Relias DYSRHYTHMIA BASIC A Exam (2026/2027) Exam Elaboration Questions and Answers Graded A+| 100% Correct Answers 2026/2027 2026/2027 | Page 1 | Passing Score: 85%
RELIAS
Relias DYSRHYTHMIA BASIC A Exam (2026/2027) Exam
Elaboration Questions and Answers Graded A+| 100% Correct
DYSRHYTHMIA BASIC A Official Exam 2026/2027
Answers 2026/2027
100 85% CERTIFIED
QUESTIONS PASSING SCORE RECERTIFICATION
TABLE OF CONTENTS
Section 1 Cardiac Anatomy, Physiology & Electrophysiology Q1-Q20
Section 2 Sinus Rhythms & Dysrhythmias Q21-Q40
Section 3 Atrial Dysrhythmias Q41-Q60
Section 4 Ventricular Dysrhythmias & Heart Blocks Q61-Q80
Section 5 ACLS Interventions, Pharmacology & Patient Management Q81-Q100
Instructions: Select the single best answer for each question. This exam is designed for Relias Dysrhythmia Basic A
certification preparation. Passing score: 85% (85 questions correct).
Relias DYSRHYTHMIA BASIC A Exam (2026/2027) Exam Elaboration Questions and Answers Graded A+| 100% Correct Answers 2026/2027 - 2026/2027 | Passing Score: 85% | Page 1 of 37
, SECTION 1 | Cardiac Anatomy, Physiology & Electrophysiology | Q1-Q20 | Relias DYSRHYTHMIA BASIC A Exam (2026/2027) Exam Elaboration
Questions and Answers Graded A+| 100% Correct Answers 2026/2027 2026/2027
Q1 Question 1 of 100Question 1 of 100
A 54-year-old male is admitted to the telemetry unit after presenting with chest discomfort and palpitations.
The nurse reviews the cardiac conduction system and recalls that electrical impulses normally originate in
the sinoatrial (SA) node. What is the primary reason the SA node is considered the heart's natural
pacemaker?
A. It has the fastest intrinsic firing rate of all cardiac pacemaker cells
B. It is the only structure capable of generating electrical impulses
C. It receives direct parasympathetic innervation exclusively
D. It is located in the interventricular septum near the AV node
Correct Answer: A
Rationale:
The SA node has the highest intrinsic firing rate (60-100 bpm), which allows it to dominate slower pacemakers like the
AV node (40-60 bpm) and Purkinje fibers (20-40 bpm). It is not the only impulse-generating structure; other pacemaker
cells exist but fire more slowly.
Q2 Question 2 of 100Question 2 of 100
A 62-year-old female undergoes an electrophysiology study that reveals a prolonged PR interval on her
ECG. The cardiologist explains that the PR interval represents atrial depolarization and the delay at the
atrioventricular (AV) node. What is the primary physiological purpose of the AV nodal delay?
A. To prevent retrograde conduction from the ventricles to the atria
B. To allow sufficient time for ventricular filling before contraction
C. To increase the force of atrial contraction against closed valves
D. To synchronize left and right ventricular depolarization
Correct Answer: B
Rationale:
The AV nodal delay (0.1 seconds) allows the atria to complete contraction and empty their blood into the ventricles
before ventricular systole begins. While the AV node does prevent retrograde conduction, this is not the primary
purpose of the delay.
Q3 Question 3 of 100Question 3 of 100
A 48-year-old patient in the ICU has a heart rate of 45 bpm with a regular rhythm. The nurse identifies this
as a junctional rhythm originating from the AV node. At what intrinsic firing rate does the AV junction
normally generate impulses?
A. 60 to 100 beats per minute
B. 20 to 40 beats per minute
C. 40 to 60 beats per minute
D. 80 to 120 beats per minute
Correct Answer: C
Rationale:
The AV junction has an intrinsic firing rate of 40-60 bpm. Rates of 20-40 bpm belong to Purkinje fibers, and 60-100
bpm is the SA node rate. The junctional escape rhythm at 45 bpm is consistent with AV node pacemaker activity.
Relias DYSRHYTHMIA BASIC A Exam (2026/2027) Exam Elaboration Questions and Answers Graded A+| 100% Correct Answers 2026/2027 - 2026/2027 | Passing Score: 85% | Page 2 of 37
, Q4 Question 4 of 100Question 4 of 100
A nursing student is reviewing the cardiac action potential and asks why Phase 2 (the plateau phase) is
critical for cardiac muscle function. Which explanation best describes the significance of the plateau
phase?
