A patient is in cardiac arrest. Ventricular fibrillation has been refractory to an initial shock. If no pathway for medication administration is in place, which method is preferred?
  • Epinephrine 1mg IV/IO
  • 150 mg IV push
  • IV or IO
  • Amiodarone 300mg
Which action should you take immediately after providing an AED shock?
  • Ventilating too quickly
  • Start rescue breathing
  • Resume high quality chest compressions
  • Resume chest compressions
A 35-year-old woman has palpitations, light-headedness, and a stable tachycardia. The monitor shows a regular narrow-complex QRS at a rate of 180/min. Vagal maneuvers have not been effective in terminating the rhythm. An IV has been established. Which drug should be administered?
  • Perform electrical cordioversion
  • Vagal maneuvers
  • Adenosine 6mg
  • Atropine 0.5mg IV
A patient with possible STEMI has ongoing chest discomfort. What is a contraindication to nitrate administration?
  • Use of a phosphodiestrase inhibitor within the previous 24 hours
  • Give an immediate unsynchronized high-energy shock (defibrillation dose)
  • 0.5mg
  • Give aspirin 160-325 mg to chew
A patient is in refractory ventricular fibrillation and has received multiple appropriate defribillation shocks, epinephrine 1 mg IV twice, and an initial dose of amiodarone 300mg IV. The patient is intubated. Which best describe the recommended second does of amiodarone for this patient?
  • 150 mg IV push
  • IV or IO
  • Epinephrine 1 mg IV/IO
  • Epinephrine 1mg IV/IO
A 45-year-old woman with a history of palpitations develops light-headedness and palpitations. She has received adensoine 6mg IV for the rhythm shown here, without conversion of the rhythm. She is now extremely apprehensive. Her blood pressure si 128/70mm Hg. What is the next appropriate intervention?
  • Perform electrical cordioversion
  • Vagal maneuvers
  • Administer adenosine 12 mg IV
  • Adenosine 6mg
A monitored patient in the ICU developed a sudden onset of narrow-complex tachycardia at a rate of 220/min. The patient's blood pressure is 128/58 mm Hg, the PETCO2 is 38mm Hg, and the pulse oximetry reading is 98%. There is vascular access in the left arm, and the patient has not been given any vasoactive drugs. A 12-lead ECG confirm a supraventricular tachycardia with no evidence of ischemia or infarction. The heart rate has not responded to vagal maneuvers. what is your next action?
  • Epinephrine 2 to 10 mcg/min
  • Seeking expert consultation
  • Repersfusion therapy
  • Administer adenosine 6mg IV push
A 35-year-old woman presents with a chief complaint of palpitations. She has no chest discomfort, shortness of breath, or light-headedness. Her blood pressure is 120/78mm Hg. Which intervention is indicated first?
  • Vagal maneuvers
  • Atropine 0.5mg IV
  • Administer adenosine 12 mg IV
  • Adenosine 6mg
You are caring for a 66-year-old man with a history of a large intracerebral hemorrhage 2 months ago. He is being evaluated for another acute stroke. The CT scan is negative for hemorrhage. The patient is receiving oxygen via nasal cannula at 2L/min, and an IV has been established. His blood pressure is 180/100mm Hg. Which drug do you anticipate giving to this patient?
  • IV or IO
  • Epinephrine 1 mg IV
  • Aspirin
  • Give aspirin 160-325 mg to chew
Your patient is not responsive and is not breathing, You can palpate a carotid pulse. Which action do you take next?
  • Ventilating too quickly
  • About every 5-6 seconds
  • Start high-quality CPR
  • Start rescue breathing
You are the code team leader and arrive to find a patient with CPR in progress. On the next rhythm check, you see the rhythm shown here. Team members tell you that the patient was well but reported chest discomfort and then collapsed. She has no pulse or respirations. Bag-mask ventilations are producing visible chest rise, and IV access has been established, Which intervention would be your next action?
