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

A) 140 and 160 ms

B) 120 and 140 ms

C) 100 and 120 ms

D) 80 and 100 ms

2) 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) 75 bpm, Ventricles

B) 50 bpm, sinus node

C) 60 bpm, AV node

D) 40 bpm, Atrial ectopic focus

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

A) Left bundle branch block

B) Right bundle branch block

C) Left anterior fascicular block

D) Incomplete bundle branch block

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

A) 0 and –90 degrees

B) –90 and –180 degrees

C) 0 and +90 degrees

D) +90 and +180 degrees

5) Regarding a given rhythm strip, is a

A) Slightly irregular

B) Regular

C) Irregularly irregular

D) Consistently variable

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

A) +90 and +180 degrees

B) –90 and –180 degrees

C) 0 and –90 degrees

D) 0 and +90 degrees

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

A) –180 and –90 degrees

B) 0 and +90 degrees

C) +90 and +180 degrees

D) –90 and 0 degrees

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

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

B) Incomplete bundle branch block

C) First-degree AV block

D) Third-degree (complete) AV block

9) Normal sinus activity occurs at a rate between:

A) 60 and 100 bpm

B) 100 and 140 bpm

C) 40 and 60 bpm

D) 20 and 40 bpm

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

A) Premature sinus beat

B) Premature junctional contraction

C) Premature ventricular contraction

D) Premature atrial contraction

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

A) Wide

B) Identical in width

C) Narrow

D) Variable in width

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

A) Cause an unpredictable fluctuation

B) Increase the heart rate

C) Decrease the heart rate

D) No significant change

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

A) Left anterior fascicular block

B) Right bundle branch block

C) Left bundle branch block

D) Mobitz type I AV block

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

A) Right bundle branch block

B) Left bundle branch block

C) First-degree AV block

D) Left anterior fascicular block

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

A) Up and to the patient’s right

B) Down and to the patient’s left

C) Directly upward

D) Directly leftward

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

A) 60 and 100 bpm

B) 100 and 140 bpm

C) 20 and 40 bpm

D) 40 and 60 bpm

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

A) Left axis deviation

B) Extreme axis deviation

C) No axis deviation

D) Right axis deviation

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

A) Right axis deviation

B) Left axis deviation

C) Extreme axis deviation

D) Normal axis

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

A) Neither produces PACs

B) Atrial bigeminy

C) Atrial trigeminy

D) Both produce an equal frequency of PACs

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

A) Irregular rhythm with absence of QRS complexes

B) Irregular rhythm with lack of clear P waves

C) Regular rhythm with absent T waves

D) Regular rhythm with clear P waves

21) 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) 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

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

A) First-degree AV block

B) Mobitz type II second-degree AV block

C) Third-degree AV block

D) Mobitz type I second-degree AV block

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

A) 40 and 60 bpm

B) 60 and 100 bpm

C) 20 and 40 bpm

D) 100 and 120 bpm

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

A) Left bundle branch block

B) Left anterior fascicular block

C) Right bundle branch block

D) First-degree AV block

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

A) Left anterior fascicular block

B) Left bundle branch block

C) First-degree AV block

D) Right bundle branch block

26) Regarding a given rhythm strip, is a

A) Regular

B) Variable

C) Irregular

D) Irregularly irregular

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

A) 180 ms

B) 200 ms

C) 160 ms

D) 220 ms

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

A) 90 bpm

B) 50 bpm

C) 70 bpm

D) 60 bpm

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

A) The sinus node

B) Atrial tissue

C) The AV node

D) The ventricles

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

A) Lead I and aVL

B) Lead II and aVF

C) Lead III and aVR

D) Lead I and aVF

Your score is

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