A. It shortens the action potential duration during sympathetic stimulation
B. It allows rapid repolarization to facilitate high heart rates
C. It generates the mechanical force for atrial contraction only
D. It prevents tetanic contraction by prolonging refractoriness
Correct Answer: D
Rationale:
The plateau phase (Phase 2) of the cardiac action potential is caused by calcium influx through L-type calcium
channels. This prolonged depolarization creates a long refractory period that prevents tetanic contraction, which would
be fatal for cardiac pump function. Rapid repolarization actually describes Phase 3.
Q5 Question 5 of 100Question 5 of 100
A 71-year-old man with a history of myocardial infarction presents with wide QRS complexes on his ECG.
The provider explains that the QRS complex represents ventricular depolarization. What is the normal
duration of the QRS complex in a healthy adult?
A. 0.06 to 0.10 seconds
B. 0.12 to 0.20 seconds
C. 0.20 to 0.30 seconds
D. 0.04 to 0.06 seconds
Correct Answer: A
Rationale:
The normal QRS duration is 0.06-0.10 seconds. A QRS greater than 0.12 seconds indicates a bundle branch block or
ventricular origin. The PR interval normally ranges from 0.12-0.20 seconds, which is a different measurement.
Q6 Question 6 of 100Question 6 of 100
A 58-year-old woman with a newly implanted pacemaker asks why her device is programmed to fire at 60
bpm. The nurse explains the concept of overdrive suppression. Which statement best describes this
principle?
A. A slower pacemaker suppresses faster ectopic foci by generating a more stable rhythm
B. A faster pacemaker suppresses slower pacemakers by depolarizing them before they can fire
spontaneously
C. The autonomic nervous system suppresses all pacemaker activity during rest
D. Mechanical compression from surrounding tissue suppresses pacemaker firing
Correct Answer: B
Rationale:
Overdrive suppression occurs when a faster pacemaker (like the SA node) depolarizes slower pacemakers before they
reach their threshold potential, effectively resetting their firing cycle. This prevents competing rhythms and maintains a
single dominant pacemaker.
Relias DYSRHYTHMIA BASIC A Exam (2026/2027) Exam Elaboration Questions and Answers Graded A+| 100% Correct Answers 2026/2027 - 2026/2027 | Passing Score: 85% | Page 3 of 37
, Q7 Question 7 of 100Question 7 of 100
A 65-year-old male with chronic kidney disease presents with peaked T waves and a widened QRS
complex on his ECG. The nurse suspects hyperkalemia. How does elevated serum potassium affect
cardiac cell resting membrane potential?
A. It has no effect on resting membrane potential but slows impulse conduction
B. It makes the resting membrane potential more negative, moving it further from threshold
C. It makes the resting membrane potential less negative, moving it closer to threshold
D. It increases the action potential duration without affecting the resting potential
Correct Answer: C
Rationale:
Hyperkalemia reduces the potassium concentration gradient across the cell membrane, making the resting membrane
potential less negative (partially depolarized). This moves cells closer to threshold initially but eventually slows
conduction as sodium channels become inactivated.
Q8 Question 8 of 100Question 8 of 100
A 42-year-old patient undergoing cardiac monitoring has a QTc interval of 0.52 seconds. The nurse
recognizes this as prolonged and consults the medication list for QT-prolonging agents. What is the normal
upper limit for the corrected QT interval in adult females?
A. 0.52 seconds
B. 0.44 seconds
C. 0.50 seconds
D. 0.46 seconds
Correct Answer: D
Rationale:
The normal QTc upper limit is 0.44 seconds in males and 0.46 seconds in females. A QTc greater than 0.50 seconds
significantly increases the risk of torsades de pointes. The patient's QTc of 0.52 seconds is dangerously prolonged.
Q9 Question 9 of 100Question 9 of 100
A 39-year-old nurse is studying the autonomic innervation of the heart for a certification exam. She
understands that sympathetic stimulation increases heart rate and contractility. Through which mechanism
does the sympathetic nervous system primarily increase heart rate?
A. Increasing the slope of Phase 4 depolarization in SA node cells
B. Decreasing the resting membrane potential in ventricular myocytes
C. Blocking potassium channels in the Purkinje fiber network
D. Increasing calcium reuptake into the sarcoplasmic reticulum
Correct Answer: A
Rationale:
Sympathetic stimulation releases norepinephrine, which activates beta-1 receptors, increasing cAMP and enhancing
the funny current (If) in SA node cells. This steepens the Phase 4 depolarization slope, causing the SA node to reach
threshold faster and fire more frequently.
