62 yr old man suddenly expereinced difficulty speaking and left-sided weakness. He meets initial criteria
for fibrinolytic therapy, and a CT scan of the brain is ordered. Which best describes the guidelines for
antiplatelet and fibrinolytic therapy?
(a) Give aspirin 160 to 325 mg to be chewed immediately
(b) Give aspirin 160 mg and clopidogrel 75 mg orally
(c) Give heparin if the CT scan is negative for hemorrhage
(d) Hold aspirin for at least 24 hrs if rtPA is administered - ✔✔-(d) Hold aspirin for at least 24 hrs if rtPA
is administered
A 35 year old woman has palpitations, light headedness, and a stable tachycardia. The monitor shows a
regular narrow-complex QRS at a rate of 180/min. Vagal maneuvers have not been effective in
terminating the rhythm. An IV has been established. What drug should be administered IV? - ✔✔-
Adenosine 6 mg
A 35 year old woman has palpitations, light headedness, and a stable tachycardia. The monitor shows a
regular narrow-complex QRS at a rate of 180/min. Vagal maneuvers have not been effective in
terminating the rhythm. An IV has been established. What drug should be administered? - ✔✔-
adenosine 6 mg
,A 35 yr old female has palpitation, light-headedness, and a stable tachycardia. The monitor shows a
regular narrow-complex QRS at a rate of 180/min. Vagal manuevers have not been effective in
terminating the rhythm. An IV has been established. Which drug should be administered?
(a) Adenosine 6 mg
(b) Atropine 0.5 mg
(c) Epinephrine 2 to 10 mcg/kg per minute
(d) Lidocaine - ✔✔-(a) Adenosine 6 mg
A 35 yr old woman presents w/ a chief complaint of palpitations. She has no chest discomfort, shortness
of breath, or light-headedness. Her BP is 120/78. On EKG, it shows she is in SVT. Which intervention is
indicated first?
(a) Adenosine 3 mg IV bolus
(b) Adenosine 12 mg IV slow push (over 1 to 2 min)
(c) Metoprolol 5 mg IV and repeat if necessary
(d) Vagal manuevers - ✔✔-(d) Vagal manuevers
A 35-year-old woman has palpitations, light-headedness, and a stable tachycardia. The monitor shows a
regular narrow-complex QRS at a rate of 180/min. Vagal maneuvers have not been effective in
terminating the rhythm. An IV has been established. Which drug should be administered? - ✔✔-
Adenosine 6mg
A 35-year-old woman presents with a chief complaint of palpitations. She has no chest discomfort,
shortness of breath, or light-headedness. Her blood pressure is 120/78mm Hg. Which intervention is
indicated first? - ✔✔-Vagal maneuvers
a 45 year old woman has a history of palpitations develops lightheadedness and palpitations. She has
received adenosine 6 mg IV for SVT without conversion. BP 128/70. next step? - ✔✔-adenosine 12 mg
A 45 yr old woman with a hx of palpitations develops light-headedness and palpitations. She has
received adenosine 6 mg IV for the rhythm shown here, without conversion of the rhythm. She is now
extremely apprehensive. Her BP is 128/70 mm Hg. What is the next appropriate intervention?
(a) Administer adenosine 12 mg IV
,(b) Perform unsynchronized cardioversion
(c) Perform vagal maneuvers
(d) Perform synchronized cardioversion - ✔✔-(a) Administer adenosine 12 mg IV
A 45-year-old woman with a history of palpitations develops light-headedness and palpitations. She has
received adensoine 6mg IV for the rhythm shown here (SVT), without conversion of the rhythm. She is
now extremely apprehensive. Her blood pressure si 128/70mm Hg. What is the next appropriate
intervention? - ✔✔-Administer adenosine 12 mg IV
A 49-year-old man has retrosternal chest pain radiating into the left arm. The patient is diaphoretic, with
associated shortness of breath. The blood pressure is 130/88 mm Hg, the heart rate is 110/min, the
respiratory rate is 22 breaths/min, and the pulse oximetry value is 95%. The patient's 12-lead ECG shows
ST-segment elevation in the anterior leads. First responders administered 160 mg of aspirin, and there is
a patent peripheral IV. The pain is described as an 8 on a scale of 1 to 10 and is unrelieved after 3 doses
of nitroglycerin. What is the next action? - ✔✔-Administer 2 to 4 mg of morphine by slow IV bolus.
