpm, narrow QRS.
• Answer: Atrial flutter with 2:1 conduction
• Rationale: Flutter waves (often best seen in V1) at ~300 bpm with 2:1 block =
ventricular rate ~150.
•
4. HR 75 bpm, regular, normal P wave before each QRS, PR 0.28 sec, QRS 0.08 sec.
• Answer: First-degree AV block
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• Rationale: PR >0.20 sec with all conducted = first-degree AV block.
5. P waves normal but intermittent non-conducted P waves (e.g., 3:2 block), QRS narrow.
• Answer: Second-degree AV block Mobitz I (Wenckebach)
• Rationale: Progressive PR prolongation then dropped beat.
6. P waves normal, constant PR, sudden dropped QRS without preceding PR change.
• Answer: Second-degree AV block Mobitz II
• Rationale: Fixed PR interval with intermittent non-conducted P waves.
7. No relationship between P waves and QRS, atrial rate 100, ventricular rate 40, QRS
narrow.
• Answer: Complete heart block (third-degree AV block) with junctional escape
• Rationale: AV dissociation with narrow QRS suggests block at AV node with
junctional pacemaker.
8. HR 55, regular, P wave inverted after QRS, RP interval 0.16 sec.
• Answer: Junctional rhythm (retrograde P)
• Rationale: Inverted P after QRS (RP < PR) = junctional focus.
9. Irregular narrow-complex rhythm with early P waves different from sinus.
• Answer: Premature atrial complexes (PACs)
• Rationale: Early, abnormal P wave morphology preceding a narrow QRS.
10. Rhythm irregular, no P waves, narrow QRS, HR 80 bpm, fibrillatory baseline.
• Answer: Atrial fibrillation (controlled)
• Rationale: No P waves, irregular baseline, variable RR.
11. Regular, narrow QRS, HR 110, every other P is non-conducted (2:1 block).