Relias DYSRHYTHMIA BASIC A Exam (2026/2027) Exam Elaboration Questions and Answers Graded A+| 100% Correct Answers 2026/2027 - 2026/2027 | Passing Score: 85% | Page 4 of 37
RELIAS
Relias DYSRHYTHMIA BASIC A Exam (2026/2027) Exam
Elaboration Questions and Answers Graded A+| 100% Correct
DYSRHYTHMIA BASIC A Official Exam 2026/2027
Answers 2026/2027
100 85% CERTIFIED
QUESTIONS PASSING SCORE RECERTIFICATION
TABLE OF CONTENTS
Section 1 Cardiac Anatomy, Physiology & Electrophysiology Q1-Q20
Section 2 Sinus Rhythms & Dysrhythmias Q21-Q40
Section 3 Atrial Dysrhythmias Q41-Q60
Section 4 Ventricular Dysrhythmias & Heart Blocks Q61-Q80
Section 5 ACLS Interventions, Pharmacology & Patient Management Q81-Q100
Instructions: Select the single best answer for each question. This exam is designed for Relias Dysrhythmia Basic A
certification preparation. Passing score: 85% (85 questions correct).
Relias DYSRHYTHMIA BASIC A Exam (2026/2027) Exam Elaboration Questions and Answers Graded A+| 100% Correct Answers 2026/2027 - 2026/2027 | Passing Score: 85% | Page 1 of 37
, SECTION 1 | Cardiac Anatomy, Physiology & Electrophysiology | Q1-Q20 | Relias DYSRHYTHMIA BASIC A Exam (2026/2027) Exam Elaboration
Questions and Answers Graded A+| 100% Correct Answers 2026/2027 2026/2027
Q1 Question 1 of 100Question 1 of 100
A 54-year-old male is admitted to the telemetry unit after presenting with chest discomfort and palpitations.
The nurse reviews the cardiac conduction system and recalls that electrical impulses normally originate in
the sinoatrial (SA) node. What is the primary reason the SA node is considered the heart's natural
pacemaker?
A. It has the fastest intrinsic firing rate of all cardiac pacemaker cells
B. It is the only structure capable of generating electrical impulses
C. It receives direct parasympathetic innervation exclusively
D. It is located in the interventricular septum near the AV node
Correct Answer: A
Rationale:
The SA node has the highest intrinsic firing rate (60-100 bpm), which allows it to dominate slower pacemakers like the
AV node (40-60 bpm) and Purkinje fibers (20-40 bpm). It is not the only impulse-generating structure; other pacemaker
cells exist but fire more slowly.
Q2 Question 2 of 100Question 2 of 100
A 62-year-old female undergoes an electrophysiology study that reveals a prolonged PR interval on her
ECG. The cardiologist explains that the PR interval represents atrial depolarization and the delay at the
atrioventricular (AV) node. What is the primary physiological purpose of the AV nodal delay?
A. To prevent retrograde conduction from the ventricles to the atria
B. To allow sufficient time for ventricular filling before contraction
C. To increase the force of atrial contraction against closed valves
D. To synchronize left and right ventricular depolarization
Correct Answer: B
Rationale:
The AV nodal delay (0.1 seconds) allows the atria to complete contraction and empty their blood into the ventricles
before ventricular systole begins. While the AV node does prevent retrograde conduction, this is not the primary
purpose of the delay.
Q3 Question 3 of 100Question 3 of 100
A 48-year-old patient in the ICU has a heart rate of 45 bpm with a regular rhythm. The nurse identifies this
as a junctional rhythm originating from the AV node. At what intrinsic firing rate does the AV junction
normally generate impulses?
A. 60 to 100 beats per minute
B. 20 to 40 beats per minute
C. 40 to 60 beats per minute
D. 80 to 120 beats per minute
Correct Answer: C
Rationale:
The AV junction has an intrinsic firing rate of 40-60 bpm. Rates of 20-40 bpm belong to Purkinje fibers, and 60-100
bpm is the SA node rate. The junctional escape rhythm at 45 bpm is consistent with AV node pacemaker activity.
Relias DYSRHYTHMIA BASIC A Exam (2026/2027) Exam Elaboration Questions and Answers Graded A+| 100% Correct Answers 2026/2027 - 2026/2027 | Passing Score: 85% | Page 2 of 37
, Q4 Question 4 of 100Question 4 of 100
A nursing student is reviewing the cardiac action potential and asks why Phase 2 (the plateau phase) is
critical for cardiac muscle function. Which explanation best describes the significance of the plateau
phase?