A 49-year-old woman arrives in the emergency department with persistent epigastric pain. She had
been taking oral antacids for the past 6 hours because she thought she had heartburn. The initial blood
pressure is 118/72 mm Hg, the heart rate is 92/min and regular, the nonlabored respiratory rate is 14
breaths/min, and the pulse oximetry reading is 96%. Which is the most appropriate intervention to
perform next? - ✔✔-Obtain a 12 lead ECG.
A 53-year-old man has shortness of breath, chest discomfort, and weakness. The patient's blood
pressure is 102/59 mm Hg, the heart rate is 230/min, the respiratory rate is 16 breaths/min, and the
pulse oximetry reading is 96%. The lead II ECG is displayed below. A patent peripheral IV is in place.
What is the next action? - ✔✔-Vagal maneuvers
A 56-year-old man reports that he has palpitations but not chest pain or difficulty breathing. The blood
pressure is 132/68 mm Hg, the pulse is 130/min and regular, the respiratory rate is 12 breaths/min, and
the pulse oximetry reading is 95%. The lead II ECG displays a wide-complex tachycardia. What is the next
action after establishing an IV and obtaining a 12-lead ECG? - ✔✔-Seeking expert consultation
A 57 year old woman has palpitations, chest discomfort, and tachycardia. The monitor shows a regular
wide-complex QRS at a rate of 180 bpm. She becomes diaphoretic and her blood pressure is 80/60 mm
Hg. What is the next action? - ✔✔-cardioversion
, A 57 year old woman has palpitations, chest discomfort, and tachycardia. The monitor shows a regular
wide-complex QRS at a rate of 180 bpm. She becomes diaphoretic and her blood pressure is 80/60 mm
Hg. What is the next action? - ✔✔-Perform immediate electrical cardioversion
A 57-year-old woman has palpitation, chest discomfort, and tachycardia. The monitor shows a regular
wide-QRS at a rate of 180/min. She becomes diaphoretic, and her blood pressure is 80/60 mm HG/
Which action do you take next? - ✔✔-Perform electrical cordioversion
A 62 year old man suddenly experienced difficulty speaking and left-sided weakness. He was brought
into the emergency department. He meets initial criteria for fibrinolytic therapy, and a CT scan of the
brain is ordered. What are the guidelines for antiplatelet and fibrinolytic therapy? - ✔✔-Do not give ASA
for at least 24 hours if rtPA is administered
A 62 year old man suddenly experienced difficulty speaking and left-sided weakness. He was brought
into the emergency department. He meets initial criteria for fibrinolytic therapy, and a CT scan of the
brain is ordered. What are the guidelines for antiplatelet and fibrinolytic therapy? - ✔✔-hold aspirin for
at least 24 hours if rtPA is administered
A 62-year-old man in the emergency department says that his heart is beating fast. He says he has no
chest pain or shortness of breath. The blood pressure is 142/98 mm Hg, the pulse is 200/min, the
respiratory rate is 14 breaths/min, and pulse oximetry is 95% on room air. What intervention should you
perform next? - ✔✔-Obtain a 12 lead ECG.
A 62-year-old man suddenly experienced difficulty speaking and left-sided weakness. He meets initial
criteria for fibrinolytic therapy, and a CT scan of the brain si ordered. Which best describes the
guidelines for antiplatelet and fibrinolytic therapy? - ✔✔-Hold aspirin for at least 24 hours if rtPA is
administered
A 67 yr old woman has palpitations, chest discomfort, and tachycardia. The monitor shows a regular
wide-complex QRS at a rate of 180/min. She becomes diaphoretic, and her blood pressure is 80/60.
Which action do you take next?
(a) Establish IV access
(b) Obtain a 12 lead EKG
(c) Perform electrical cardioversion
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