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Acls Pretest Quiz
You arrive on the scene to find CPR in progress. Nursing staff report that the patient was recovering from a pulmonary embolism and suddenly collapsed. There is no pulse or spontaneous respirations. High-quality CPR and effective bag-mask ventilation are being provided. An IV has been initiated. What would you do now?
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Give epinephrine 1 mg IV.
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Give epinephrine 4 mg IV.
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Give epinephrine 99 mg IV.
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Give epinephrine 6 mg IV.
You are evaluating a patient with chest discomfort lasting 15 minutes during transportation to the emergency department. He is receiving oxygen, and 2 sublingual nitroglycerin tablets have relieved his chest discomfort. He reports no other symptoms but appears anxious. Blood pressure is 130/70 mg Hg. You observe the above rhythm on the monitor. What is your next action?
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Sublingual nitroglycerin 0.4 mg
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Continue monitoring and seek expert consultation.
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Atropine 0.5 mg IV
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Continue monitoring the patient and seek expert consultation.
A patient is in cardiac arrest. High-quality chest compressions are being given. The patient is intubated, and an IV has been started. The rhythm is asystole. Which is the first drug/dose to administer?
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Continue monitoring and seek expert consultation.
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Epinephrine 1 mg or vasopressin 40 units IV or IO
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Epinephrine 1 mg
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Second dose of epinephrine 1 mg
A patient is in cardiac arrest. Ventricular fibrillation has been refractory to an initial shock. What is the recommended route for drug administration during CPR?
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Amiodarone 300 Mg
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Epinephrine 1 Mg
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Gain Iv or Io Access
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IV or IO
You arrive on the scene to find a 56-year-old diabetic woman with dizziness. She is pale and diaphoretic. Her blood pressure is 80/60 mm Hg. The cardiac monitor documents the rhythm above. She is receiving oxygen at 4 L/min by nasal cannula, and an IV has been established. Your next order is:
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Atropine 0.5 mg IV
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Atropine 0.25 mg IV
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Atropine 0.0 mg IV
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Atropine 10.5 mg IV
A 62-year-old man suddenly experienced difficulty speaking and left-sided weakness. He was brought to 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?
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Continue monitoring and seek expert consultation.
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Do not give aspirin for at least 24 hours if rtPA is administered
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Give magnesium sulfate 1 to 2 g IV diluted in 10 mL D5W given over 5 to 20 minutes.
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Give Aspirin 160 to 325 mg chewed immediately.
You are the code team leader and arrive to find a patient with the above rhythm and CPR in progress. Team members report that the patient was well but reported chest pain and then collapsed. She has no pulse or respirations. Bag-mask ventilations are producing visible chest rise, high-quality CPR is in progress, and an IV has been established. What would be your next order?
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Administer epinephrine 99 mg.
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Administer epinephrine 1 mg.
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Administer epinephrine 101 mg.
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Administer epinephrine 2 mg.
A patient in the emergency department develops recurrent chest discomfort (8/10) suspicious for ischemia. His monitored rhythm becomes irregular as seen above. Oxygen is being administered by nasal cannula at 4 L/min, and an IV line is in place. Blood pressure is 160/96 mm Hg. There are no allergies or contraindications to any medication. You would first order:
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Sublingual nitroglycerin 0.4 mg
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Sublingual nitroglycerin 0.5 mg
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Sublingual nitroglycerin 0.3 mg
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Sublingual nitroglycerin 1.4 mg
You arrive on the scene with the code team. High-quality CPR is in progress. An AED has previously advised, "no shock indicated." A rhythm check now finds asystole. After resuming high-quality compressions, your next action is to:
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Give a single shock.
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Give Epinephrine 1 Mg iv.
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Gain IV or IO access
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Call For a Pulse check
A patient is in refractory ventricular fibrillation and has received multiple appropriate defibrillation shocks, epinephrine 1 mg IV twice, and an initial dose of 300 mg amidarone IV. The patient is intubated. A second does of amiodarone is now called for. The recommended second dose of amiodarone is
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15 mg IV push
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50 mg IV push
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150 mg IV push
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250 mg IV push
Which of the following statements about the use of magnesium in cardiac arrest is most accurate?
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Monomorphic Ventricular Tachycardia
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The correct dose of vasopressin is 40 units administered IV or IO.
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Begin CPR, starting with high-quality chest compressions.
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Magnesium is indicated for VF/pulseless VT associated with torsades de pointes.
A patient is in cardiac arrest. Ventricular fibrillation has been refractory to a second shock. Of the following, which drug and dose should be administered first by the IV/IO route?
