ACLS Pulseless 2

Question 1

A patient in pulseless VT fails to convert after the first defibrillation attempt and CPR is resumed. Which drug should be given next?

Accepted Answer

Epinephrine 1 mg IV

Answer

Lidocaine 1.5 mg/kg IV

Answer

Amiodarone 300 mg IV

Answer

Magnesium sulfate 2 g IV

Question 2

During CPR for a pulseless patient, you notice the waveform capnography reading is consistently below 10 mmHg after 20 minutes. What does this most likely indicate?

Accepted Answer

Unlikely to achieve ROSC; consider stopping resuscitation

Answer

Effective CPR with good perfusion

Answer

ETT displacement into the esophagus

Answer

Need to increase ventilation rate

Question 3

What is the recommended energy for biphasic defibrillation of pulseless VT/VF when the manufacturer's recommendation is unknown?

Accepted Answer

150–200 J

Answer

100 J

Answer

200 J and escalate

Answer

360 J

Question 4

A patient develops PEA after a witnessed cardiac arrest. The rate on the monitor is 40 bpm. Which reversible cause should be highest on your differential?

Accepted Answer

Tension pneumothorax

Answer

Hyperkalemia

Answer

Hypovolemia

Answer

Hypothermia

Question 5

After defibrillation, CPR is immediately resumed. What is the primary reason to avoid checking the pulse immediately after a shock?

Accepted Answer

Pulse checks interrupt compressions and reduce coronary perfusion

Answer

The shock may cause artifact making the pulse undetectable

Answer

Checking the pulse resets the defibrillator charge time

Answer

Pulse checks risk accidental re-shock to the provider

Question 6

Amiodarone 300 mg IV has been given for refractory VF. If VF persists, what is the correct supplemental dose?

Accepted Answer

150 mg once

Answer

300 mg repeat dose

Answer

150 mg up to two additional doses

Answer

Amiodarone should not be repeated

Question 7

A patient is found in asystole. After confirming the rhythm in two leads, which intervention should occur immediately?

Accepted Answer

Resume high-quality CPR and establish vascular access

Answer

Defibrillation at 360 J

Answer

Transcutaneous pacing at 80 bpm

Answer

Administer atropine 1 mg IV