BAYCARE HEALTH SYSTEM
EKG Test
Competency Exam
Official Practice Exam - 2026/2027 Edition
Questions Minutes Passing Score Recertification
50 90 80% Annual
TABLE OF CONTENTS
Section 1: Basic EKG Interpretation (15 Qs)
Section 2: Arrhythmia Recognition (15 Qs)
Section 3: Advanced EKG Concepts (12 Qs)
Section 4: EKG Clinical Application (8 Qs)
INSTRUCTIONS
2026/2027
This practiceEdition - Actual
exam contains Questions and
50 multiple-choice Verified
questions acrossAnswers - Competency
4 content areas Exam
aligned with the Prep
BayCare - A+ Graded
EKG
competency test plan. Each question presents a clinical scenario followed by four answer options. Select the single
best answer for each question. The correct answer and a detailed rationale are provided immediately after each
DISCLAIMER: This practice
question. A passing exam
score of 80%isoranhigher
independent study
is required (40resource and is not
of 50 questions affiliated
correct). with, endorsed
Allocate by, or90
approximately connected to
BayCare Health System. BayCare is a registered trademark of BayCare Health System. This
minutes to complete this exam under timed conditions for the most realistic practice experience. document is intended solely for
educational and practice purposes. Always refer to the official BayCare EKG competency materials for the most current
examination information.
BayCare EKG Test -- 2026/2027 | Passing Score: 80% | Page 1 of 27
,Section 1: Basic EKG Interpretation - 2026/2027 Edition
Q1 Question 1 of 50
A 58-year-old patient is admitted to the telemetry unit for chest pain monitoring. The nurse notes a
regular rhythm with a upright P wave before each QRS complex, a PR interval of 0.16 seconds, and a
heart rate of 75 beats per minute. The QRS duration measures 0.08 seconds and the T wave follows
each QRS normally. This rhythm strip is most consistent with what interpretation?
A. Sinus arrhythmia with normal conduction
B. Sinus bradycardia with first-degree AV block
C. Normal sinus rhythm with normal conduction intervals
D. Sinus tachycardia with shortened PR interval
Correct Answer: C
Rationale:
Normal sinus rhythm is characterized by a regular rate of 60-100 bpm, upright P waves preceding each
QRS, a normal PR interval (0.12-0.20 seconds), and a normal QRS duration (less than 0.12 seconds). The
top wrong answer is A because sinus arrhythmia would show irregular R-R intervals with variation during
respiration, and this strip is described as regular.
Q2 Question 2 of 50
A 72-year-old woman in the medical-surgical unit has a continuous cardiac monitor displaying a rhythm
that lacks visible P waves before each QRS complex. The nurse reviews the strip and notes the QRS
complexes are narrow at 0.08 seconds and occur at a rate of 88 per minute. The absence of P waves
in this context most likely indicates that the electrical impulse originated in what location?
A. The AV junction rather than the SA node
B. The ventricular myocardium rather than the AV node
C. The Bundle of His rather than the Purkinje fibers
D. The SA node with delayed atrial repolarization
Correct Answer: A
Rationale:
When P waves are absent and QRS complexes are narrow, the impulse most likely originated in the AV
junction (junctional rhythm), as junctional impulses produce narrow QRS complexes but may not produce
visible P waves. The top wrong answer is B because ventricular impulses would produce wide QRS
complexes greater than 0.12 seconds, not narrow ones.
BayCare EKG Test -- 2026/2027 | Passing Score: 80% | Page 2 of 27
, Q3 Question 3 of 50
A 45-year-old man presents to the emergency department with palpitations. The nurse obtains a
6-second rhythm strip and counts 9 R-R cycles within the 6-second period. Using the 6-second strip
method, what is the calculated heart rate?
A. 54 beats per minute
B. 90 beats per minute
C. 108 beats per minute
D. 150 beats per minute
Correct Answer: B
Rationale:
The 6-second strip method calculates heart rate by counting the number of QRS complexes in a 6-second
strip and multiplying by 10. Nine R-R cycles multiplied by 10 equals 90 beats per minute. The top wrong
answer is C, which would result from multiplying 9 by 12, incorrectly using a different time interval or
calculation method.
Q4 Question 4 of 50
A 63-year-old patient in the ICU has a rhythm strip showing a PR interval that measures 5 small boxes
on the ECG paper. The nurse understands that the PR interval represents the time from the onset of
atrial depolarization to the onset of ventricular depolarization. Based on this measurement, what is the
PR interval duration and what does it indicate?
A. 0.16 seconds and indicates a first-degree AV block
B. 0.12 seconds and indicates normal AV conduction
C. 0.10 seconds and indicates accelerated AV conduction
D. 0.20 seconds and indicates normal AV conduction
Correct Answer: D
Rationale:
Each small box on standard ECG paper represents 0.04 seconds, so 5 small boxes equals 0.20 seconds,
which falls within the normal PR interval range of 0.12-0.20 seconds and indicates normal AV conduction.
The top wrong answer is A because 0.16 seconds (4 small boxes) would also be normal, not indicative of
first-degree AV block, which requires a PR interval greater than 0.20 seconds.