  • Vagal maneuvers
  • Epinephrine 1mg
  • Atropine 0.5mg IV
  • Adenosine 6mg
A patient's 12-lead ECG is transmitted by the paramedics and shows a STEMI. When the patient arrives in the emergency department, the rhythm shown here is seen on the cardiac monitor. The patient has resolution of moderate (5/10) chest pain after 3 doses of sublingual nitroglycerin. Blood pressure is 104/70mm Hg. Which intervention is most important in reducing this patient's in-hospital and 30-day mortality rate?
  • Epinephrine 1 mg
  • Epinephrine 1 mg IV/IO
  • Repersfusion therapy
  • Epinephrine 1mg IV/IO
A patient with STEMI has ongoing chest discomfort. Heparin 4000 units IV bolus and a heparin infusion of 1000 units per hour are being administered. The patient did not take aspirin because he has a history of gastritis, with was treated 5 years ago. What is your next action?
  • Give an immediate unsynchronized high-energy shock (defibrillation dose)
  • Epinephrine 1mg IV/IO
  • Give aspirin 160-325 mg to chew
  • Seeking expert consultation
Your patient is a 56-year-old woman with a history of type 2 diabetes who reports feeling dizzy. She is pale and diaphoretic. Her blood pressure is 80/66mm Hg. The cardiac monitor documents the rhythm shown here. She is receiving oxygen at 4L/min by nasal cannula, and an Iv has been established. What do you administer next?
  • Adenosine 6mg
  • Vagal maneuvers
  • Atropine 0.5mg IV
  • Administer adenosine 12 mg IV
What is the indication for the use of magnesium in cardiac arrest?
  • Use of a phosphodiestrase inhibitor within the previous 24 hours
  • Pulseless ventricular tachycardia-associated torsades de pointes
  • 10 seconds
  • 100-120 compressions per minute
What action minimizes the risk of air entering the victim's stomach during-bag mask ventilation?
  • Ventilating until you see the chest rise
  • Epinephrine 1 mg IV/IO
  • Resume high quality chest compressions
  • Ventilating too quickly
A patient with sinus bradycardia and a heart rate of 42/min has diaphoresis and a blood pressure of 80/60mm Hg. What is the initial does of atropine?
  • Epinephrine 1mg IV/IO
  • 0.5mg
  • Use of a phosphodiestrase inhibitor within the previous 24 hours
  • Amiodarone 300mg
What is the maximum interval for pausing chest compressions?
  • 10 seconds
  • 100-120 compressions per minute
  • At least 2 inches
  • Hypotension
A patient is in cardiac arrest. Ventricular fibrillation has been refractory to a second shock. Which drug should be administered first?
  • Epinephrine 1 mg IV/IO
  • Epinephrine 1 mg
  • Epinephrine 2 to 10 mcg/min
  • Epinephrine 1mg IV/IO
A patient was in refractory ventricular fibrillation. A thrid shock has just been administered. Your team looks to you for instructions. What is your next action?
  • Resume high quality chest compressions
  • Epinephrine 1 mg IV/IO
  • Start high-quality CPR
  • Epinephrine 2 to 10 mcg/min
A patient is in refractory ventricular fibrillation. High-quality CPR is in progress. One does of epinephrine was given after the second shock. An antiarrhythmic drug was given immediately after the third shock. You are the team leader. Which medication do you order next.
  • Epinephrine 2 to 10 mcg/min
  • Epinephrine 1 mg IV/IO
  • Epinephrine 1 mg
  • Epinephrine 1mg IV/IO
A 62-year-old man suddenly experienced difficulty speaking and left-sided weakness. He meets initial criteria for fibrinolytic therapy, and a CT scan of the brain si ordered. Which best describes the guidelines for antiplatelet and fibrinolytic therapy?
  • Epinephrine 2 to 10 mcg/min
  • Hold aspirin for at least 24 hours if rtPA is administered
  • Give an immediate unsynchronized high-energy shock (defibrillation dose)
  • Use of a phosphodiestrase inhibitor within the previous 24 hours
A patient has sinus bradycardia with a heart rate of 36/min. Atropine has been administered to a toal does of 3 mg. A transcutaneous pacemaker has failed to capture. The patient is confused, and her blood pressure is 88/56 mm Hg. Which therapy is now indicated?
