DC Clinical Procedures & Protocols 4

Question 1

A patient in third-degree AV block with a ventricular rate of 28 bpm is hypotensive. After atropine fails, the next intervention is:

Accepted Answer

Transcutaneous pacing (TCP)

Answer

If atropine is ineffective for symptomatic complete heart block, transcutaneous pacing is the next bridge therapy while preparing for transvenous pacing.

Question 2

The recommended energy for the first biphasic shock in ventricular fibrillation using manufacturer-recommended settings is:

Accepted Answer

120–200 J

Answer

Biphasic defibrillators are effective at 120–200 J for the first shock; if the manufacturer's recommendation is unknown, 200 J is used.

Question 3

Which maneuver can terminate AVNRT by increasing vagal tone?

Accepted Answer

All of the above

Answer

Carotid massage, standard Valsalva, and modified Valsalva all increase vagal tone and can terminate AVNRT, with the modified Valsalva showing higher success rates.

Question 4

When interpreting a 12-lead ECG for suspected ST-elevation MI during a resuscitation, leads V1–V4 ST elevation indicates involvement of which coronary artery territory?

Accepted Answer

Left anterior descending artery (anterior)

Answer

ST elevation in V1–V4 represents anterior wall STEMI, most commonly due to LAD occlusion.

Question 5

A patient with stable wide-complex tachycardia of unknown origin should initially be treated as if it is:

Accepted Answer

Ventricular tachycardia

Answer

All wide-complex tachycardias of uncertain origin are presumed to be VT until proven otherwise because mismanagement of VT as SVT can be fatal.

(DC) Dysrhythmia Certification Practice Test

(DC) Dysrhythmia Certification Practice Test

DC Clinical Procedures & Protocols 4