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Epinephrine 5 mg
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Epinephrine 1 mg
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Epinephrine 4 mg
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Epinephrine 6 mg
A patient is in refractory ventricular fibrillation. High-quality CPR is in progress, and shocks have been given. One dose of epinephrine was given after the second shock. An antiarrhythmic drug was given immediately after the third shock. What drug should the team leader request to be prepared for administration next?
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Epinephrine 1 mg or vasopressin 40 units IV or IO
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Amiodarone 300 mg
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Sublingual nitroglycerin 0.4 mg
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Second dose of epinephrine 1 mg
A patient has a rapid irregular wide-complex tachycardia. The ventricular rate is 138/min. He is asymptomatic, with a blood pressure of 110/70 mm Hg. He has a history of angina. Which of the following actions is recommended?
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Epinephrine 1 mg
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Sublingual nitroglycerin 0.4 mg
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Seeking expert consultation
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Amiodarone 300 mg
You are monitoring a patient with chest discomfort who suddenly becomes unresponsive. You observe the following rhythm on the cardiac monitor. A defibrillator is present. What is your first action?
Report Question
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Give a single shock.
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Gain iv or io access
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Give epinephrine 1 mg iv.
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Give atropine 0.5 mg iv
You are monitoring the patient and note the above rhythm on the cardiac monitor. She has dizziness, and her blood pressure is 80/40 mm Hg. She has an IV in place. What is your next action?
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Give atropine 5.5 mg IV
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Give atropine 0.4 mg IV
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Give atropine 0.0 mg IV
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Give atropine 0.5 mg IV
Bradycardia requires treatment when:
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Epinephrine 1 mg or vasopressin 40 units IV or IO
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Chest pain or shortness of breath is present
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Reentry supraventricular tachycardia
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Course Ventricular Fibrillation
Following imitation of CPR and 1 shock for VF, this rhythm is present on the next rhythm check. A second shock is give, and chest compressions are resumed immediately. An IV is in place, and no drugs have been given. Bag-mask ventilations are producing visible chest rise. What is your next order?
Report Question
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Second dose of epinephrine 1 mg
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Prepare to give epinephrine 1 mg IV.
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Continue monitoring and seek expert consultation.
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Seek expert consultation
A patient is in pulseless ventricular tachycardia. Two shocks and 1 dose of epinephrine have been given. Which is the next drug/dose to anticipate administering?
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Amiodarone 200 mg
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Amiodarone 300 mg
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Amiodarone 301 mg
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Amiodarone 310 mg
Which of the following statements is most accurate regarding the administration of vasopressin during cardiac arrest?
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Lidocaine, epinephrine, vasopressin
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Give normal Saline 250 mL to 500 ml fluid bolus
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Second-degree AV block (Mobitz I Wenchebach)
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The correct dose of vasopressin is 40 units administered IV or IO.
Following resuscitation with CPR and a single shock, you observe this rhythm while preparing the patient for transport. Your patient is stable, and blood pressure is 120/80 mg Hg. She is apprehensive but has no symptoms other than palpitations. At this time you would?
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Give epinephrine 1 mg iv.
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Give atropine 0.5 mg iv.
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Gain iv or io access
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Seek expert consultation
This patient has been resuscitated from cardiac arrest. During the resuscitation, amiodarone 300 mg was administered. The patient developed severe chest discomfort with diaphoresis. He is now unresponsive. What is the next indicated action?
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Give magnesium sulfate 1 to 2 g IV diluted in 10 mL D5W given over 5 to 20 minutes.
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Give an immediate unsynchronized high-energy shock (defibrillation dose).
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Give atropine 0.5 mg IV.
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Give normal Saline 250 mL to 500 ml fluid bolus
A patient with ST-segment elevation MI has ongoing chest discomfort. Fibrinolytic therapy has been ordered. Heparin 4000 units IV bolus was administered, and a heparin infusion of 1000 units per hour is being administered. Aspirin was taken by the patient because he had a history of gastritis treated 5 years ago. Your next action is?
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0%
Give atropine 0.5 mg IV.
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Give Aspirin 160 to 325 mg chewed immediately.
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Continue monitoring and seek expert consultation.
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Give magnesium sulfate 1 to 2 g IV diluted in 10 mL D5W given over 5 to 20 minutes.
A patient with a possible acute coronary syndrome has ongoing chest discomfort unresponsive to 3 sublingual nitroglycerin tablets. There are no contraindications, and 4 mg of morphine sulfate was administered. Shortly afterward, blood pressure falls to 88/60 mm Hg, and the patient has increased chest discomfort. You should:
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Use of phosphodiesterase inhibitor within 12 hours.
