This EKG practice test is designed to help you learn to recoginze all of the EKG rhythms that you will encounter during emergencies and during the AHA ACLS provider course. Use these EKG practice tests to help you become proficient in your rapid rhythm identification.
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Question 1 of 14
1. Question
Choose the correct rhythm for this rhythm strip.
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Question 2 of 14
2. Question
Choose the correct rhythm for this rhythm strip.
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Question 3 of 14
3. Question
Choose the correct rhythm for this rhythm strip.
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Question 4 of 14
4. Question
Choose the correct rhythm for this rhythm strip.
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Question 5 of 14
5. Question
Choose the correct rhythm for this rhythm strip.
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Question 6 of 14
6. Question
Choose the correct rhythm for this rhythm strip.
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Question 7 of 14
7. Question
Choose the correct rhythm for this rhythm strip.
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Question 8 of 14
8. Question
Choose the correct rhythm for this rhythm strip.
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Question 9 of 14
9. Question
Choose the correct rhythm for this rhythm strip.
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Question 10 of 14
10. Question
Choose the correct rhythm for this rhythm strip.
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Question 11 of 14
11. Question
Choose the correct rhythm for this rhythm strip.
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Question 12 of 14
12. Question
Choose the correct rhythm for this rhythm strip.
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Question 13 of 14
13. Question
Choose the correct rhythm for this rhythm strip.
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Question 14 of 14
14. Question
Choose the correct rhythm for this rhythm strip.
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Elly says
I am having a hard time distinguishing the blocks and v.fib, A.fib
ACLS says
Practice, practice, practice.
Make sure you go through the section that reviews the basics on interpreting these. You can find that here: https://acls-algorithms.com/rhythms/
Kind regards,
Jeff
Rachel says
Props to the people who read these for a living. I can barely learn them for an exam lol
ALEXANDRA says
for question 5 in test 3: so, one “almost looking like a” QRS doesn’t make it a 3rd degree block.
i mistook it for 3rd degree, thinking there were a lot of p-waves and one qrs.
still learning.. 🙂
thank you
Rachel says
It’s so confusing, isn’t it
Kris says
14 is vfib?? How??
ACLS says
Question 14 is atrial fibrillation. Kind regards, Jeff
Hichena Raphael says
I have a hard time identity the normal st and the first degree heart block..
ACLS says
I recommend a thorough review of the section on bradycardia listed on this page. One of the main things is to practice by looking at EKG rhythms. Knowing what normal looks like is the best way to recognize when you see some an ekg because you’ll then immediately recognize abnormal.
EKG rhythms
Kind regards, Jeff
Neicy rice says
I’m having the same problem. These blocks are killing me tool
Reyes says
I’m have the same probkem
RF says
1st degree has a long PR interval and is consistent.
2nd degree type 1- The P wave has a going . going.. gone pattern which can be confusing with a third degree HB.
2nd degree type 2 will have a consistent PR interval but will have extra P’s between complexes.
3rd degree will have the P waves disassociated from the QRS complex so there wont be a pattern of P waves between the complexes.
Jesse says
The only difference between normal sinus rhythm and a first degree heart block is that the PR interval is more than .20. A regular PR interval is .12 – .20. So if you could your small boxes, they are .04 each. 3-5 boxes is normal. Anything more than 5 boxes or .20 classifies the rhythm as a first degree heart block. Hopefully this helps!
Ricky Choders says
That “first degree block” doesn’t look 0.2 apart to me…
cocolino says
V-Fib with agonal Ventricular beat. Shock it!
JALEESA NICHELLE says
SVT have thin QRS complexes vs ST
ACLS says
Typically this is true. However, if a person has a bundle branch block this can present SVT with a wide QRS complex. Kind regards, Jeff
SADIE ALDINGER says
I am not understanding how this is SVT with a rhythm of 150. I assumed that for SVT the rhythm needs to be greater than 150, whereas sinus tach is 100-150. On other similar strips that have a rhythm of 150, the answer is usually sinus tach. What is the best way to differentiate between the two?
Question 12
ACLS says
SVT can have a rate of 150 and it may be difficult to differentiate between SVT and ST at times.
Gathering a history and physical exam plays and important part in distinguishing the two:
In sinus tachycardia, there is gradual onset and termination of symptoms like palpitation.
SVT typically presents with sudden onset and termination of palpitations, light-headedness, chest pain, abnormal pulsations in the neck and dyspnea lasting between seconds to several hours.
Less commonly, symptoms of SVT may include syncope secondary to vasovagal response or compromised cardiac output, and polyuria secondary to the diuretic effects of atrial natriuretic factor.
Sinus tachycardia is usually due to physical, emotional, pathological (fever, hypovolemia, anemia, anxiety, infection, malignancy, myocardial infarction, congestive heart failure, pulmonary embolus, thyrotoxicosis) or pharmacological (caffeine, alcohol, nicotine, salbutamol, aminophylline, atropine, cocaine, doxorubicin, daunorubicin) stimulus.
Majority of the SVT occurs without any underlying cause.
Kind regards, Jeff
Vicki Powell says
Awesome Review !! Thanks!!
ACLS says
You’re welcome! Kind regards, Jeff