  • Epinephrine 1mg IV/IO
  • Epinephrine 2 to 10 mcg/min
  • Epinephrine 1 mg IV/IO
  • Seeking expert consultation
Which action is likely to cause air to enter the victim's stomach (gastric inflation) during bag-mask ventilation?
  • Ventilating too quickly
  • Start rescue breathing
  • Epinephrine 1mg IV/IO
  • Epinephrine 1 mg IV/IO
A patient has a rapid irregular wide-complex tachycardia. The ventricular rate is 138/min. He is asymptomatic, with a blood pressure of 110/70 mm Hg. He has a history of angina. What action is recommended next?
  • Seeking expert consultation
  • Give aspirin 160-325 mg to chew
  • Epinephrine 2 to 10 mcg/min
  • Epinephrine 1mg IV/IO
How does complete chest recoil contribute to effective CPR?
  • Ventilating until you see the chest rise
  • Allows maximum blood return to the heart
  • About every 2 minutes
  • At least 2 inches
A patient is in pulseless ventricular tachycardia. Two shocks and 1 dose of epinephrine have been given. Which drug should be given next?
  • Epinephrine 1 mg
  • Amiodarone 300mg
  • Epinephrine 1 mg IV/IO
  • Epinephrine 1mg IV/IO
What is recommended depth of chest compressions for an adult victim?
  • Epinephrine
  • At least 2 inches
  • 10 seconds
  • About every 2 minutes
Identify the rhythm.
IuctFDci8KVexU0.mMNDDw_m.png
  • Sinus tachycardia
  • Monomorphic Ventricular tachycardia
  • Sinus bradycardia
  • Agonal rhythm/asystole
A 35-year-old woman has palpitations, light-headedness, and a stable tachycardia. The monitor shows a regular narrow-complex QRS at a rate of 180/min. Vagal maneuvers have not been effective in terminating the rhythm. An IV has been established. What drug should be administered IV?Lidocaine 1mg/kgAdenosine 6 mgEpinephrine 2 to 10 mcg/kg per minuteAtropine 0.5 mg
  • 1. Perform vagal maneuvers.
  • 2. Adenosine 6 mg
  • 2. Perform immediate electrical cardioversion.
  • 5. 150 mg IV push.
You are monitoring a patient with chest discomfort who suddenly becomes unresponsive. You observe the following rhythm on the cardiac monitor. A defibrillator is present. What is your first action?Intubate the patient and give epinephrine 2 to 4 mg via the endotracheal tube.Being CPR with chest compressions for 2 minutes or about 5 cycles of compressions and ventilations.Establish an IV and give epinephrine 1 mg.Establish and IV and give vasopressin 40 units.Give a single shock.
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  • 5. Give a single shock.
  • 5. 150 mg IV push.
  • 4. Give atropine 0.5 mg IV .
  • 1. Give normal saline 250 mL to 500 mL fluid bolus.
A patient is in cardiac arrest. Ventricular fibrillation has been refractory to an initial shock. What is the recommended route for drug administration during CPR?Femoral veinIV or IOCentral lineEndotrachealExternal jugular vein
  • 2. IV or IO
  • 5. 150 mg IV push.
  • 2. Second dose of epinephrine 1 mg
  • 4. Dose of 0.5mg
Which of the following statements about the use of magnesium in cardiac arrest is most accurate?Magnesium is indicated for shock-refractory monomorphic VT.Magnesium is indicated for VF/pulseless VT associated with torsades de pointes.Magnesium is contraindicated for VT associated with a normal QT interval.Magnesium is indicated for VF refractory to shock and amiodarone or lidocaine.
  • 2. Magnesium is indicated for VF/pulseless VT associated with torsades de pointes.
  • 1. Do not give aspirin for at least 24 hours if rtPA is administered.
  • 1. Epinephrine 1 mg or vasopressin 40 units IV or IO.
