DC Pharmacology & Drug Administration 4

Question 1

Which drug used for rate control in atrial fibrillation is MOST appropriate in a patient with decompensated heart failure and hypotension?

Accepted Answer

Digoxin IV

Answer

Digoxin has a mild positive inotropic effect and does not cause vasodilation, making it preferable for rate control in patients with decompensated heart failure and hypotension.

Question 2

Epinephrine 1 mg IV/IO is administered every 3–5 minutes during cardiac arrest. Its primary benefit in VF/pVT is:

Accepted Answer

Increasing coronary and cerebral perfusion pressure via alpha-1-mediated vasoconstriction

Answer

Epinephrine's alpha-1 agonist effect causes peripheral vasoconstriction, raising aortic diastolic pressure and improving coronary and cerebral perfusion during CPR.

Question 3

Which antiarrhythmic is most appropriate for a patient with recurrent symptomatic AF and a history of pulmonary fibrosis?

Accepted Answer

Sotalol

Answer

Sotalol is preferred because amiodarone can worsen or cause pulmonary toxicity, dronedarone is less effective and contraindicated with certain conditions, and flecainide requires structurally normal hearts.

Question 4

The recommended dose of amiodarone for a pulseless VF/VT arrest unresponsive to defibrillation is:

Accepted Answer

300 mg IV push, followed by 150 mg for recurrence

Answer

ACLS guidelines recommend amiodarone 300 mg IV push for shock-refractory VF/pVT, with a supplemental dose of 150 mg IV for recurrence.

Question 5

Verapamil should NOT be administered to a patient with wide-complex tachycardia of unknown origin because:

Accepted Answer

If the rhythm is VT, verapamil can cause hemodynamic collapse

Answer

Verapamil causes vasodilation and negative inotropy; in VT (misidentified as SVT), it can precipitate severe hypotension and cardiovascular collapse.

(DC) Dysrhythmia Certification Practice Test

(DC) Dysrhythmia Certification Practice Test

DC Pharmacology & Drug Administration 4