ACLS Electrical Therapies and Defibrillation 2

Question 1

What is the recommended initial energy for synchronized cardioversion of unstable atrial flutter using a biphasic device?

Accepted Answer

50–100 J

Answer

10–20 J

Answer

120–200 J

Answer

200–360 J

Question 2

A patient in pulseless VT is refractory after two defibrillation attempts. What is the recommended next action regarding energy?

Accepted Answer

Use manufacturer-recommended escalating doses or maximum dose for subsequent shocks

Answer

Continue at the same energy level for all subsequent shocks

Answer

Decrease the energy by 50 J with each subsequent attempt

Answer

Switch to synchronized cardioversion for the next attempt

Question 3

Which condition requires immediate unsynchronized defibrillation rather than synchronized cardioversion?

Accepted Answer

Polymorphic VT (irregular) with a pulse and hemodynamic instability

Answer

Atrial fibrillation with rapid ventricular response

Answer

Supraventricular tachycardia with hypotension

Answer

Regular monomorphic VT with a pulse and hypotension

Question 4

During transcutaneous pacing for a patient with symptomatic bradycardia, what initial pacing rate is recommended?

Accepted Answer

60–80 beats per minute

Answer

40–50 beats per minute

Answer

100–120 beats per minute

Answer

150 beats per minute

Question 5

How is electrical capture confirmed during transcutaneous pacing?

Accepted Answer

Wide QRS complexes follow each pacing spike AND a pulse is palpable

Answer

The patient reports feeling a shock with each pacing spike

Answer

Pacing spikes appear on the ECG at the set rate

Answer

The monitor shows a paced rhythm at the set rate only

Question 6

When placing defibrillator pads on a patient with an implanted pacemaker or ICD, how should the pads be positioned?

Accepted Answer

At least 1 inch (2.5 cm) away from the implanted device

Answer

Directly over the implanted device for best conduction

Answer

Only posterior pad placement should be used

Answer

The device must be deactivated before defibrillation

Question 7

A patient in unstable SVT requires synchronized cardioversion but the device keeps firing randomly. What is the most likely cause?

Accepted Answer

The ECG lead is detecting artifact instead of R-waves, preventing sync

Answer

The device is malfunctioning and must be replaced

Answer

The synchronize button was not activated before charging

Answer

The energy selected is too low for synchronization to occur