  • 3. The correct dose of vasopressin is 40 units administered by IV or IO.
A patient is in pulseless ventricular tachycardia. Two shocks and 1 dose of epinephrine have been given. Which is the next drug/dose to anticipate to administer?Amiodarone 300 mgAmiodarone 150 mgVasopressin 40 unitsEpinephrine 3 mgLidocaine 0.5 mg/kg
  • 5. 150 mg IV push.
  • 1. Sublingual nitroglycerin 0.4 mg.
  • 1. Amiodarone 300 mg
  • 1. Reperfusion therapy.
A patient has been resuscitated from cardiac arrest and is being prepared for transport. She is intubated and is receiving 100% oxygen. Blood pressure is 80/60 mm Hg. During the resuscitation, she received 2 doses of epinephrine 1 mg and 1 does of amiodarone 300 mg IV. You now observe this rhythm on the cardiac monitor. The rhythm abnormality is becoming more frequent and increasing in number. You should order:Amiodarone 150 mg IV bolus; start infusion.A repeat dose of epinephrine 1 mg IV.Lidocaine 1 to 1.5 mg IV; star infusion.1 to 2 L of normal saline.Amiodarone 300 mg IV.
.HUqnj8Y6yjchpfoZY-7xg_m.png
  • 1. Sublingual nitroglycerin 0.4 mg.
  • 4. 1 to 2 L of normal saline.
  • 5. 150 mg IV push.
  • 4. Start epinephrine 2 to 10 mcg/min.
You arrive on the scene to find CPR in progress. Nursing staff report that the patient was recovering from a pulmonary embolism and suddenly collapsed. There is no pulse or spontaneous respirations. High-quality CPR and effective bag-mask ventilation are being provided. An IV has been initiated. What wouldyou do now?Give atropine 1 mg IV.Give atropine 0.5 mg IVOrder immediate endotracheal intubation.Give epinephrine 1 mg IV .Initiate transcutaneous pacing.
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  • 1. Gain IV or IO access.
  • 3. Give atropine 0.5 mg IV .
  • 4. Atropine 0.5 mg IV .
  • 4. Give epinephrine 1 mg IV .
A patient has a rapid irregular wide-complex tachycardia. The ventricular rate is 138/min. He is asymptomatic, with a blood pressure of 110/70 mm Hg. He has a history of angina. Which of the following actions is recommended?Giving adenosine 6 mg IV bolus.Seeking expert consultation.Giving lidocaine 1 to 1.5 mg IV bolus.Immediate synchronized cardioversion.
  • 4. Start epinephrine 2 to 10 mcg/min.
  • 4. 1 to 2 L of normal saline.
  • 2. Second dose of epinephrine 1 mg
  • 2. Seeking expert consultation.
This patient was admitted to the general medical ward with a history of alcoholism. A code is in progress and he has recurrent episodes of this rhythm. You review his chart. Notes about the 12-lead ECG saythat his baseline QT interval is high normal to slightly prolonged. He has received 2 doses of epinephrine 1 mg and 1 dose of amiodarone 300 mg IV so far. What would you order for his next medication?Lidocaine 1 to 1.5 mg IV and start infusion 2 mg/min.Repeat amiodarone 300 mg IV.Repeat amiodarone 150 mg IV.Give sodium bicarbonate 50 mEq IV.Give magnesium sulfate 1 to 2 g IV diluted in 10 mL D5W given over 5 to 20 minutes
xM9N7x7xIqVwadod0wSNpA_m.png
  • 5. Give magnesium sulfate 1 to 2 g IV diluted in 10 mL D5W given over 5 to 20 minutes
  • 4. Lidocaine, epinephrine, vasopressin
  • 1. Give aspirin 160 to 325 mg chewed immediately.
  • 1. Give normal saline 250 mL to 500 mL fluid bolus.
