Relias Advanced
Dysrhythmia Exam B
1.
A rhythm shows a regular R-R interval, rate of 150 bpm, narrow QRS complexes, and
P waves are not visible. What is the most likely rhythm?
A. Atrial flutter
B. Sinus tachycardia
C. SVT (Supraventricular tachycardia)
D. Ventricular tachycardia
✅ Answer: C. SVT
Rationale: Rapid, regular narrow-complex rhythm with no visible P waves is
consistent with supraventricular tachycardia.
2.
You note a rhythm with wide QRS complexes, rate of 40 bpm, and no relationship
between P waves and QRS complexes. What rhythm is this?
A. Second-degree AV block type II
B. Third-degree AV block
C. Junctional escape rhythm
D. Idioventricular rhythm
✅ Answer: B. Third-degree AV block
Rationale: Complete AV dissociation between atria and ventricles defines third-
degree AV block.
,3.
A wide QRS complex tachycardia with monomorphic appearance at 160 bpm is seen.
What is the initial management?
A. Adenosine 6 mg IV push
B. Synchronized cardioversion
C. Atropine 1 mg IV
D. Amiodarone 150 mg IV over 10 minutes
✅ Answer: D. Amiodarone 150 mg IV over 10 min
Rationale: Monomorphic VT with a pulse should be treated with antiarrhythmic such
as amiodarone if stable.
4.
What rhythm shows a sawtooth pattern between QRS complexes?
A. Atrial flutter
B. Atrial fibrillation
C. SVT
D. Sinus tachycardia
✅ Answer: A. Atrial flutter
Rationale: Sawtooth F-waves indicate atrial flutter, commonly at a rate of 250–350
bpm.
5.
A 12-lead ECG shows irregularly irregular rhythm with no identifiable P waves. What
is the likely diagnosis?
A. Sinus arrhythmia
B. Atrial fibrillation
C. Atrial flutter with variable block
D. Multifocal atrial tachycardia
, ✅ Answer: B. Atrial fibrillation
Rationale: Irregularly irregular rhythm without P waves is hallmark of atrial
fibrillation.
6.
Which rhythm has progressive PR interval prolongation until a QRS is dropped?
A. First-degree AV block
B. Second-degree AV block Type I (Wenckebach)
C. Second-degree AV block Type II
D. Third-degree AV block
✅ Answer: B. Second-degree AV block Type I (Wenckebach)
Rationale: Gradual lengthening of PR interval followed by a dropped beat is classic
for Mobitz I.
7.
A rhythm strip shows P waves with consistent PR interval and QRS dropped
intermittently without PR change. What is this?
A. Second-degree Type II AV block
✅ Answer: A. Second-degree Type II AV block
Rationale: Dropped QRS without PR change indicates Mobitz II — more serious than
Type I.
8.
A patient’s ECG shows chaotic, disorganized ventricular activity with no discernible
QRS complexes.
A. Ventricular tachycardia
B. Asystole
C. Ventricular fibrillation
D. PEA
Dysrhythmia Exam B
1.
A rhythm shows a regular R-R interval, rate of 150 bpm, narrow QRS complexes, and
P waves are not visible. What is the most likely rhythm?
A. Atrial flutter
B. Sinus tachycardia
C. SVT (Supraventricular tachycardia)
D. Ventricular tachycardia
✅ Answer: C. SVT
Rationale: Rapid, regular narrow-complex rhythm with no visible P waves is
consistent with supraventricular tachycardia.
2.
You note a rhythm with wide QRS complexes, rate of 40 bpm, and no relationship
between P waves and QRS complexes. What rhythm is this?
A. Second-degree AV block type II
B. Third-degree AV block
C. Junctional escape rhythm
D. Idioventricular rhythm
✅ Answer: B. Third-degree AV block
Rationale: Complete AV dissociation between atria and ventricles defines third-
degree AV block.
,3.
A wide QRS complex tachycardia with monomorphic appearance at 160 bpm is seen.
What is the initial management?
A. Adenosine 6 mg IV push
B. Synchronized cardioversion
C. Atropine 1 mg IV
D. Amiodarone 150 mg IV over 10 minutes
✅ Answer: D. Amiodarone 150 mg IV over 10 min
Rationale: Monomorphic VT with a pulse should be treated with antiarrhythmic such
as amiodarone if stable.
4.
What rhythm shows a sawtooth pattern between QRS complexes?
A. Atrial flutter
B. Atrial fibrillation
C. SVT
D. Sinus tachycardia
✅ Answer: A. Atrial flutter
Rationale: Sawtooth F-waves indicate atrial flutter, commonly at a rate of 250–350
bpm.
5.
A 12-lead ECG shows irregularly irregular rhythm with no identifiable P waves. What
is the likely diagnosis?
A. Sinus arrhythmia
B. Atrial fibrillation
C. Atrial flutter with variable block
D. Multifocal atrial tachycardia
, ✅ Answer: B. Atrial fibrillation
Rationale: Irregularly irregular rhythm without P waves is hallmark of atrial
fibrillation.
6.
Which rhythm has progressive PR interval prolongation until a QRS is dropped?
A. First-degree AV block
B. Second-degree AV block Type I (Wenckebach)
C. Second-degree AV block Type II
D. Third-degree AV block
✅ Answer: B. Second-degree AV block Type I (Wenckebach)
Rationale: Gradual lengthening of PR interval followed by a dropped beat is classic
for Mobitz I.
7.
A rhythm strip shows P waves with consistent PR interval and QRS dropped
intermittently without PR change. What is this?
A. Second-degree Type II AV block
✅ Answer: A. Second-degree Type II AV block
Rationale: Dropped QRS without PR change indicates Mobitz II — more serious than
Type I.
8.
A patient’s ECG shows chaotic, disorganized ventricular activity with no discernible
QRS complexes.
A. Ventricular tachycardia
B. Asystole
C. Ventricular fibrillation
D. PEA
