21: 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.
22: A patient with ST-segment elevation MI has ongoing chest discomfort. Fibrinolytic therapy has been ordered. Heparin 4000
units IV bolus was administered, and a heparin infusion of 1000 units per hour is being administered. Aspirin was not taken by th
patient because he had a history of gastritis treated 5 years ago. Your next action is to:
Give aspirin 160 to 325 mg chewed
immediately. Give 75 mg enteric-coated aspirin
orally.
Give 325 mg enteric-coated aspirin rectally.
Substitute clopidogrel 300 mg loading
dose.
23: A patient has sinus bradycardia with a heart rate of 36/min. Atropine has been administered to a total of 3 mg. A
transcutaneous pacemaker has failed to capture. The patient is confused, and her blood pressure is 110/60 mm Hg. Which of the
following is now indicated?
A. Give additional 1 mg atropine. B. Start dopamine 10 to 20 mcg/kg per minute.
C. Give normal saline bolus 250 mL to 500 mL. D. Start epinephrine 2 to 10 mcg/min.
24: 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>
A. Do not give aspirin for at least 24 hours if rtPA is administered.
B. Give aspirin 160 mg and clopidogrel 75 mg orally.
C. Administer heparin if CT scan is negative for hemorrhage.
D. Administer aspirin 160 to 325 mg chewed immediately.
25: 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?
A. Heart rate 90/min. C. Blood pressure greater than 180 mm Hg.
B. Left ventricular infarct with bilateral rales. D Use of a phosphodiesterase inhibitor within 12 hours
26: 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?
A. Epinephrine 1 mg B. Vasopressin 20 units C. Sodium bicarbonate 50 mEq D. Atropine 1 mg
27: 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?
A. Lidocaine 1mg/kg B. Adenosine 6 mg C. Epinephrine 2 to 10 mcg/kg per minute D. Atropine 0.5 mg
28: 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? A. 0.1mg B. 3 mg C. 1 mg D. 0.5 mg
29: 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:
A. An endotracheal dose of 2 to 4 mg/kg.
B. 300 mg IV push.
C. 1 mg/kg IV push.
,
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.
22: A patient with ST-segment elevation MI has ongoing chest discomfort. Fibrinolytic therapy has been ordered. Heparin 4000
units IV bolus was administered, and a heparin infusion of 1000 units per hour is being administered. Aspirin was not taken by th
patient because he had a history of gastritis treated 5 years ago. Your next action is to:
Give aspirin 160 to 325 mg chewed
immediately. Give 75 mg enteric-coated aspirin
orally.
Give 325 mg enteric-coated aspirin rectally.
Substitute clopidogrel 300 mg loading
dose.
23: A patient has sinus bradycardia with a heart rate of 36/min. Atropine has been administered to a total of 3 mg. A
transcutaneous pacemaker has failed to capture. The patient is confused, and her blood pressure is 110/60 mm Hg. Which of the
following is now indicated?
A. Give additional 1 mg atropine. B. Start dopamine 10 to 20 mcg/kg per minute.
C. Give normal saline bolus 250 mL to 500 mL. D. Start epinephrine 2 to 10 mcg/min.
24: 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>
A. Do not give aspirin for at least 24 hours if rtPA is administered.
B. Give aspirin 160 mg and clopidogrel 75 mg orally.
C. Administer heparin if CT scan is negative for hemorrhage.
D. Administer aspirin 160 to 325 mg chewed immediately.
25: 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?
A. Heart rate 90/min. C. Blood pressure greater than 180 mm Hg.
B. Left ventricular infarct with bilateral rales. D Use of a phosphodiesterase inhibitor within 12 hours
26: 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?
A. Epinephrine 1 mg B. Vasopressin 20 units C. Sodium bicarbonate 50 mEq D. Atropine 1 mg
27: 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?
A. Lidocaine 1mg/kg B. Adenosine 6 mg C. Epinephrine 2 to 10 mcg/kg per minute D. Atropine 0.5 mg
28: 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? A. 0.1mg B. 3 mg C. 1 mg D. 0.5 mg
29: 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:
A. An endotracheal dose of 2 to 4 mg/kg.
B. 300 mg IV push.
C. 1 mg/kg IV push.
,