You are monitoring the patient and note the rhythm below on the cardiac monitor. She has dizziness and her blood pressure is 80/40 mm Hg. She has an IV in place. What is your next action?Start transcutaneous pacing.Give atropine 1 mg IV.Give atropine 0.5 mg IV .Administer sedation and begin immediate transcutaneous pacing at 80/min.Start dopamine at 2 to 10 mcg/kg per minute and titrate to patient response.
zmAQ5CKbULt5SRYWQ4RWeQ_m.png
  • 5. Give a single shock.
  • 3. Give atropine 0.5 mg IV .
  • 4. Atropine 0.5 mg IV .
  • 4. Give atropine 0.5 mg IV .
A patient becomes unresponsive. You are uncertain if a faint pulse is present with the rhythmbelow. What is your next action?Order transcutaneous pacing.Begin CPR, starting with high-quality chest compressions.Start an IV and give epinephrine 1 mg IV.Consider causes of pulseless electrical activity.Start an IV and give atropine 1 mg.
kAznYVAuSLX57XExZ5ueGQ_m.png
  • 2. Begin CPR, starting with high-quality chest compressions.
  • 2. Resume high-quality chest compressions.
  • 1. Give normal saline 250 mL to 500 mL fluid bolus.
  • 4. Use of a phosphodiesterase inhibitor within 12 hours
A patient was in refractory ventricular fibrillation. A third shock has just been administered. Your team looks to you for instructions. Your immediate next order is:Perform endotracheal intubation.Resume high-quality chest compressions.Check the carotid pulse.Give atropine 1 mg IV.Give amiodarone 300 mg IV.
Nzth5tz5aqwC.Qtz2HlL.Q_m.png
  • 2. Resume high-quality chest compressions.
  • 2. Seeking expert consultation.
  • 1. Epinephrine 1 mg
  • 2. Second dose of epinephrine 1 mg
A patient is in refractory ventricular fibrillation and has received multiple appropriate defibrillation shocks, epinephrine 1 mg IV twice, and an initial dose of 300 mg amiodarone IV. The patient is intubated. A second dose of amiodarone is now called for. The recommended second dose of amiodarone is:An endotracheal dose of 2 to 4 mg/kg.300 mg IV push.1 mg/kg IV push.An infusion of 1 to 2 mg/min.150 mg IV push.
  • 5. 150 mg IV push.
  • 2. IV or IO
  • 2. Second dose of epinephrine 1 mg
  • 1. Epinephrine 1 mg
You are the code team leader and arrive to find a patient with above rhythm and CPR in progress. Team members report that the patient was well but reported chest pain and then collapsed. She has no pulse or respirations. Bag-mask ventilations are producing visible chest rise, high-quality CPR is in progress, and an IV has been established. What would be your next order?Administer atropine 1 mg.Perform endotracheal intubation.Start dopamine at 10 to 20 mcg/kg per minute.Administer epinephrine 1 mg.Administer amiodarone 300 mg.
gL7W9tz.u7iOHWJ-yRwbEw_m.png
  • 4. Administer epinephrine 1 mg.
  • 2. Adenosine 6 mg
  • 5. Administer adenosine 6 mg; seek expert consultation.
  • 1. Perform vagal maneuvers.
You arrive on the scene to find a 56-year-old diabetic woman with dizziness. She is pale and diaphoretic. Her blood pressure is 80/60 mm Hg. The cardiac monitor documents the rhythm below. She is receiving oxygen at 4 L/min by nasal cannula and an IV has been established. Your next order is:Dopamine at 2 to 10 mcg/kg per minute.Sublingual nitroglycerin 0.4 mg.Morphine sulfate 4 mg IV.Atropine 0.5 mg IV .Atropine 1 mg IV.
IrG3N3RtaZDWJ3yoZIJoOw_m.png
  • 4. Atropine 0.5 mg IV .
  • 3. Give atropine 0.5 mg IV .
  • 4. Give atropine 0.5 mg IV .
  • 4. Give epinephrine 1 mg IV .