BayCare EKG Test -- 2026/2027 | Passing Score: 80% | Page 3 of 27
EKG Test
Competency Exam
Official Practice Exam - 2026/2027 Edition
Questions Minutes Passing Score Recertification
50 90 80% Annual
TABLE OF CONTENTS
Section 1: Basic EKG Interpretation (15 Qs)
Section 2: Arrhythmia Recognition (15 Qs)
Section 3: Advanced EKG Concepts (12 Qs)
Section 4: EKG Clinical Application (8 Qs)
INSTRUCTIONS
2026/2027
This practiceEdition - Actual
exam contains Questions and
50 multiple-choice Verified
questions acrossAnswers - Competency
4 content areas Exam
aligned with the Prep
BayCare - A+ Graded
EKG
competency test plan. Each question presents a clinical scenario followed by four answer options. Select the single
best answer for each question. The correct answer and a detailed rationale are provided immediately after each
DISCLAIMER: This practice
question. A passing exam
score of 80%isoranhigher
independent study
is required (40resource and is not
of 50 questions affiliated
correct). with, endorsed
Allocate by, or90
approximately connected to
BayCare Health System. BayCare is a registered trademark of BayCare Health System. This
minutes to complete this exam under timed conditions for the most realistic practice experience. document is intended solely for
educational and practice purposes. Always refer to the official BayCare EKG competency materials for the most current
examination information.
BayCare EKG Test -- 2026/2027 | Passing Score: 80% | Page 1 of 27
,Section 1: Basic EKG Interpretation - 2026/2027 Edition
Q1 Question 1 of 50
A 58-year-old patient is admitted to the telemetry unit for chest pain monitoring. The nurse notes a
regular rhythm with a upright P wave before each QRS complex, a PR interval of 0.16 seconds, and a
heart rate of 75 beats per minute. The QRS duration measures 0.08 seconds and the T wave follows
each QRS normally. This rhythm strip is most consistent with what interpretation?
A. Sinus arrhythmia with normal conduction
B. Sinus bradycardia with first-degree AV block
C. Normal sinus rhythm with normal conduction intervals
D. Sinus tachycardia with shortened PR interval
Correct Answer: C
Rationale:
Normal sinus rhythm is characterized by a regular rate of 60-100 bpm, upright P waves preceding each
QRS, a normal PR interval (0.12-0.20 seconds), and a normal QRS duration (less than 0.12 seconds). The
top wrong answer is A because sinus arrhythmia would show irregular R-R intervals with variation during
respiration, and this strip is described as regular.
Q2 Question 2 of 50
A 72-year-old woman in the medical-surgical unit has a continuous cardiac monitor displaying a rhythm
that lacks visible P waves before each QRS complex. The nurse reviews the strip and notes the QRS
complexes are narrow at 0.08 seconds and occur at a rate of 88 per minute. The absence of P waves
in this context most likely indicates that the electrical impulse originated in what location?
A. The AV junction rather than the SA node
B. The ventricular myocardium rather than the AV node
C. The Bundle of His rather than the Purkinje fibers
D. The SA node with delayed atrial repolarization
Correct Answer: A
Rationale:
When P waves are absent and QRS complexes are narrow, the impulse most likely originated in the AV
junction (junctional rhythm), as junctional impulses produce narrow QRS complexes but may not produce
visible P waves. The top wrong answer is B because ventricular impulses would produce wide QRS
complexes greater than 0.12 seconds, not narrow ones.
BayCare EKG Test -- 2026/2027 | Passing Score: 80% | Page 2 of 27
, Q3 Question 3 of 50
A 45-year-old man presents to the emergency department with palpitations. The nurse obtains a
6-second rhythm strip and counts 9 R-R cycles within the 6-second period. Using the 6-second strip
method, what is the calculated heart rate?
A. 54 beats per minute
B. 90 beats per minute
C. 108 beats per minute
D. 150 beats per minute
Correct Answer: B
Rationale:
The 6-second strip method calculates heart rate by counting the number of QRS complexes in a 6-second
strip and multiplying by 10. Nine R-R cycles multiplied by 10 equals 90 beats per minute. The top wrong
answer is C, which would result from multiplying 9 by 12, incorrectly using a different time interval or
calculation method.
Q4 Question 4 of 50
A 63-year-old patient in the ICU has a rhythm strip showing a PR interval that measures 5 small boxes
on the ECG paper. The nurse understands that the PR interval represents the time from the onset of
atrial depolarization to the onset of ventricular depolarization. Based on this measurement, what is the
PR interval duration and what does it indicate?
A. 0.16 seconds and indicates a first-degree AV block
B. 0.12 seconds and indicates normal AV conduction
C. 0.10 seconds and indicates accelerated AV conduction
D. 0.20 seconds and indicates normal AV conduction
Correct Answer: D
Rationale:
Each small box on standard ECG paper represents 0.04 seconds, so 5 small boxes equals 0.20 seconds,
which falls within the normal PR interval range of 0.12-0.20 seconds and indicates normal AV conduction.
The top wrong answer is A because 0.16 seconds (4 small boxes) would also be normal, not indicative of
first-degree AV block, which requires a PR interval greater than 0.20 seconds.
BayCare EKG Test -- 2026/2027 | Passing Score: 80% | Page 3 of 27