A. It shortens the action potential duration during sympathetic stimulation
B. It allows rapid repolarization to facilitate high heart rates
C. It generates the mechanical force for atrial contraction only
D. It prevents tetanic contraction by prolonging refractoriness
Correct Answer: D
Rationale:
The plateau phase (Phase 2) of the cardiac action potential is caused by calcium influx through L-type calcium
channels. This prolonged depolarization creates a long refractory period that prevents tetanic contraction, which would
be fatal for cardiac pump function. Rapid repolarization actually describes Phase 3.
Q5 Question 5 of 100Question 5 of 100
A 71-year-old man with a history of myocardial infarction presents with wide QRS complexes on his ECG.
The provider explains that the QRS complex represents ventricular depolarization. What is the normal
duration of the QRS complex in a healthy adult?
A. 0.06 to 0.10 seconds
B. 0.12 to 0.20 seconds
C. 0.20 to 0.30 seconds
D. 0.04 to 0.06 seconds
Correct Answer: A
Rationale:
The normal QRS duration is 0.06-0.10 seconds. A QRS greater than 0.12 seconds indicates a bundle branch block or
ventricular origin. The PR interval normally ranges from 0.12-0.20 seconds, which is a different measurement.
Q6 Question 6 of 100Question 6 of 100
A 58-year-old woman with a newly implanted pacemaker asks why her device is programmed to fire at 60
bpm. The nurse explains the concept of overdrive suppression. Which statement best describes this
principle?
A. A slower pacemaker suppresses faster ectopic foci by generating a more stable rhythm
B. A faster pacemaker suppresses slower pacemakers by depolarizing them before they can fire
spontaneously
C. The autonomic nervous system suppresses all pacemaker activity during rest
D. Mechanical compression from surrounding tissue suppresses pacemaker firing
Correct Answer: B
Rationale:
Overdrive suppression occurs when a faster pacemaker (like the SA node) depolarizes slower pacemakers before they
reach their threshold potential, effectively resetting their firing cycle. This prevents competing rhythms and maintains a
single dominant pacemaker.
Relias DYSRHYTHMIA BASIC A Exam (2026/2027) Exam Elaboration Questions and Answers Graded A+| 100% Correct Answers 2026/2027 - 2026/2027 | Passing Score: 85% | Page 3 of 37
, Q7 Question 7 of 100Question 7 of 100
A 65-year-old male with chronic kidney disease presents with peaked T waves and a widened QRS
complex on his ECG. The nurse suspects hyperkalemia. How does elevated serum potassium affect
cardiac cell resting membrane potential?
A. It has no effect on resting membrane potential but slows impulse conduction
B. It makes the resting membrane potential more negative, moving it further from threshold
C. It makes the resting membrane potential less negative, moving it closer to threshold
D. It increases the action potential duration without affecting the resting potential
Correct Answer: C
Rationale:
Hyperkalemia reduces the potassium concentration gradient across the cell membrane, making the resting membrane
potential less negative (partially depolarized). This moves cells closer to threshold initially but eventually slows
conduction as sodium channels become inactivated.
Q8 Question 8 of 100Question 8 of 100
A 42-year-old patient undergoing cardiac monitoring has a QTc interval of 0.52 seconds. The nurse
recognizes this as prolonged and consults the medication list for QT-prolonging agents. What is the normal
upper limit for the corrected QT interval in adult females?
A. 0.52 seconds
B. 0.44 seconds
C. 0.50 seconds
D. 0.46 seconds
Correct Answer: D
Rationale:
The normal QTc upper limit is 0.44 seconds in males and 0.46 seconds in females. A QTc greater than 0.50 seconds
significantly increases the risk of torsades de pointes. The patient's QTc of 0.52 seconds is dangerously prolonged.
Q9 Question 9 of 100Question 9 of 100
A 39-year-old nurse is studying the autonomic innervation of the heart for a certification exam. She
understands that sympathetic stimulation increases heart rate and contractility. Through which mechanism
does the sympathetic nervous system primarily increase heart rate?
A. Increasing the slope of Phase 4 depolarization in SA node cells
B. Decreasing the resting membrane potential in ventricular myocytes
C. Blocking potassium channels in the Purkinje fiber network
D. Increasing calcium reuptake into the sarcoplasmic reticulum
Correct Answer: A
Rationale:
Sympathetic stimulation releases norepinephrine, which activates beta-1 receptors, increasing cAMP and enhancing
the funny current (If) in SA node cells. This steepens the Phase 4 depolarization slope, causing the SA node to reach
threshold faster and fire more frequently.
Relias DYSRHYTHMIA BASIC A Exam (2026/2027) Exam Elaboration Questions and Answers Graded A+| 100% Correct Answers 2026/2027 - 2026/2027 | Passing Score: 85% | Page 4 of 37