A patient's 12-lead ECG was transmitted by the paramedics and showed an acute MI. The above findings are seen on rhythm strip when a monitor is placed in emergency department. The patient had resolution of moderate (5.10) chest pain with 3 doses of sublingual nitroglycerin. Blood pressure is 104/70 mm Hg. Which intervention below is most important, reducing in-hospital and 30-day mortality?Reperfusion therapy.IV nitroglycerin for 24 hours.Temporary pacing.Atropine 0.5 mg IV, total dose 2 mg as needed.Atropine 1 mg IV, total dose 3 mg as needed.
aMOzVetYWVYweEo7Q7k2eQ_m.png
  • 1. Reperfusion therapy.
  • 5. 150 mg IV push.
  • 2. Second dose of epinephrine 1 mg
  • 1. Amiodarone 300 mg
A 57-year-old woman has palpitations, chest discomfort, and tachycardia. The monitor shows a regular wide-complex ORS at a rate of 180/min. She becomes diaphoretic, and her blood pressure is 80/60 mm Hg. The next action is to:Give amiodarone 300 mg IV push.Perform immediate electrical cardioversion.Establish IV access.Obtain a 12-lead ECG.
  • 2. Perform immediate electrical cardioversion.
  • 5. Administer adenosine 6 mg; seek expert consultation.
  • 1. Perform vagal maneuvers.
  • 4. Repeat adenosine 12 mg IV .
A 62-year-old man suddenly experienced difficulty speaking and left-side weakness. He was brought to the emergency department. He meets initial criteria for fibrinolytic therapy, and a CT scan of the brain is ordered. What are the guidelines for antiplatelet and fibrinolytic therapy?Do not give aspirin for at least 24 hours if rtPA is administered.Give aspirin 160 mg and clopidogrel 75 mg orally.Administer heparin if CT scan is negative for hemorrhage.Administer aspirin 160 to 325 mg chewed immediately.
  • 1. Do not give aspirin for at least 24 hours if rtPA is administered.
  • 3. The correct dose of vasopressin is 40 units administered by IV or IO.
  • 4. Continue monitoring the patient and seek expert consultation.
  • 1. Give normal saline 250 mL to 500 mL fluid bolus.
A patient with possible ST-segment elevation MI has ongoing chest discomfort. Which of the following would be a contraindication to the administration of nitrates?Heart rate 90/min.Left ventricular infarct with bilateral rales.Blood pressure greater than 180 mm Hg.Use of a phosphodiesterase inhibitor within 12 hours
  • 1. Epinephrine 1 mg or vasopressin 40 units IV or IO.
  • 2. Continue monitoring and seek expert consultation.
  • 4. Use of a phosphodiesterase inhibitor within 12 hours
  • 4. Dose of 0.5mg
A patient presents with the rhythm below and reports an irregular heartbeat. She has no other symptoms. Her medical history is significant for a myocardial infarction 7 years ago. Blood pressure is 110/70 mm Hg. What would you do at this time?Perform elective synchronized cardioversion with presedation.Continue monitoring and seek expert consultation.Administer nitroglycerin 0.4 sublingual or spray.Administer lidocaine 1mg/kg IV.Perform emergency synchronized cardioversion
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  • 2. Continue monitoring and seek expert consultation.
  • 1. Give normal saline 250 mL to 500 mL fluid bolus.
  • 1. Epinephrine 1 mg or vasopressin 40 units IV or IO.
  • 4. Continue monitoring the patient and seek expert consultation.
A patient is in cardiac arrest. High-quality chest compressions are being given. The patient is intubated and an IV has been started. The rhythm is asystole. Which is the first drug/dose to administer?Epinephrine 1 mg or vasopressin 40 units IV or IO.Atropine 1 mg IV or IO.Atropine 0.5 mg IV or IO.Epinephrine 3 mg via endotracheal route.Dopamine 2 to 20 mcg/kg per minute IV or IO.
  • 2. Second dose of epinephrine 1 mg
  • 1. Give aspirin 160 to 325 mg chewed immediately.
  • 1. Epinephrine 1 mg or vasopressin 40 units IV or IO.
  • 1. Give normal saline 250 mL to 500 mL fluid bolus.
