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Quizzes > Health & Medicine

ECG Practice Test: Timed Rhythm Recognition Quiz

Quick, free ECG quiz with answers. Instant scoring and feedback.

Editorial: Review CompletedCreated By: Jennifer ChaeUpdated Aug 26, 2025
Difficulty: Moderate
2-5mins
Learning OutcomesCheat Sheet
Paper art illustration with ECG waveform teal background quiz test your ECG knowledge free scored questions instant answers

This ECG practice test helps you build speed and accuracy reading rhythm strips under a timer, with clear answers after each item. If you want more focused review, try our 12 lead ecg quiz for lead placement skills or take an ekg practice test to see a broader question set. You can also sharpen pattern spotting with an ekg rhythm quiz between study sessions.

Which method best estimates heart rate on a regular rhythm using a standard 25 mm/s ECG when the R-R interval is 5 large boxes?
Count QRS complexes in 6 seconds and multiply by 20 regardless of rhythm regularity
Use 1500 divided by number of large boxes
Multiply the PR interval in seconds by 100
Use 300 divided by the number of large boxes: 300/5 = 60 bpm (correct)
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The normal PR interval ranges from 120 ms to 200 ms.
True
False
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Which ECG finding is most characteristic of atrial fibrillation?
Regular narrow-complex tachycardia with retrograde P waves
Sawtooth flutter waves at 300 bpm
Sinus rhythm with first-degree AV block
Irregularly irregular rhythm without distinct P waves (correct)
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A normal adult QRS duration is best defined as which range?
80-200 ms
< 120 ms (correct)
120-160 ms
> 160 ms
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Hyperkalemia typically causes peaked T waves before QRS widening.
True
False
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Which finding suggests left ventricular hypertrophy by Sokolow-Lyon criteria?
R in V1 >= 7 mm
S in V1 + R in V5 or V6 >= 35 mm (correct)
QRS duration < 100 ms
R in aVL <= 7 mm
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Mobitz I (Wenckebach) is characterized by progressive PR prolongation before a dropped QRS.
False
True
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Which leads reflect the anterior wall of the left ventricle?
II, III, aVF
I, aVL
V7-V9
V3-V4 (correct)
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Which feature supports a diagnosis of ventricular tachycardia over SVT with aberrancy?
AV dissociation with capture or fusion beats (correct)
Visible retrograde P waves after each QRS
Regular narrow QRS at 160 bpm
QRS duration of 110 ms
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Hypokalemia often presents with U waves and flattened T waves.
True
False
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De Winter T-wave pattern indicates acute proximal LAD occlusion without classic ST elevation.
True
False
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Which set of precordial lead positions is correct for V1-V2?
5th intercostal space right anterior axillary line
2nd intercostal space midclavicular line
4th intercostal space at right (V1) and left (V2) sternal border (correct)
Midsternal at the level of the xiphoid
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Which finding favors left bundle branch block (LBBB)?
Wide QRS with broad, notched R in I and V6; deep QS in V1 (correct)
Q waves in lateral leads with narrow QRS
Peaked T in precordials with narrow QRS
rsR' in V1 with narrow QRS
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Hypercalcemia is associated with QT interval prolongation.
False
True
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Which criterion supports LVH by Cornell voltage?
QTc < 400 ms
R in aVL + S in V3 > 28 mm in men or > 20 mm in women (correct)
R in V1 > 10 mm
QRS > 120 ms
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Which finding supports right ventricular hypertrophy (RVH)?
Left axis deviation with tall R in V6
Right axis deviation with tall R in V1 and deep S in V6 (correct)
Q waves in V5-V6
Short PR interval with delta wave
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Which ECG sign is characteristic of arrhythmogenic right ventricular cardiomyopathy (ARVC)?
U waves in lateral leads
Epsilon wave in V1-V3 (correct)
Delta wave in inferior leads only
Osborne J wave in V3-V6
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In torsades de pointes, the hallmark is a polymorphic VT with QRS amplitude twisting around the baseline in the setting of QT prolongation.
True
False
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Which statement best describes Wellens vs hyperacute T waves in early STEMI?
Wellens occurs pain-free with preserved R waves; hyperacute T waves are broad, tall during ongoing occlusion (correct)
Both show ST depression in V2-V3 only
Wellens has QT prolongation; hyperacute has QT shortening
They are indistinguishable on ECG
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A capture beat during a wide-complex tachycardia argues against VT.
True
False
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0

Study Outcomes

  1. Interpret ECG Waveforms -

    Identify the P wave, QRS complex, and T wave on various tracings to accurately decode cardiac electrical activity.

  2. Recognize Common Arrhythmias -

    Detect and classify frequent rhythm disturbances, such as atrial fibrillation and ventricular tachycardia, during the ECG quiz game.

  3. Calculate Heart Rate -

    Apply systematic methods to determine heart rate from ECG strips, enhancing speed and accuracy under timed conditions.

  4. Assess Interval Durations -

    Evaluate PR, QRS, and QT intervals to spot conduction delays or repolarization abnormalities in basic ECG quiz with answers.

  5. Apply a Step-by-Step Approach -

    Use a structured framework for ECG interpretation, ensuring comprehensive analysis of each practice question.

  6. Self-Assess Proficiency -

    Leverage instant feedback from the electrocardiogram quiz to pinpoint strengths and areas for improvement in your ECG skills.

Cheat Sheet

  1. Heart Rate Calculation with the 300 Rule -

    Master the 300 Rule by dividing 300 by the number of large boxes between two consecutive R waves to get beats per minute. For more precision in an ecg quiz or ecg quiz game, use the 1500 Rule (1500 ÷ small boxes). This quick formula is recommended by the American Heart Association for accurate rate determination in ECG practice questions.

  2. Assessing Rhythm and P Wave Morphology -

    Always check for a P wave before each QRS complex to confirm sinus rhythm, as noted in major cardiology texts. In a basic ecg quiz with answers, look for consistent P-R intervals (120 - 200 ms) to rule out AV blocks or ectopic rhythms. Remember the mnemonic "P before QRS = Sinus," which helps boost your confidence during timed quizzes.

  3. Electrical Axis Determination -

    Use Leads I and aVF to quickly locate the heart's electrical axis on the hexaxial reference system, a staple in reputable ECG workbooks. If Lead I is positive and aVF is positive, the axis is normal (−30° to +90°). This simple quadrant method is a go-to trick in an electrocardiogram quiz for assessing left or right axis deviation.

  4. Interval Norms and QTc Correction -

    Memorize normal intervals - PR: 120 - 200 ms, QRS: <120 ms, QT: <450 ms in men and <470 ms in women - and apply Bazett's formula (QTc = QT/√RR) for heart rate correction. In ecg practice questions, a prolonged QTc can signal torsades de pointes risk, as highlighted by electrophysiology guidelines. Use the phrase "QT Corrected by Bazett" to recall this formula under pressure.

  5. Recognizing Common Arrhythmias -

    Differentiate atrial fibrillation (irregularly irregular, absent P waves) from atrial flutter (sawtooth pattern) and SVT (narrow QRS, rapid rate) using pattern recognition from peer-reviewed journals. Spot WPW syndrome by identifying the delta wave and short PR interval in your next ecg quiz game. Practicing these classic patterns will elevate your interpretation skills in any scored ECG practice questions.

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