CCRN Cardiac Rhythm Interpretation and Management 2

Question 1

A hemodynamically stable patient develops sustained monomorphic ventricular tachycardia with a palpable pulse. What is the preferred first-line pharmacological intervention?

Accepted Answer

Amiodarone 150 mg IV over 10 minutes

Answer

Atropine 0.5 mg IV push

Answer

Adenosine 6 mg rapid IV push

Answer

Digoxin 0.5 mg IV

Question 2

A patient in pulseless ventricular fibrillation is identified on the monitor. What is the immediate priority intervention?

Accepted Answer

Deliver unsynchronized defibrillation

Answer

Administer epinephrine 1 mg IV first

Answer

Perform 2 minutes of CPR before shocking

Answer

Deliver synchronized cardioversion at 200 joules

Question 3

Atropine 0.5 mg IV is the appropriate initial treatment for which dysrhythmia?

Accepted Answer

Symptomatic sinus bradycardia

Answer

Ventricular fibrillation

Answer

Atrial fibrillation with rapid ventricular response

Answer

Second-degree Mobitz type II AV block

Question 4

A patient presents with paroxysmal supraventricular tachycardia (PSVT) at 180 bpm. Vagal maneuvers have failed. What is the first pharmacological treatment of choice?

Accepted Answer

Adenosine 6 mg rapid IV push followed by a 20 mL saline flush

Answer

Amiodarone 150 mg IV over 10 minutes

Answer

Synchronized cardioversion at 50 joules

Answer

Verapamil 5 mg IV over 2 minutes

Question 5

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?

Accepted Answer

Rate control with a beta-blocker or calcium channel blocker

Answer

Immediate unsynchronized defibrillation at 200 joules

Answer

Temporary transvenous pacemaker insertion

Answer

Magnesium sulfate 2 g IV over 10 minutes

Question 6

A patient in the ICU develops torsades de pointes (polymorphic VT associated with a prolonged QT). Which treatment is most appropriate?

Accepted Answer

Magnesium sulfate 1–2 g IV over 5–10 minutes

Answer

Amiodarone 150 mg IV bolus

Answer

Lidocaine 1 mg/kg IV push

Answer

Adenosine 12 mg rapid IV push

Question 7

When performing synchronized cardioversion for hemodynamically unstable atrial fibrillation using a biphasic defibrillator, what is the recommended initial energy setting?

Accepted Answer

120–200 joules

Answer

10–50 joules

Answer

50–100 joules

Answer

300–360 joules