EKG Practice Test for the Nurse Practitioner and Physician Assistant

Last Updated on March 28, 2025

EKG Practice Test for the Nurse Practitioner and Physician Assistant. There are 30 multiple-choice questions on EKG. Each question has four choices. Select one correct choice. You can check your score at the end of the quiz.

It is imperative to implement a systematic approach to EKG interpretation. There are five main areas to master. They are rate, rhythm, axis, block, and infarction. If you review each EKG and identify and appropriately interpret these five areas, you will know everything you need to know about that EKG.

The next critical point to master after calculating the heart rate is the evaluation of the rhythm. This can be done by establishing the presence or absence of regularly occurring QRS complexes. Simply put, evaluate if the rhythm is regular or irregular. Using calipers, march from R wave to R wave across the EKG. If the QRS complexes march out at even intervals across the page, the rhythm is regular (EKG 5.1).

A rhythm is irregular if it has a variation (EKG 5.2). An irregular rhythm is not necessarily pathologic. This chapter focuses on identifying and classifying irregular rhythms as normal or abnormal. If a rhythm is identified as irregular, it must be further classified as regularly irregular or irregularly irregular. These points are accomplished by adequately identifying the presence or absence of patterns and evaluating the P wave.

EKG Practice Test for the Nurse Practitioner and Physician Assistant

EKG Practice Test

EKG Practice Test
For the Nurse Practitioner and Physician Assistant Exam
Total Items: 30
Time Limit: N/A

1) Left posterior fascicular block (LPFB) causes which type of axis deviation?

A) Normal axis

B) Extreme axis deviation

C) Left axis deviation

D) Right axis deviation

2) What is the effect of increased vagal tone on heart rate?

A) No significant change

B) Decrease the heart rate

C) Cause an unpredictable fluctuation

D) Increase the heart rate

3) A ventricular escape focus typically fires at a rate between:

A) 100 and 140 bpm

B) 60 and 100 bpm

C) 40 and 60 bpm

D) 20 and 40 bpm

4) Assuming a 10-second rhythm strip, a calculated heart rate of 36 bpm most likely indicates a rhythm originating from:

A) The AV node

B) The ventricles

C) The sinus node

D) Atrial tissue

5) Which type of second-degree AV block carries more immediate concern due to a higher risk of progression to complete heart block?

A) Third-degree AV block

B) First-degree AV block

C) Mobitz type I second-degree AV block

D) Mobitz type II second-degree AV block

6) An interventricular conduction delay is defined by a QRS duration greater than _______ milliseconds and less than _______ milliseconds.

A) 120 and 140 ms

B) 80 and 100 ms

C) 100 and 120 ms

D) 140 and 160 ms

7) Define the type of conduction delay present in this EKG.

A) Right bundle branch block

B) Left anterior fascicular block

C) Left bundle branch block

D) Mobitz type I AV block

8) Define the type of conduction delay present in this EKG.

A) Left bundle branch block

B) First-degree AV block

C) Right bundle branch block

D) Left anterior fascicular block

9) Relative to the surrounding beats, premature ventricular contractions (PVCs) will display a QRS complex that is:

A) Identical in width

B) Narrow

C) Variable in width

D) Wide

10) An EKG is described as having a normal axis if the mean QRS vector lies between ______ and ______ degrees.

A) –90 and –180 degrees

B) 0 and –90 degrees

C) 0 and +90 degrees

D) +90 and +180 degrees

11) The four axis quadrants are created by the intersection of which two leads?

A) Lead II and aVF

B) Lead I and aVL

C) Lead I and aVF

D) Lead III and aVR

12) In which direction does the normal axis vector point?

A) Down and to the patient’s left

B) Directly leftward

C) Up and to the patient’s right

D) Directly upward

13) Which of the following results in more frequent premature atrial contractions (PACs)?

A) Atrial trigeminy

B) Both produce an equal frequency of PACs

C) Atrial bigeminy

D) Neither produces PACs

14) An EKG is described as having a right axis if the mean QRS vector lies between ______ and ______ degrees.

A) –180 and –90 degrees

B) –90 and 0 degrees

C) +90 and +180 degrees

D) 0 and +90 degrees

15) Left anterior fascicular block (LAFB) causes which type of axis deviation?

A) No axis deviation

B) Left axis deviation

C) Extreme axis deviation

D) Right axis deviation

16) Regarding a given rhythm strip, is a

A) Irregular

B) Irregularly irregular

C) Regular

D) Variable

17) Determine the heart rate of the patient in this rhythm strip, assuming it is a 10-second recording.

A) 90 bpm

B) 60 bpm

C) 70 bpm

D) 50 bpm

18) Calculate the heart rate of the patient in this rhythm strip utilizing the 300-150-100-75-60-50 method for determining heart rate. Is it originating from the sinus node, AV node, or in the ventricles?

A) 50 bpm, sinus node

B) 75 bpm, Ventricles

C) 60 bpm, AV node

D) 40 bpm, Atrial ectopic focus

19) A gradually lengthening PR interval followed by a dropped QRS complex and a subsequent shorter PR interval is diagnostic of which type of heart block?

A) First-degree AV block

B) Third-degree AV block

C) Mobitz type II second-degree AV block

D) Mobitz type I second-degree AV block

20) Define the type of conduction delay present in this EKG.

A) Left bundle branch block

B) Left anterior fascicular block

C) First-degree AV block

D) Right bundle branch block

21) Atrial fibrillation typically produces an _____ rhythm with a lack of clear ______.

A) Regular rhythm with clear P waves

B) Irregular rhythm with lack of clear P waves

C) Irregular rhythm with absence of QRS complexes

D) Regular rhythm with absent T waves

22) Which type of complete bundle branch block is more likely to be associated with structural heart disease?

A) Right bundle branch block

B) Left bundle branch block

C) Left anterior fascicular block

D) Incomplete bundle branch block

23) An AV nodal junctional focus typically fires at a rate between:

A) 100 and 120 bpm

B) 60 and 100 bpm

C) 40 and 60 bpm

D) 20 and 40 bpm

24) Dissociation of regular P waves from regular QRS complexes defines which type of heart block?

A) Third-degree (complete) AV block

B) Incomplete bundle branch block

C) Second-degree AV block (Mobitz type I)

D) First-degree AV block

25) Regarding a given rhythm strip, is a

A) Irregularly irregular

B) Slightly irregular

C) Regular

D) Consistently variable

26) AV dissociation is diagnostic of which type of premature beat?

A) Premature atrial contraction

B) Premature ventricular contraction

C) Premature sinus beat

D) Premature junctional contraction

27) An EKG is described as having a left axis if the mean QRS vector lies between ______ and ______ degrees.

A) +90 and +180 degrees

B) 0 and –90 degrees

C) –90 and –180 degrees

D) 0 and +90 degrees

28) Which type of complete bundle branch block is more likely to be seen in the setting of advanced pulmonary disease?

A) Right bundle branch block

B) Left bundle branch block

C) Left anterior fascicular block

D) First-degree AV block

29) Normal sinus activity occurs at a rate between:

A) 100 and 140 bpm

B) 60 and 100 bpm

C) 40 and 60 bpm

D) 20 and 40 bpm

30) A first-degree AV block is defined by a PR interval that is greater than:

A) 200 ms

B) 220 ms

C) 160 ms

D) 180 ms

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