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Give Aspirin 160 to 325 mg chewed immediately.
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Give normal Saline 250 mL to 500 ml fluid bolus
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Epinephrine 1 mg or vasopressin 40 units IV or IO
A patient was admitted to the general medical ward with a history of alcoholism. A code in progress, and he has recurrent episodes of the rhythm. You review his chart. Notes about the 12-lead ECG say that his baseline QT interval is high normal to slightly prolonged. He has received 2 doses of epinephrine 1 mg and 1 dose of aminodarone 300 mg IV so far. What would you order for his next medication?
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Epinephrine 1 mg or vasopressin 40 units IV or IO
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1 to 2 L of normal saline
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Start epinephrine 2 to 10 mcg/min
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Give magnesium sulfate 1 to 2 g IV diluted in 10 mL D5W given over 5 to 20 minutes.
A patient's 12-lead ECG was transmitted by the paramedics and showed an acute MI. The above findings are seen on a rhythm strip when a monitor is placed in the emergency department. The patient had resolution of moderate (5/10) chest pain with 3 does of sublingual nitroglycerin. Blood pressure is 104/70 mm Hg. Which intervention below is most important, reducing in-hospital and 30-day mortality?
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Sublingual nitroglycerin 0.4 mg
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Reperfusion therapy
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Atropine 0.5 mg iv
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Epinephrine 1 mg
A patient presents with the above rhythm and reports an irregular heartbeat. She has no other symptoms. Her medical history is significant for a myocardial infarction 7 years ago. Blood pressure is 110/70 mm Hg. What would you do at this time
Report Question
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Give Aspirin 160 to 325 mg chewed immediately.
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Epinephrine 1 mg or vasopressin 40 units IV or IO
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Continue monitoring the patient and seek expert consultation.
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Continue monitoring and seek expert consultation.
A patient becomes unresponsive. You are uncertain if a faint pulse is present with the above rhythm. What is your next action?
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0%
Begin CPR, starting with high-quality chest compressions.
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Epinephrine 1 mg or vasopressin 40 units IV or IO
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Use of phosphodiesterase inhibitor within 12 hours.
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Resume high-quality chest compressions.
A patient was in refractory ventricular fibrillation. A shock has just been administered. Your team looks to you for instructions. Your immediate next order is:
Report Question
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Resume high-quality chest compressions.
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Epinephrine 1 mg
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Deliver an unsynchronized shock/defibrillation at 120 j.
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Administer atropine 1 mg intravenously.
A 35-year-old woman has palpitations, light-headiness, 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 terminated the rhythm. An IV has been established. What drug should be administered IV?
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Adenosine 94 mg
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Adenosine 12 mg
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Adenosine 6 mg
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Adenosine 106 mg
A patient has sinus bradycardia with a heart rate of 36/min. Atropine has been administered to a total dose of 3 mg. A transcutaneous pacemaker has failed to capture. The patient is confused, and her blood pressure is 100/60 mm Hg. Which of the following is now indicated?
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Second dose of epinephrine 1 mg
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Start epinephrine 2 to 10 mcg/min
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1 to 2 L of normal saline
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Seeking expert consultation
A patient with possible ST-segment elevation MI has ongoing chest discomfort. Which of the following would be a contraindication to the administration of nitrates?
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Resume high-quality chest compressions.
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Use of phosphodiesterase inhibitor within 12 hours.
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Give normal Saline 250 mL to 500 ml fluid bolus
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Give Aspirin 160 to 325 mg chewed immediately.
A 45-year-old woman with a history of palpitations develops light-headedness and palpitations. She has received adenosine 6 mg IV for the rhythm shown above without conversion of the rhythm. She is now extremely apprehensive. Blood pressure is 108/70 mm Hg. What is the next appropriate intervention?
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Repeat adenosine 11 mg IV.
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Repeat adenosine 112 mg IV.
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Repeat adenosine 12 mg IV.
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Repeat adenosine 1 mg IV.
You are monitoring a patient. He suddenly has the above persistent rhythm. You ask about symptoms, and he reports that he has mild palpitations, but otherwise he is clinically stable with unchanged vital signs. What is your next action?
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Repeat adenosine 12 mg IV.
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Adenosine 6 mg
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Perform immediate electrical cardioversion
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Administer adenosine 6 mg; seek 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/min. She becomes diaphoretic, and her blood pressure is 80/60 mm Hg. The next action is to:
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Perform immediate electrical cardioversion
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Adenosine 6 mg
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Perform vagal maneuvers
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Administer epinephrine 1 mg.
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