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

Atrial flutter typically responds to lower cardioversion energies; ACLS recommends starting at 50–100 J biphasic for unstable flutter.

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

For refractory VF/pVT, subsequent shocks should use manufacturer-recommended escalating energy or the maximum device dose to improve defibrillation success.

Question 3

Which condition requires immediate unsynchronized defibrillation rather than synchronized cardioversion?

Accepted Answer

Polymorphic VT (irregular) with a pulse and hemodynamic instability

Answer

Polymorphic VT is treated like VF with unsynchronized high-energy shocks because the irregular rhythm makes synchronization difficult and dangerous.

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

Transcutaneous pacing is typically initiated at 60–80 beats per minute, which provides adequate cardiac output without causing excessive tachycardia.

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

Electrical capture is confirmed by wide QRS complexes following each pacing spike AND mechanical capture by palpating a pulse corresponding to the paced rate.

ACLS Practice Test

ACLS Practice Test

ACLS Electrical Therapies and Defibrillation 2