Cardiac Rhythm Interpretation and Management Flashcards
7 cards from real CCRN practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Cardiac Rhythm Interpretation and Management flashcards as text
A hemodynamically stable patient develops sustained monomorphic ventricular tachycardia with a palpable pulse. What is the preferred first-line pharmacological intervention?
Answer: Amiodarone 150 mg IV over 10 minutes
Amiodarone 150 mg IV over 10 minutes is the first-line antiarrhythmic for stable monomorphic VT when the patient is not in cardiac arrest.
A patient in pulseless ventricular fibrillation is identified on the monitor. What is the immediate priority intervention?
Answer: Deliver unsynchronized defibrillation
Unsynchronized defibrillation is the definitive treatment for VF and should be delivered as soon as the rhythm is identified; CPR is resumed immediately after the shock.
Atropine 0.5 mg IV is the appropriate initial treatment for which dysrhythmia?
Answer: Symptomatic sinus bradycardia
Atropine blocks vagal tone and increases heart rate, making it first-line for symptomatic sinus bradycardia; Mobitz II typically requires pacing, not atropine.
A patient presents with paroxysmal supraventricular tachycardia (PSVT) at 180 bpm. Vagal maneuvers have failed. What is the first pharmacological treatment of choice?
Answer: Adenosine 6 mg rapid IV push followed by a 20 mL saline flush
Adenosine 6 mg rapid IV push with a saline flush is the first-line drug for PSVT; it briefly blocks AV conduction to terminate reentrant circuits.
A hemodynamically stable patient with atrial flutter and a ventricular rate of 150 bpm has no history of prior episodes. What is the most appropriate initial management?
Answer: Rate control with a beta-blocker or calcium channel blocker
For hemodynamically stable atrial flutter, rate control with a beta-blocker (e.g., metoprolol) or non-dihydropyridine calcium channel blocker (e.g., diltiazem) is the initial priority.
A patient in the ICU develops torsades de pointes (polymorphic VT associated with a prolonged QT). Which treatment is most appropriate?
Answer: Magnesium sulfate 1–2 g IV over 5–10 minutes
Magnesium sulfate 1–2 g IV is the treatment of choice for torsades de pointes because it stabilizes the cardiac membrane and shortens the QT interval.
When performing synchronized cardioversion for hemodynamically unstable atrial fibrillation using a biphasic defibrillator, what is the recommended initial energy setting?
Answer: 120–200 joules
ACLS guidelines recommend 120–200 joules (biphasic, manufacturer-recommended) as the initial energy for cardioversion of atrial fibrillation.