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 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

2) 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) First-degree AV block

D) Right bundle branch block

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

A) Left bundle branch block

B) Incomplete bundle branch block

C) Right bundle branch block

D) Left anterior fascicular block

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

A) Both produce an equal frequency of PACs

B) Neither produces PACs

C) Atrial trigeminy

D) Atrial bigeminy

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

A) Directly upward

B) Directly leftward

C) Down and to the patient’s left

D) Up and to the patient’s right

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

A) Irregular rhythm with absence of QRS complexes

B) Regular rhythm with absent T waves

C) Regular rhythm with clear P waves

D) Irregular rhythm with lack of clear P waves

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

A) 40 and 60 bpm

B) 100 and 140 bpm

C) 20 and 40 bpm

D) 60 and 100 bpm

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

A) Right bundle branch block

B) First-degree AV block

C) Left bundle branch block

D) Left anterior fascicular block

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

A) The ventricles

B) The AV node

C) The sinus node

D) Atrial tissue

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

A) Mobitz type I second-degree AV block

B) Third-degree AV block

C) First-degree AV block

D) Mobitz type II second-degree AV block

11) 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) Third-degree (complete) AV block

D) First-degree AV block

12) Normal sinus activity occurs at a rate between:

A) 60 and 100 bpm

B) 20 and 40 bpm

C) 100 and 140 bpm

D) 40 and 60 bpm

13) 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) 40 bpm, Atrial ectopic focus

B) 75 bpm, Ventricles

C) 50 bpm, sinus node

D) 60 bpm, AV node

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

A) 20 and 40 bpm

B) 100 and 120 bpm

C) 40 and 60 bpm

D) 60 and 100 bpm

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

A) Left bundle branch block

B) Mobitz type I AV block

C) Left anterior fascicular block

D) Right bundle branch block

16) Regarding a given rhythm strip, is a

A) Regular

B) Irregular

C) Variable

D) Irregularly irregular

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

A) Premature junctional contraction

B) Premature ventricular contraction

C) Premature sinus beat

D) Premature atrial contraction

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

A) Identical in width

B) Wide

C) Narrow

D) Variable in width

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

A) Right axis deviation

B) No axis deviation

C) Extreme axis deviation

D) Left axis deviation

20) Regarding a given rhythm strip, is a

A) Irregularly irregular

B) Consistently variable

C) Regular

D) Slightly irregular

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

A) Increase the heart rate

B) Decrease the heart rate

C) Cause an unpredictable fluctuation

D) No significant change

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

A) 220 ms

B) 200 ms

C) 160 ms

D) 180 ms

23) 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) Mobitz type I second-degree AV block

B) Third-degree AV block

C) First-degree AV block

D) Mobitz type II second-degree AV block

24) 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

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

A) Right bundle branch block

B) First-degree AV block

C) Left anterior fascicular block

D) Left bundle branch block

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

A) Lead I and aVF

B) Lead I and aVL

C) Lead II and aVF

D) Lead III and aVR

27) 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) 140 and 160 ms

D) 100 and 120 ms

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

A) Right axis deviation

B) Extreme axis deviation

C) Left axis deviation

D) Normal axis

29) 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

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

A) 0 and +90 degrees

B) –180 and –90 degrees

C) +90 and +180 degrees

D) –90 and 0 degrees

Your score is

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