NCLEX Dysrhythmias & EKG Interpretation Exam Questions and Answers

175 Questions and Answers

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Prepare confidently for your NCLEX exam with this expertly designed set of NCLEX Dysrhythmias & EKG Interpretation Exam Questions and Answers. This practice resource offers comprehensive coverage of essential cardiac rhythm topics, equipping nursing students and aspiring RNs with the clinical accuracy and test-taking skills needed to succeed.

Inside this practice test, you’ll find:

  • In-depth questions on cardiac conduction system and rhythm interpretation

  • Common dysrhythmias: atrial fibrillation, ventricular tachycardia, bradycardia, heart blocks, and more

  • Step-by-step EKG interpretation strategies

  • Clinical manifestations and priority nursing interventions for abnormal rhythms

  • Pharmacologic management including antiarrhythmics, beta-blockers, calcium channel blockers

  • Emergency responses to life-threatening arrhythmias

  • Holistic care strategies including patient education and monitoring

  • Practice scenarios to build critical thinking and clinical decision-making skills

  • Detailed rationales explaining both correct and incorrect choices

Each question reflects NCLEX-style formatting and complexity, allowing you to apply theoretical knowledge to practical scenarios with confidence.

Sample Questions and Answers

  1. Which of the following EKG findings is characteristic of atrial fibrillation?
  • A) Wide QRS complex
  • B) Irregularly irregular rhythm
  • C) P waves are visible
  • D) QRS complexes are absent
  • Answer: B) Irregularly irregular rhythm
  1. What is the hallmark of ventricular tachycardia on an EKG?
  • A) P wave before each QRS
  • B) Fast, wide QRS complexes
  • C) Shortened PR interval
  • D) Absence of QRS complexes
  • Answer: B) Fast, wide QRS complexes
  1. Which of the following is a sign of a third-degree AV block?
  • A) Prolonged PR interval
  • B) Regular P to QRS ratio
  • C) No relation between P waves and QRS complexes
  • D) T wave inversion
  • Answer: C) No relation between P waves and QRS complexes
  1. What is the first-line treatment for atrial fibrillation with rapid ventricular response?
  • A) Beta-blockers
  • B) Anticoagulants
  • C) Defibrillation
  • D) Amiodarone
  • Answer: A) Beta-blockers
  1. Which of the following is characteristic of a normal sinus rhythm?
  • A) Heart rate 100-150 bpm
  • B) Regular rhythm, P wave before each QRS
  • C) P wave absent
  • D) QRS complexes greater than 0.12 seconds
  • Answer: B) Regular rhythm, P wave before each QRS
  1. In an EKG, what does the QRS complex represent?
  • A) Atrial depolarization
  • B) Ventricular depolarization
  • C) Atrial repolarization
  • D) Ventricular repolarization
  • Answer: B) Ventricular depolarization
  1. What is the characteristic EKG finding in hyperkalemia?
  • A) Tall, peaked T waves
  • B) Prolonged QT interval
  • C) Shortened PR interval
  • D) Small P waves
  • Answer: A) Tall, peaked T waves
  1. Which of the following is the most appropriate treatment for ventricular fibrillation?
  • A) Administer atropine
  • B) Cardioversion
  • C) Defibrillation
  • D) Lidocaine infusion
  • Answer: C) Defibrillation
  1. What does a prolonged QT interval increase the risk of?
  • A) Bradycardia
  • B) Tachycardia
  • C) Torsades de pointes
  • D) Atrial fibrillation
  • Answer: C) Torsades de pointes
  1. Which of the following is the most common cause of sinus bradycardia?
  • A) Vagal stimulation
  • B) Hyperthyroidism
  • C) Drug overdose
  • D) Increased sympathetic stimulation
  • Answer: A) Vagal stimulation
  1. A prolonged PR interval on an EKG indicates which type of heart block?
  • A) First-degree AV block
  • B) Second-degree AV block Type I
  • C) Second-degree AV block Type II
  • D) Third-degree AV block
  • Answer: A) First-degree AV block
  1. In an EKG strip, what does the T wave represent?
  • A) Ventricular depolarization
  • B) Atrial depolarization
  • C) Ventricular repolarization
  • D) Atrial repolarization
  • Answer: C) Ventricular repolarization
