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

A) Right bundle branch block

B) Left anterior fascicular block

C) Incomplete bundle branch block

D) Left bundle branch block

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

A) First-degree AV block

B) Third-degree (complete) AV block

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

D) Incomplete bundle branch block

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

A) 20 and 40 bpm

B) 100 and 140 bpm

C) 40 and 60 bpm

D) 60 and 100 bpm

4) 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

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

A) Irregular rhythm with lack of clear P waves

B) Irregular rhythm with absence of QRS complexes

C) Regular rhythm with absent T waves

D) Regular rhythm with clear P waves

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

A) Left anterior fascicular block

B) First-degree AV block

C) Right bundle branch block

D) Left bundle branch block

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

A) Both produce an equal frequency of PACs

B) Atrial trigeminy

C) Atrial bigeminy

D) Neither produces PACs

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

A) Decrease the heart rate

B) No significant change

C) Cause an unpredictable fluctuation

D) Increase the heart rate

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

A) 50 bpm

B) 90 bpm

C) 70 bpm

D) 60 bpm

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

A) First-degree AV block

B) Left bundle branch block

C) Left anterior fascicular block

D) Right bundle branch block

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

A) 120 and 140 ms

B) 140 and 160 ms

C) 80 and 100 ms

D) 100 and 120 ms

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

A) Left bundle branch block

B) Right bundle branch block

C) First-degree AV block

D) Left anterior fascicular block

13) 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

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

A) Directly leftward

B) Down and to the patient’s left

C) Directly upward

D) Up and to the patient’s right

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

A) 200 ms

B) 220 ms

C) 180 ms

D) 160 ms

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

A) Lead II and aVF

B) Lead I and aVF

C) Lead III and aVR

D) Lead I and aVL

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

A) Variable in width

B) Narrow

C) Wide

D) Identical in width

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

A) Left axis deviation

B) No axis deviation

C) Right axis deviation

D) Extreme axis deviation

19) Regarding a given rhythm strip, is a

A) Regular

B) Slightly irregular

C) Consistently variable

D) Irregularly irregular

20) 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) Mobitz type I second-degree AV block

D) Third-degree AV block

21) 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) Atrial tissue

D) The sinus node

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

A) Left bundle branch block

B) Right bundle branch block

C) Left anterior fascicular block

D) Mobitz type I AV block

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

A) Premature atrial contraction

B) Premature junctional contraction

C) Premature sinus beat

D) Premature ventricular contraction

24) 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) Mobitz type II second-degree AV block

C) First-degree AV block

D) Mobitz type I second-degree AV block

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

A) Extreme axis deviation

B) Left axis deviation

C) Normal axis

D) Right axis deviation

26) 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) 60 bpm, AV node

C) 40 bpm, Atrial ectopic focus

D) 75 bpm, Ventricles

27) 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 0 degrees

D) +90 and +180 degrees

28) Regarding a given rhythm strip, is a

A) Irregular

B) Irregularly irregular

C) Variable

D) Regular

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

A) 20 and 40 bpm

B) 40 and 60 bpm

C) 100 and 120 bpm

D) 60 and 100 bpm

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

A) 0 and +90 degrees

B) +90 and +180 degrees

C) –90 and –180 degrees

D) 0 and –90 degrees

Your score is

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