Allied Health EKG Technician Exam Prep 2026 | 280+ Verified Questions & Detailed Rationales

Allied Health EKG Technician Exam Prep 2026 |
280+ Verified Questions & Detailed Rationales
Allied Health EKG Technician Exam Prep 2026

280 Verified Questions & Detailed RATIONALE




SECTION 1: COMPLEX CARDIAC CONCEPTS & ADVANCED RHYTHM
INTERPRETATION


Question 1 A patient's EKG shows a regular rhythm with a rate of 150 bpm, narrow
QRS complexes, and no visible P waves. Suddenly, the rhythm terminates and reverts
to normal sinus rhythm. Which of the following BEST describes this rhythm?

A) Atrial flutter with 2:1 block

B) Accelerated junctional rhythm
C) Ventricular tachycardia

D) Paroxysmal supraventricular tachycardia (PSVT)

E) Sinus tachycardia

CORRECT ANSWER: D RATIONALE: PSVT is characterized by a sudden
onset and abrupt termination of a rapid, regular rhythm (150–250 bpm) with narrow
QRS complexes and absent or retrograde P waves. Its paroxysmal (sudden start/stop)
nature differentiates it from sinus tachycardia, and the narrow QRS rules out ventricular
tachycardia.


Question 2 On a 12-lead EKG, ST-segment elevation is noted in leads II, III, and aVF
with reciprocal ST depression in leads I and aVL. Which coronary artery is MOST likely
occluded?

A) Left anterior descending artery (LAD)

B) Left circumflex artery (LCx)

C) Left main coronary artery

D) Right coronary artery (RCA)

E) Diagonal branch of the LAD

, CORRECT ANSWER: D RATIONALE: Leads II, III, and aVF represent the
inferior wall of the left ventricle, which is predominantly supplied by the Right Coronary
Artery (RCA). ST elevation in these leads with reciprocal changes in I and aVL is classic
for an inferior STEMI caused by RCA occlusion.


Question 3 An EKG strip shows a PR interval of 0.32 seconds that remains constant,
with a regular P-to-P and R-to-R interval. Every P wave is followed by a QRS complex.
Which conduction abnormality is present?

A) Second-degree AV block, Mobitz Type I (Wenckebach)

B) Second-degree AV block, Mobitz Type II
C) Third-degree (complete) AV block

D) First-degree AV block

E) Accelerated idioventricular rhythm

CORRECT ANSWER: D RATIONALE: First-degree AV block is defined by a
PR interval greater than 0.20 seconds (0.32 seconds here) that is constant with every
beat. Every P wave conducts to a QRS, ruling out second- or third-degree block. It
represents a conduction delay in the AV node, not a true block.


Question 4 A patient presents with syncope. The EKG shows intermittent dropped QRS
complexes, a constant PR interval before each conducted beat, and no progressive PR
prolongation. Which rhythm is MOST dangerous and requires immediate intervention?
A) First-degree AV block
B) Second-degree AV block Mobitz Type I

C) Second-degree AV block Mobitz Type II

D) Accelerated junctional rhythm

E) Wandering atrial pacemaker

CORRECT ANSWER: C RATIONALE: Mobitz Type II is characterized by a
constant PR interval with sudden, unexpected dropped QRS complexes. It is more
dangerous than Mobitz Type I because it frequently progresses to complete (third-
degree) heart block without warning, often requiring permanent pacemaker
implantation.

,Question 5 An EKG shows P waves and QRS complexes that are completely
dissociated, with a ventricular rate of 38 bpm and wide QRS complexes. The atrial rate
is 80 bpm. What rhythm is this?

A) Second-degree AV block, Mobitz Type II

B) Junctional rhythm with aberrant conduction

C) Accelerated idioventricular rhythm

D) Third-degree (complete) AV block with ventricular escape

E) Ventricular fibrillation

CORRECT ANSWER: D RATIONALE: Complete heart block shows total
dissociation between atrial and ventricular activity. The atria fire independently (80 bpm)
and the ventricles are driven by a ventricular escape pacemaker (20–40 bpm),
producing wide QRS complexes. This is a life-threatening emergency requiring
pacemaker insertion.



Question 6 A delta wave, short PR interval, and wide QRS complex are identified on an
EKG. The patient complains of palpitations and episodes of rapid heart rate. This
pattern is MOST consistent with which syndrome?

A) Brugada syndrome

B) Long QT syndrome

C) Lown-Ganong-Levine syndrome

D) Wolff-Parkinson-White (WPW) syndrome

E) Short QT syndrome

CORRECT ANSWER: D RATIONALE: WPW syndrome is characterized by
the triad of a delta wave (slurred upstroke of the QRS), a shortened PR interval (<0.12
sec), and a widened QRS complex. These findings result from ventricular pre-excitation
via an accessory pathway (Bundle of Kent) that bypasses the AV node.



Question 7 A 12-lead EKG shows ST elevation in leads V1–V4, with new left bundle
branch block in a patient presenting with crushing chest pain. What is the MOST
appropriate immediate action?

, A) Repeat the EKG in 30 minutes

B) Administer oral aspirin and observe

C) Perform a stress test

D) Activate the cardiac catheterization lab for primary PCI

E) Obtain a chest X-ray first

CORRECT ANSWER: D RATIONALE: ST elevation in V1–V4 indicates an
anterior STEMI, likely involving the LAD artery. New LBBB in the context of chest pain is
treated as a STEMI equivalent. The standard of care is emergent primary percutaneous
coronary intervention (PCI) within 90 minutes of first medical contact (door-to-balloon
time).



Question 8 An EKG shows an irregular rhythm with no discernible P waves, and
instead shows a chaotic, irregular baseline. QRS complexes are narrow and occur at
irregular intervals. What is this rhythm?

A) Atrial flutter

B) Multifocal atrial tachycardia

C) Ventricular fibrillation

D) Atrial fibrillation

E) Supraventricular tachycardia

CORRECT ANSWER: D RATIONALE: Atrial fibrillation (AF) presents with an
irregularly irregular rhythm, absence of distinct P waves replaced by a chaotic/fibrillatory
baseline (f-waves), and narrow QRS complexes (unless aberrant conduction exists).
The irregular ventricular response is a hallmark distinguishing it from other
supraventricular tachycardias.



Question 9 During EKG acquisition, you notice artifact that mimics atrial flutter with a
"sawtooth" pattern but occurs at exactly 60 cycles/second. What is the MOST likely
cause?

A) Patient movement
B) Loose electrode