  1. What is the primary treatment for supraventricular tachycardia (SVT)?
  • A) Cardioversion
  • B) Vagal maneuvers
  • C) Epinephrine administration
  • D) Defibrillation
  • Answer: B) Vagal maneuvers
  1. What is the primary concern when assessing a patient with a third-degree heart block?
  • A) Low blood pressure
  • B) Bradycardia and reduced cardiac output
  • C) Tachycardia
  • D) Elevated heart rate
  • Answer: B) Bradycardia and reduced cardiac output
  1. What is the classic appearance of “sawtooth” waves in an EKG?
  • A) Atrial flutter
  • B) Atrial fibrillation
  • C) Ventricular fibrillation
  • D) Sinus tachycardia
  • Answer: A) Atrial flutter
  1. Which EKG finding is indicative of a myocardial infarction?
  • A) ST segment depression
  • B) Shortened PR interval
  • C) ST segment elevation
  • D) Inverted P waves
  • Answer: C) ST segment elevation
  1. What does the U wave typically represent in an EKG?
  • A) Ventricular depolarization
  • B) Atrial depolarization
  • C) Repolarization of the Purkinje fibers
  • D) Ventricular repolarization
  • Answer: C) Repolarization of the Purkinje fibers
  1. What is the primary treatment for atrial fibrillation with rapid ventricular response?
  • A) Digoxin
  • B) Anticoagulants
  • C) Beta-blockers or calcium channel blockers
  • D) Amiodarone
  • Answer: C) Beta-blockers or calcium channel blockers
  1. What does a P wave represent on an EKG?
  • A) Atrial depolarization
  • B) Ventricular depolarization
  • C) Ventricular repolarization
  • D) Atrial repolarization
  • Answer: A) Atrial depolarization
  1. Which EKG rhythm is characterized by an absent P wave and a wide QRS complex?
  • A) Atrial fibrillation
  • B) Premature ventricular complex
  • C) Ventricular tachycardia
  • D) Junctional rhythm
  • Answer: C) Ventricular tachycardia
  1. Which of the following is a risk factor for developing atrial fibrillation?
  • A) Hyperthyroidism
  • B) Hypertension
  • C) Coronary artery disease
  • D) All of the above
  • Answer: D) All of the above
  1. What is the purpose of administering atropine in the case of bradycardia?
  • A) Increase heart rate
  • B) Lower blood pressure
  • C) Slow down conduction
  • D) Decrease heart rate
  • Answer: A) Increase heart rate
  1. What is the primary intervention for patients with symptomatic bradycardia?
  • A) Amiodarone administration
  • B) IV fluids
  • C) Atropine administration
  • D) External defibrillation
  • Answer: C) Atropine administration
  1. What is the effect of digitalis toxicity on the heart rhythm?
  • A) Sinus tachycardia
  • B) Sinus bradycardia and AV block
  • C) Ventricular fibrillation
  • D) Atrial fibrillation
  • Answer: B) Sinus bradycardia and AV block
  1. Which of the following is an indication for synchronized cardioversion?
  • A) Ventricular fibrillation
  • B) Atrial fibrillation
  • C) Asystole
  • D) Pulseless electrical activity
  • Answer: B) Atrial fibrillation
  1. What does a prolonged QT interval indicate?
  • A) Increased risk of sudden death from arrhythmia
  • B) Increased risk of stroke
  • C) Increased heart rate
  • D) Decreased risk of arrhythmias
  • Answer: A) Increased risk of sudden death from arrhythmia
  1. Which EKG rhythm is characterized by a “regularly irregular” pattern?
  • A) Atrial fibrillation
  • B) Ventricular tachycardia
  • C) Premature atrial contractions
  • D) Sinus arrhythmia
  • Answer: D) Sinus arrhythmia
  1. What is a common cause of a U wave in an EKG?
  • A) Hyperkalemia
  • B) Hypokalemia
  • C) Hypercalcemia
  • D) Hypocalcemia
  • Answer: B) Hypokalemia
  1. What is the primary cause of a myocardial infarction-related arrhythmia?
  • A) Tissue ischemia
  • B) Increased sympathetic tone
  • C) Decreased parasympathetic tone
  • D) Hypoxia
  • Answer: A) Tissue ischemia
  1. Which of the following is a classic symptom of a PVC (Premature Ventricular Contraction)?
  • A) Skipped heartbeat
  • B) Increased heart rate
  • C) Chest pain
  • D) Low blood pressure
  • Answer: A) Skipped heartbeat

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