ACLS - Pharmacology

A 35-year-old woman has palpitations, light-headedness, and a stable tachycardia. The monitor show a regular narrow-complex QRS at a rate of 180/min. Vagal maneuvers have not been effective in terminating the rhythm. An IV has ben 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

A. adenosine 6 mg

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 supraventricular tachycardia with no evidence of ischemia or infarction. The heart rate has no responded to vagal maneuvers. What is your next action? A. administer adenosine 6 mg IV push B. administer amiodarone 300 mg IV push C. perform synchronized cardioversion at 50 J D. perform synchronized cardioversion at 200 J

A. administer adenosine 6 mg IV push

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 2 L/min, and an IV has been established. His blood pressure is 180/100 mm Hg. Which drug do you anticipate giving to this patient? A. aspirin B. glucose (D50) C. nicardipine D. rtPA

A. aspirin

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 bicarbonate 50 mEq D. a second dose of the antiarrhythmic drug

A. epinephrine 1 mg

A patient with STEMI has ongoing chest discomfort. Heparin 4000 units IV bolus and a heparin infusion of 1000 unit per hour are being administered. The patient did not take aspirin because he has a history of gastritis, which was treated 5 years ago. What is your next action? A. give aspirin 160 to 325 mg to chew B. give clopidogrel 300 mg orally C. give enteric-coated aspirin 75 mg orally D. give enteric-coated aspirin 325 mg rectally

A. give aspirin 160 to 325 mg to chew

A patient with sinus bradycardia and a heart rate of 42/min has diaphoresis and a blood pressure of 80/60 mm Hg. What is the initial dose of atropine? A. 0.1 mg B. 0.5 mg C. 1 mg D. 3 mg

B. 0.5 mg

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

B. amiodarone 300 mg

A patient is in cardiac arrest. Ventricular fibrillation has been refractory to second shock. Which drug should be administered first? A. atropine 1 mg IV / IO B. epinephrine 1 mg IV / IO C. lidocaine 1 mg/kg IV / IO D. sodium bicarbonate 50 mEq IV / IO

B. epinephrine 1 mg IV / IO

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

B. epinephrine 2 to 10 mcg/min

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

B. establish IV or IO access

In which situation does bradycardia require treatment? A. 12-lead ECG showing a normal sinus rhythm B. hypotension C. diastolic blood pressure greater than 90 mm Hg D. systolic blood pressure greater than 100 mm Hg

B. hypotension

A patient is in refractory ventricular fibrillation and has received multiple appropriate defibrillation shocks, epinephrine 1 mg IV twice, and an initial dose of amiodarone 300 mg IV. The patient is intubated. Which best describe the recommended second dose of amiodarone for this patient? A. 1 mg/kg IV push B. 1 to 2 mg/min infusion C. 150 mg IV push D. 300 mg IV push

C. 15o mg IV push

Which intervention is most appropriate for the treatment of a patient in asystole? A. atropine B. defibrillation C. epinephrine D. transcutaneous pacing

C. epinephrine

a 57 year-old-woman has palpitations, chest discomfort, and tachycardia. The monitor show a regular wide-complex QRS at a rate of 180/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

C. perform electrical cardioversion

What is the indication for the us 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

C. pulseless ventricular tachycardia-associated torsades de pointes

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? A. central line B. endotracheal tube C. external jugular vein D. IV or IO

D. IV or IO

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. What is the first drug/dose to administer? A. atropine 0.5 mg IV / IO B. atropine 1 mg IV / IO C. dopamine 2 to 20 mcg/kg per minute IV / IO D. epinephrine 1 mg IV / IO

D. epinephrine 1 mg 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 is ordered. Which best describes the guidelines for antiplatelet and fibrinolytic therapy? A. give aspirin 160 to 325 mg to be chewed immediately B. give aspirin 160 mg and clopidogrel 75 mg orally C. give heparin if the CT scan is negative for hemorrhage D. hold aspirin for at least 24 hours if rtPA is administered

D. hold aspirin for at least 24 hours if rtPA is administered

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? A. giving adenosine 6 mg IV bolus B. giving lidocaine 1 to 1.5 mg IV bolus C. performing synchronized cardioversion D. seeking expert consultation

D. seeking expert consultation

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 that 180 mm Hg D. use of a phosphodiesterase inhibitor within the previous 24 hours

D. use of a phosphodiesterase inhibitor within the last 24 hours