Which of the following statements is most accurate regarding the administration of vasopressin during cardiac arrest?Vasopressin can be administered twice during cardiac arrest.Vasopressin is indicated for VF and pulseless VT before delivery of the first shock.The correct dose of vasopressin is 40 units administered by IV or IO.Vasopressin is recommended instead of epinephrine for the treatment of asystole.
  • 3. The correct dose of vasopressin is 40 units administered by IV or IO.
  • 1. Give normal saline 250 mL to 500 mL fluid bolus.
  • 5. Give magnesium sulfate 1 to 2 g IV diluted in 10 mL D5W given over 5 to 20 minutes
  • 3. Give an immediate unsynchronized high-energy shock (defibrillation dose).
Your patient has been intubated. IV/IO access is not available. Which combination of drugs can be administered by the endotracheal route?Vasopressin, amiodarone, lidocaineAmiodarone, lidocaine, epinephrineEpinephrine, vasopressin, amiodaroneLidocaine, epinephrine, vasopressin
  • 4. Lidocaine, epinephrine, vasopressin
  • 2. Resume high-quality chest compressions.
  • 4. Give epinephrine 1 mg IV .
  • 2. Seeking expert consultation.
You arrive on the scene with the code team. High-quality CPR is in progress. An AED has previously advised "no shock indicated." A rhythm check now finds asystole. After resuming high-quality compressions, your next action is to:Gain IV or IO access.Place an esophageal-tracheal tube or laryngeal mask airway.Attempt endotracheal intubation with minimal interruptions in CPR.Call for a pulse check.
  • 4. Atropine 0.5 mg IV .
  • 2. Seek expert consultation.
  • 4. Give atropine 0.5 mg IV .
  • 1. Gain IV or IO access.
A 45-year-old woman with a history of palpitations develops light-headedness and palpitations. She has received adenosine 6 mg IV for the rhythm shown above without conversion of the rhythm. She is now extremely apprehensive. Blood pressure is 108/70 mm Hg. What is the next appropriate intervention?Repeat adenosine 3 mg IV.Perform immediate unsynchronized cardioversion.Sedate and perform synchronized cardioversion.Repeat adenosine 12 mg IV .Perform vagal maneuvers and repeat adenosine 6 mg IV.
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  • 2. Perform immediate electrical cardioversion.
  • 4. Repeat adenosine 12 mg IV .
  • 4. Administer epinephrine 1 mg.
  • 1. Perform vagal maneuvers.
Following resuscitation with CPR and a single shock, you observe this rhythm while preparing the patient for transport. Your patient is stable and blood pressure is 120/80 mm Hg. She is apprehensive but has no symptoms other than palpitations. At this time you would:Give magnesium sulfate 1 to 2 g over 20 minutes.Seek expert consultation.Give lidocaine 1 to 1.5 mg IV and start infusion.Give amiodarone 300 mg IV and start infusion
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  • 4. Start epinephrine 2 to 10 mcg/min.
  • 4. Give atropine 0.5 mg IV .
  • 2. Seek expert consultation.
  • 5. Prepare to give epinephrine 1 mg IV.
A patient is in cardiac arrest. Ventricular fibrillation has been refractory to a second shock. Of the following, which drug and dose should be administered first by the IV/IO route?Epinephrine 1 mgVasopressin 20 unitsSodium bicarbonate 50 mEqAtropine 1 mg
  • 1. Epinephrine 1 mg
  • 1. Reperfusion therapy.
  • 2. IV or IO
  • 2. Resume high-quality chest compressions.
You are monitoring a patient. He suddenly has the persistent rhythm shown below. You ask about symptoms and he reports that he has mild palpitations, but otherwise he is clinically stable with unchanged vital signs. What is your next action?Give an immediate synchronized shock.Give sedation and perform synchronized cardioversion.Administer magnesium sulfate 1 to 2 g IV diluted in 10 mL D5W given over 5 to 20 minutes.Give an immediate unsynchronized shock.Administer adenosine 6 mg; seek expert consultation.
