DC Dysrhythmia Emergency Response & Intervention 3

Question 1

A patient in stable wide-complex tachycardia of uncertain origin is seen in the ED. What is the safest initial approach?

Accepted Answer

Treat as ventricular tachycardia until proven otherwise

Answer

Wide-complex tachycardia of uncertain origin should be treated as VT because misidentifying VT as SVT can lead to dangerous interventions.

Question 2

After successful defibrillation, a patient's rhythm converts to sinus tachycardia at 110 bpm but remains unresponsive with no palpable pulse. What should the team suspect?

Accepted Answer

Pulseless electrical activity

Answer

An organized rhythm without a palpable pulse is pulseless electrical activity, requiring continued CPR and treatment of reversible causes.

Question 3

Which of the following represents the correct initial energy dose for synchronized cardioversion of hemodynamically unstable atrial flutter?

Accepted Answer

50–100J biphasic

Answer

Atrial flutter typically responds to low energy levels of 50–100J biphasic for synchronized cardioversion.

Question 4

A patient with Wolff-Parkinson-White syndrome develops rapid atrial fibrillation. Which medication is contraindicated?

Accepted Answer

IV verapamil

Answer

AV nodal blocking agents like verapamil and diltiazem are contraindicated in WPW with AF because they can accelerate conduction through the accessory pathway, causing VF.

Question 5

During transcutaneous pacing for complete heart block, you see pacing spikes on the monitor but the patient remains unresponsive with no pulse. What is the most likely problem?

Accepted Answer

Pacing capture has not been achieved

Answer

Electrical activity on the monitor without a palpable pulse indicates failure to achieve mechanical capture despite pacing spikes.

(DC) Dysrhythmia Certification Practice Test

(DC) Dysrhythmia Certification Practice Test

DC Dysrhythmia Emergency Response & Intervention 3