Exam prep · Basic A · Basic B
Relias dysrhythmia test practice: the same rhythms, marked the same way
The Relias dysrhythmia test shows you rhythm strips and asks for the full interpretation, measurements included. Practise on the rhythms from its review list, with a magnifier, a rate chart and a pass mark, until the real one feels like one more paper.
Also known as the Prophecy dysrhythmia test, the Relias EKG test or the basic dysrhythmia test. ekgstrips.com is an independent practice site, and every strip here is our own. For education only.
What the test is like, and how our mock exam matches it
Staffing agencies want their nurses to pass, so they tell them what to expect. We built the mock exam from that advice, from hospital study guides and from what job postings require, point by point.
- Question mix
- On the test · Relias publishes it: 31% sinus rhythms, 26% atrial, 17% lethal arrhythmias, 9% heart blocks, 9% ventricular, 6% paced and 3% junctional.
- Here · The “Relias Basic outline” setting shares every paper out in those proportions: 11, 9, 6, 3, 3, 2 and 1 questions of 35.
- Strips
- On the test · Every strip on the assessment is 6 seconds long.
- Here · Every strip is 6 seconds of lead II at 25 mm/s, drawn to scale.
- Questions
- On the test · A rhythm strip and four answers to choose from.
- Here · The same: one strip, four answers.
- Length
- On the test · The Basic forms are most often described as 35 questions.
- Here · 35 strips by default. Papers of 10, 20 and 50 for a short session or a long one.
- Answers
- On the test · Whole interpretations, such as “sinus rhythm with first-degree AV block”. Half an answer is a wrong answer.
- Here · A strip with two findings is offered with the half-right answers beside the complete one. Only the complete one scores.
- Measuring
- On the test · You measure the PR interval, the QRS and the QT yourself, and work out the heart rate.
- Here · Calipers and a magnifier on every strip. The hospital mix adds questions that ask for a PR interval or a heart rate, and the caliper trainer drills PR, QRS, QT and rate on their own.
- Magnifier
- On the test · Moving the pointer over a strip enlarges it, so that the small squares can be counted.
- Here · Move the pointer over the strip, or switch the magnifier on with a button on a phone.
- Reference sheet
- On the test · Candidates are told to keep a heart rate chart and their notes at hand.
- Here · Normal values and the three rate methods open under the paper.
- Pausing
- On the test · Log out part-way and the test picks up where you left off.
- Here · The paper is saved as you go and waits for you.
- Pass mark
- On the test · Set by your employer or agency. 80% is the usual figure and some ask for 85%. Many also require every lethal rhythm to be right.
- Here · 80% by default, with V-tach, V-fib, torsades and asystole all required. Change it to 85 or 90% if that is what you were told.
- Attempts
- On the test · Usually one or two, by the employer’s rule.
- Here · As many papers as you like. Each one is drawn new, so none can be memorized.
Length, pass mark and attempts depend on the form and on the employer that assigns it. Your recruiter can confirm yours, and the mock exam can be set to match.
Open the practice testThe published outline: how much of the test each rhythm category gets
Relias publishes a content outline for the Dysrhythmia (Basic) assessment. It gives the share of each rhythm category and says that every strip is 6 seconds long. Sinus and atrial rhythms are more than half of the test, and one question in six is a lethal arrhythmia. Our practice test has a setting that follows it.
| Category | Share of the test | In a 35-question paper | Rhythms the outline lists |
|---|---|---|---|
| Sinus rhythms | 31% | 11 | Normal sinus rhythm, sinus bradycardia, sinus tachycardia |
| Atrial rhythms | 26% | 9 | Atrial fibrillation, atrial fibrillation with a rapid ventricular response, atrial flutter, PACs |
| Lethal arrhythmias | 17% | 6 | Asystole, ventricular fibrillation, ventricular tachycardia |
| Heart blocks | 9% | 3 | Second-degree type I (Mobitz I), second-degree type II (Mobitz II), third-degree |
| Ventricular rhythms | 9% | 3 | Sinus rhythm with PVCs, with bigeminy and with a couplet; sinus rhythm running into ventricular tachycardia |
| Paced rhythms | 6% | 2 | Paced rhythms |
| Junctional rhythms | 3% | 1 | Junctional rhythms |
Source: Relias, Dysrhythmia (Basic) Exam Content Outline, 2021. The shares are as published and add up to 101% because they are rounded. Your recruiter can confirm the form you have been assigned.
- Relias Basicoutline built in
- One setting shares the questions out as Relias publishes for its Dysrhythmia (Basic) assessment: 31% sinus, 26% atrial, 17% lethal.
- 35 questionsmarked like a hospital exam
- A pass mark of 80, 85 or 90%, every lethal rhythm required, a score for each section, and every question explained afterwards.
- 492,000different practice strips
- 12,000 of each of 41 rhythms. The rate, the intervals and the wave shapes change every time, so there is no picture to memorize.
- 552,000strips measured before release
- A separate program that sees only the finished trace reads every strip back. It has to find the rhythm, the rate and the intervals we report.
Where nurses lose marks on this test
One agency wrote its advice after going through the answers its own nurses most often got wrong. Six of those places are below, and none of them is a rare rhythm. Its rule fits in six words: “NEVER just look at a rhythm.”
Sinus rhythm that is not just sinus rhythm
A regular strip with a P wave before every QRS looks finished. Measure the PR interval anyway: over 0.20 s, the answer is sinus rhythm with first-degree AV block, and plain “sinus rhythm” is marked wrong.
First-degree AV blockSinus tachycardia or SVT
Both are fast, narrow and regular. Sinus tachycardia runs from 101 to about 160 and has a P wave before each QRS. SVT runs from 150 to 250 and the P waves cannot be found.