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  • 5. Administer adenosine 6 mg; seek expert consultation.
  • 2. Perform immediate electrical cardioversion.
  • 2. Adenosine 6 mg
  • 4. Repeat adenosine 12 mg IV .
A patient with sinus bradycardia and heart rate of 42/min has diaphoresis and a blood pressure of 80/60 mm Hg. What is the initial dose of atropine?Dose of 0.1mgDose of 3 mgDose of 1 mgDose of 0.5mg
  • 2. IV or IO
  • 4. Use of a phosphodiesterase inhibitor within 12 hours
  • 4. Dose of 0.5mg
  • 1. Amiodarone 300 mg
A patient is in refractory ventricular fibrillation. High-quality CPR is in progress, and shocks have been given. One does of epinephrine was given after the second shock. An antiarrhythmic drug was given immediately after the third shock. What drug should the team leader request to be prepared for administration next?Escalating dose of epinephrine 3 mg.Second dose of epinephrine 1 mgRepeat the antiarrhythmic drugSodium bicarbonate 50 mEq
  • 2. Seeking expert consultation.
  • 2. Resume high-quality chest compressions.
  • 2. Second dose of epinephrine 1 mg
  • 1. Amiodarone 300 mg
Following initiation of CPR and 1 shock for VF, this rhythm is present on the next rhythm check. A second shock is given and chest compressions are resumed immediately. An IV is in place and no drugs have been given. Bag-mask ventilations are producing visible chest rise. What is your next order?Administer 3 sequential (stacked) shocks at 360 J (monophasic defibrillator).Prepare to give amiodarone 300 mg IV.Administer 3 sequential (stacked) shocks at 200 J (biphasic defibrillator).Perform endotracheal intubation; administer 100% oxygen.Prepare to give epinephrine 1 mg IV.
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  • 1. Give aspirin 160 to 325 mg chewed immediately.
  • 1. Give normal saline 250 mL to 500 mL fluid bolus.
  • 1. Epinephrine 1 mg or vasopressin 40 units IV or IO.
  • 5. Prepare to give epinephrine 1 mg IV.
Bradycardia requires treatment when:The blood pressure is less than 100 mm Hg systolic with or without symptoms.The heart rate is less than 60/min with or without symptoms.The patient's 12-lead ECG show an MI.Chest pain or shortness of breath is present.
  • 2. Begin CPR, starting with high-quality chest compressions.
  • 4. Lidocaine, epinephrine, vasopressin
  • 2. Continue monitoring and seek expert consultation.
  • 4. Chest pain or shortness of breath is present.
A 35-year-old woman presents to the emergency department with a chief compliant of palpitations. She has no chest discomfort, shortness of breath, or light-headedness. Which of the following is indicated first?Perform vagal maneuvers.Give adenosine 12 mg IV slow push (over 1 to 2 minutes).Give metoprolol 5 mg IV and repeat if necessary.Give adenosine 3 mg IV bolus.
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  • 5. Administer adenosine 6 mg; seek expert consultation.
  • 4. Administer epinephrine 1 mg.
  • 2. Seeking expert consultation.
  • 1. Perform vagal maneuvers.
You are evaluating a patient with chest discomfort lasting 15 minutes during transportation to the emergency department. He is receiving oxygen and 2 sublingual nitroglycerin tablets have relieved his chest discomfort. He reports no other symptoms but appears anxious. Blood pressure is 130/70 mm Hg. You observe the rhythm below on the monitor. What is your next action?Give atropine 0.5 mg IV.Initiate transcutaneous pacing (TCP).Start epinephrine 2 to 10 mcg/min and titrate to patient response.Continue monitoring the patient and seek expert consultation.Administer sublingual nitroglycerin 0.4 mg.
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  • 4. Continue monitoring the patient and seek expert consultation.
  • 1. Do not give aspirin for at least 24 hours if rtPA is administered.
  • 1. Sublingual nitroglycerin 0.4 mg.
  • 4. Lidocaine, epinephrine, vasopressin
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