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a) Administer adenosine 6 mg IV push - Answer: 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 38 mm 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 confirms a superventricular
tachycardia with no evidence of ischemia or infarction. The heart rate has not responded to vagal
maneuvers. What is your next action?
a) Administer adenosine 6 mg IV push
b) Administer adenosine 300 mg IV push
c) Perform synchronized cardioversion at 50 J
d) Perform synchronized cardioversion at 200 J
b) Amiodarone 300 mg - Answer: A patient is in pulseless ventricular tachycardia.Two shocks and 1 dose
of epinephrine have been given. Which drug should be given next?
a) Adenosine 6 mg
b) Amiodarone 300 mg
c) Epinephrine 3 mg
d) Lidocaine 0.5 mg/kg
c) Epinephrine - Answer: Which intervention is more appropriate for the treatment of a patient in
asystole?
a) Atropine
b) Defibrillation
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c) Epinephrine
d) Transcutaneous pacing
a) Adenosine 6 mg - Answer: 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?
a) Adenosine 6 mg
b) Atropine 0.5 mg
c) Epinephrine 2 to 10 mcg/kg per minute
d) Lidocaine 1 mg/kg
b) Establish IV or IO access - Answer: 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, which action do you take next?
a) Call for a pulse check
b) Establish IV or IO access
c) Insert a laryngeal airway
d) Perform endotracheal intubation
c) Pulseless ventricular tachycardia-associated torsades de pointes - Answer: What is the indication for
the use of magnesium in cardiac arrest?
a) Ventricular tachycardia associated with a normal QT interval
b) Shock-refractory monomorphic ventricular tachycardia
c) Pulseless ventricular tachycardia-associated torsades de pointes
d) Shock-refractory ventricular fibrillation
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d) Hold asprin for at least 24 hours if rtPA is administered - Answer: 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 is ordered. Which best describes the guidelines for antiplatelet and fibrinolytic
therapy?
a) Give asprin 160 to 325 mg to be chewed immediately
b) Give asprin 160 mg and clopidogrel 75 mg orally
c) Give heprin if the CT scan is negative for hemorrhage
d) Hold asprin for at least 24 hours if rtPA is administered
b) Hypertension - Answer: In which situation does bradycardia require treatment?
a) 12-lead ECG showing a normal sinus rhythm
b) Hypertension
c) Diastolic blood pressure greater than 90 mm Hg
d) Systolic blood pressure greater than 100 mm Hg
c) Perform electrical cardioversion - Answer: A 57-year-old woman has palpitations, chest discomfort,
and tachycardia. The monitor shows a regular wide-complex QRS at a rate of 100/min. She becomes
diaphoretic, and her blood pressure is 80/60 mm Hg. Which action do you take next?
a) Establish IV access
b) Obtain a 12-lead ECG
c) Perform electrical cardioversion
d) Seek expert consultation
a) Give asprin 160 to 325 mg to chew - Answer: 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 asprin because he has a history of gastritis, which was treated 5 years ago. What is
your next action?
a) Give asprin 160 to 325 mg to chew
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b) Give clopidogrel 300 mg orally
c) Give enteric-coated asprin 75 mg orally
d) Give enteric-coated asprin 325 mg rectally
a) Epinephrine 1 mg - Answer: A patient is in refractory ventricular fibrillation. High-quality CPR is in
progress. One dose 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?
a) Epinephrine 1 mg
b) Epinephrine 3 mg
c) Sodium bicarbinate 50 mEq
d) A second dose of the antiarrhythmic drug
b) Epinephrine 2 to 10 mcg/min - Answer: A patient has sinus bradycardia with a heart rate of 36/min.
Atropine has been administered to a total dose 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?
a) Atropine 1 mg
b) Epinephrine 2 to 10 mcg/min
c) Adenosine 6 mg
d) Normal saline 250 mL to 500 mL bolus
d) Use of a phosphodiesterase inhibitor within the previous 24 hours - Answer: A patient with possible
STEMI has ongoing chest discomfort. What is a contraindication to nitrate administration?
a) Anterior wall myocardial infarction
b) Heart rate less than 90/min
c) Systolic blood pressure greater than 180 mm Hg
d) Use of a phosphodiesterase inhibitor within the previous 24 hours