SVTWhich AV block
All four are told apart by the PR interval: long but constant, growing until a beat drops, constant with a beat dropped, or no relation between P waves and QRS complexes at all.
Heart blocks comparedOne shape, three names
A junctional rhythm is named by its rate: 40 to 60, 61 to 100, or over 100. So is a wide ventricular rhythm: under 40, 40 to 100, or over 100. Get the rate wrong and the name is wrong.
Junctional rhythmPVCs in a pattern
Every other beat is bigeminy, every third is trigeminy, two together are a couplet. The answer names the underlying rhythm and the pattern, not just “PVCs”.
Ventricular bigeminyThe rate of an irregular strip
Count the R waves on the 6-second strip and multiply by ten. Counting squares between two beats works only when the rhythm is regular.
Caliper trainer
Try six strips now
Six rhythms from the review list, chosen because they are the ones that get confused. There are no calipers on them. Measure the PR interval yourself; one small square is 0.04 s.
For ten mixed strips with measuring questions, take the free EKG quiz.
Strip 1 of 6
Lead II · 25 mm/s · 6 s
The rhythms to know for the Relias dysrhythmia test
The rhythms on the published outline, together with the review list agencies give their nurses for the basic test and the lethal rhythms that hospital study guides insist on. Each one is measured and explained in our library:
AV blocks
All four. They are told apart by the PR interval and by nothing else.
Junctional rhythms
One shape at three rates: 40 to 60, 61 to 100, and over 100.
Ventricular rhythms
One wide shape at three rates: under 40, 40 to 100, and over 100. Then torsades, and the two with no complexes at all.
Atrial rhythms
Fibrillation and flutter, and the two fast narrow rhythms that get confused: sinus tachycardia and SVT.
Early beats
Premature atrial and ventricular beats, and the patterns PVCs come in.
Paced rhythms
Atrial, ventricular and dual-chamber pacing, and a spike that fails to capture.
Normal sinus rhythm, sinus bradycardia and sinus arrhythmia are on the test too, as the rhythms everything else is compared with. Agencies tell nurses to review the advanced material even for a basic form; the mock exam has a wider range for that.
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Unlimited practice
Strip after strip from the review list, each one new, each one explained with the measurements marked on it. Missed strips are kept so you can go back to them.
Open practiceCaliper trainer
The measuring questions are where a prepared nurse still drops marks. Set calipers on the PR, QRS and QT and be marked to the small square.
Open the trainerMock exams
35 strips, a clock, an 80% pass mark and the lethal rhythms required. The report shows the families you are weak in before the real test does.
Open the practice test
If your test is in a week
- Day 1
The five steps and the paper. Learn to measure a PR interval and a QRS, and to get a rate two ways.
Caliper trainer - Day 2
The four AV blocks, side by side, until the PR interval tells you which one it is.
Heart blocks compared - Day 3
Atrial and junctional rhythms. Sort the fast narrow ones by whether you can find a P wave.
Rhythm library - Day 4
Ventricular rhythms by rate, and the lethal four until you never miss one.
Lethal rhythms - Day 5
Paced rhythms and strips with two findings. Practise giving the whole interpretation.
Unlimited practice - Day 6
A full paper under exam conditions. Read the report, not just the score.
Practice test - Day 7
Your missed strips and your weakest rhythms, then one more paper.
- Test day
Rate chart beside you. Five steps on every strip, in the same order. Measure before you look at the choices.
Why practise instead of hunting for an answer key
- The keys sold online disagree with each other, down to how many questions there are. You cannot tell which one matches the form you will be given.
- A nurse who measures every strip passes any form, Basic A or Basic B, this employer’s or the next one’s.
- The unit you are being tested for does not come with a key. The skill is what you are hired for.
ekgstrips.com is not affiliated with or endorsed by Relias and does not reproduce its questions. Relias is a trademark of its owner, used here only to name the test this page is about. The strips are simulations for education only: see the medical disclaimer.
Questions about the Relias dysrhythmia test
How many questions are on the Relias dysrhythmia test?
The Basic forms are most often described as 35 questions, which is the default length of our mock exam. Relias does not print the number on a public page and employers can assign different forms, so check your assignment email or ask your recruiter for the exact count.
What is the passing score for the Relias dysrhythmia test?
Your employer or agency sets it. 80% is the figure seen most often in job postings and hospital study guides, and some ask for 85%. Many also require every lethal rhythm to be identified correctly, whatever the total. Practise until you score 90% and neither figure is a worry.
What is the difference between Dysrhythmia Basic A and Basic B?
They are two forms of the same basic-level test, and employers assign one or the other. Agency study advice does not separate them: the same review list and the same five steps apply to both, so prepare the same way. If you have been assigned an Advanced form, widen the range in our mock exam to add the harder rhythms, such as bundle branch block, WPW and multifocal atrial tachycardia.
Is the Relias EKG test timed?
Prepare as if it is. A good pace is about a minute a strip with the measurements done, and our mock exam runs 35 strips against a 60-minute clock that you can tighten. Agencies also tell candidates that the test can be left and resumed.
How many times can I take it?
Usually once or twice; the employer decides. Job postings range from “may be taken twice” to no second attempt at all, which is why agencies coach their nurses to pass the first time.
Can I use notes during the test?
Agency advice to candidates says to keep a heart rate chart and one reference sheet at hand, and not to juggle several. Follow the instructions that come with your own assignment, because an employer can set its own rules.
Are these the same rhythms as on the Relias test?
Yes: the rhythm categories of the outline Relias publishes, in the same proportions, asked the same way, one strip and four whole interpretations. The strips themselves are our own, drawn new for every paper by our software, and that is why they work: the test will show you rhythms you have read here fifty times, on strips you have never seen.