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CRAT EXAM (CERTIFIED RHYTHM ANALYSIS TECHNICIAN
PREP)2025-2026 COMPLETE QUESTIONS AND ANSWERS
ALREADY SOLVED 100% CORRECT,GRADED A+
Q1 — Identification / rate calculation
A rhythm strip (paper speed 25 mm/s) shows a regular rhythm. Each R–R
interval equals 5 large boxes. P waves are upright in leads II and present
before every QRS. QRS duration is 90 ms. What is the best interpretation?
A. Sinus bradycardia
B. Sinus rhythm with normal rate
C. Sinus tachycardia
D. Atrial tachycardia
Answer: B. Sinus rhythm with normal rate.
Why:
Each large box = 0.2 seconds at 25 mm/s. Five large boxes → R–R =
5 × 0.2 s = 1.0 s.
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Heart rate = 60 seconds ÷ RR = 60 ÷ 1.0 = 60 beats per minute. That
is within the normal adult resting range (60–100 bpm).
There is a P wave before each QRS and the P waves are upright in
lead II → sinus origin.
QRS duration 90 ms is < 120 ms → narrow QRS.
Pearl: For quick estimation, 300 / (# of big boxes between R waves)
= = 60.
Q2 — Sinus brady vs junctional
A patient’s monitor shows a regular rhythm at 48 bpm, P waves are present
and identical before each QRS, PR interval = 180 ms, QRS = 100 ms. Which
is correct?
A. Sinus bradycardia
B. Junctional escape rhythm
C. AV block type II
D. Sinus arrest
Answer: A. Sinus bradycardia.
Why:
Rate 48 bpm (brady: <60).
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P waves present and identical preceding every QRS with PR = 180 ms
(normal PR 120–200 ms) → sinoatrial node is pacing the heart
(sinus).
Junctional escape would have absent or retrograde P waves (or
inverted P in II) and often narrow QRS; not the case here.
Management note: If asymptomatic, often observation; if
symptomatic (dizziness, hypotension), consider atropine or pacing per
ACLS/organization protocols.
Q3 — SVT vs sinus tach
A narrow-complex tachycardia at 170 bpm with no visible P waves on the
strip, onset is sudden with palpitations. Vagal maneuvers stopped the
tachycardia transiently. Most likely diagnosis?
A. Sinus tachycardia
B. Atrial fibrillation
C. Supraventricular tachycardia (AV nodal reentrant or AV reentrant)
D. Atrial flutter
Answer: C. Supraventricular tachycardia (SVT).
Why:
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Rate 170 bpm with sudden onset favors SVT over sinus tachycardia
(sinus usually slower and gradual).
No visible P waves — in SVT P waves are often hidden in the QRS or
just after (because atrial and ventricular activation are nearly
simultaneous).
Response to vagal maneuvers (transient termination) is characteristic
of AV node–dependent SVT (AVNRT or AVRT).
Exam pearl: If vagal/adenosine terminates rhythm → likely AV
nodal dependent SVT.
Q4 — Atrial flutter 2:1 block
An ECG shows regular, sawtooth atrial activity at 300 atrial beats/min with
a ventricular rate of 150/min (narrow complexes). What is the correct
rhythm label?
A. Atrial flutter with 4:1 conduction
B. Atrial flutter with 2:1 conduction
C. Atrial fibrillation with rapid ventricular response
D. Multifocal atrial tachycardia
Answer: B. Atrial flutter with 2:1 conduction.
Why:
CRAT EXAM (CERTIFIED RHYTHM ANALYSIS TECHNICIAN
PREP)2025-2026 COMPLETE QUESTIONS AND ANSWERS
ALREADY SOLVED 100% CORRECT,GRADED A+
Q1 — Identification / rate calculation
A rhythm strip (paper speed 25 mm/s) shows a regular rhythm. Each R–R
interval equals 5 large boxes. P waves are upright in leads II and present
before every QRS. QRS duration is 90 ms. What is the best interpretation?
A. Sinus bradycardia
B. Sinus rhythm with normal rate
C. Sinus tachycardia
D. Atrial tachycardia
Answer: B. Sinus rhythm with normal rate.
Why:
Each large box = 0.2 seconds at 25 mm/s. Five large boxes → R–R =
5 × 0.2 s = 1.0 s.
,2|Page
Heart rate = 60 seconds ÷ RR = 60 ÷ 1.0 = 60 beats per minute. That
is within the normal adult resting range (60–100 bpm).
There is a P wave before each QRS and the P waves are upright in
lead II → sinus origin.
QRS duration 90 ms is < 120 ms → narrow QRS.
Pearl: For quick estimation, 300 / (# of big boxes between R waves)
= = 60.
Q2 — Sinus brady vs junctional
A patient’s monitor shows a regular rhythm at 48 bpm, P waves are present
and identical before each QRS, PR interval = 180 ms, QRS = 100 ms. Which
is correct?
A. Sinus bradycardia
B. Junctional escape rhythm
C. AV block type II
D. Sinus arrest
Answer: A. Sinus bradycardia.
Why:
Rate 48 bpm (brady: <60).
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P waves present and identical preceding every QRS with PR = 180 ms
(normal PR 120–200 ms) → sinoatrial node is pacing the heart
(sinus).
Junctional escape would have absent or retrograde P waves (or
inverted P in II) and often narrow QRS; not the case here.
Management note: If asymptomatic, often observation; if
symptomatic (dizziness, hypotension), consider atropine or pacing per
ACLS/organization protocols.
Q3 — SVT vs sinus tach
A narrow-complex tachycardia at 170 bpm with no visible P waves on the
strip, onset is sudden with palpitations. Vagal maneuvers stopped the
tachycardia transiently. Most likely diagnosis?
A. Sinus tachycardia
B. Atrial fibrillation
C. Supraventricular tachycardia (AV nodal reentrant or AV reentrant)
D. Atrial flutter
Answer: C. Supraventricular tachycardia (SVT).
Why:
, 4|Page
Rate 170 bpm with sudden onset favors SVT over sinus tachycardia
(sinus usually slower and gradual).
No visible P waves — in SVT P waves are often hidden in the QRS or
just after (because atrial and ventricular activation are nearly
simultaneous).
Response to vagal maneuvers (transient termination) is characteristic
of AV node–dependent SVT (AVNRT or AVRT).
Exam pearl: If vagal/adenosine terminates rhythm → likely AV
nodal dependent SVT.
Q4 — Atrial flutter 2:1 block
An ECG shows regular, sawtooth atrial activity at 300 atrial beats/min with
a ventricular rate of 150/min (narrow complexes). What is the correct
rhythm label?
A. Atrial flutter with 4:1 conduction
B. Atrial flutter with 2:1 conduction
C. Atrial fibrillation with rapid ventricular response
D. Multifocal atrial tachycardia
Answer: B. Atrial flutter with 2:1 conduction.
Why:
