VF / Pulseless VT Quiz - Gyath Shammha

Atropine doses of less than 0.5 mg may paradoxically result in further slowing of the heart rate.

True

False

Symptoms of bradycardia include acutely altered mental status, signs of shock, and ischemic chest discomfort.

True

False

Preparation for transcutaneous pacing (standby pacing) should be made for which of the following?

unstable sinus bradycardia

third degree AV block

Mobitz type II second-degree AV block

all of the above

Which rhythm is most likely to be associated with symptomatic bradycardia?

PEA

sinus rhythm

ventricular fibrillation

Mobitz II

The following rhythm is a complete block. Which definition of complete block is correct.

One or more (but not all) of the atrial impulses fail to conduct to the ventricles due to impaired conduction.

The impulse conducting from atria to ventricles through the AV node is delayed and travels slower than normal PR interval is lengthened beyond 0.20 seconds

The impulse generated in the SA node in the atrium does not propagate to the ventricles and there is no apparent relationship between P waves and QRS complexes.

There is no impulse generated from the SA node in the atrium but the ventricles contract from random locations below the AV Node.

The key clinical question when determining steps to take for the patient with symptomatic bradycardia is:

Is the bradycardia reversible?

Does the patient respond to medications?

Are the symptoms caused by bradycardia or some other illness?

Is the patient a DNR?

Transcutaneous pacing should be started immediately if:

there is no response to atropine

atropine is unlikely to be effective or if IV access cannot be quickly established

the patient is severely symptomatic

all of the above

Symptomatic bradycardia exists when_________.

the heart rate is slow

the patient has symptoms

the symptoms are due to a slow heart rate

all of the above are needed for symptomatic bradycardia to exist.

If atropine fails, the treatment of choice for symptomatic bradycardia with signs of poor perfusion is ____________.

pacemaker placement

transcutaneous pacing

CPR

none of the above

10.

What is generally considered the most important and clinically significant degree of block?

type I (Mobitz I)

type II (Mobitz II)

third-degree AV block

first-degree AV block

11.

The treatment sequence for bradycardia with poor perfusion is:

start IV drip of dopamine or epinephrine, if ineffective begin transcutaneous pacing, and if this is not effective, give atropine

begin cpr, give epinephrine, give atropine, defibrillate, repeat epinephrine if needed.

give epinephrine, if ineffective give atropine, if atropine is ineffective start transcutaneous pacing

prepare for transcutaneous pacing, give atropine while preparing TCP, use epinephrine or dopamine while awaiting pacemaker or if pacing is ineffective.

12.

After initiating external pacing, you should assess the carotid pulse to confirm mechanical capture.

True

False

13.

The correct dose of epinephrine given in the bradycardia algorithm is:

1-5 mcg/min infusion

2-8 mcg/min infusion

2-10 mcg/min infusion

5-10 mcg/min infusion

14.

If transcutaneous pacing is ineffective for symptomatic bradycardia, the next step would be to prepare for:

begin CPR

prepare for transvenous pacing & begin an infusion of dopamine or epinephrine

prepare for pacemaker placement

give repeat doses of atropine

15.

For transcutaneous pacing, the demand rate should be set at:

no higher than 60/min

started at 60-80/min with adjustment based on clinical response

started at 80/min with adjustment based on clinical response

started at 100/min and reduced to minimum for clinical response

16.

Transcutaneous pacing is contraindicated in the patient with ________________.

severe hypothermia

hypokalemia

chest pain

all of the above

17.

For bradycardia unresponsive to atropine, what other drug should be considered?

vasopressin

epinephrine

magnesium sulfate

all of the above

18.

The correct dose of atropine given in the bradycardia algorithm is:

1 mg atropine, may repeat up to a total dose of 3 mg

0.5 mg atropine, may repeat up to a total dose of 2 mg

0.5 mg atropine, may repeat up to a total dose of 3 mg

1 mg atropine, may repeat up to a total dose of 4 mg

19.

The primary decision point in the bradycardia algorithm is the determination of:

heart rate

adequate perfusion

blood pressure

rhythm

20.

Identify the following rhythm.

second degree av block type 1

second degree av block type 2

first degree av block

21.

Bradyarrhythmia is defined as:

any rhythm disorder with a heart rate less than 40 beats per minute

any rhythm disorder with a heart rate less than 60 beats per minute

any symptomatic rhythm disorder with a heart rate less than 50 beats per minute

any rhythm disorder with a heart rate less than 50 beats per minute

22.

If transcutaneous pacing and drugs fail, what would be your next intervention?

defibrillation

synchronized cardioversion

transvenous pacing

CPR

23.

Which drugs are involved in the Bradycardia Algorithm?

atropine, epinephrine, dopamine

atropine, norepinephrine, dopamine

atropine, lidocaine, adenosine

atropine, epinephrine, lidocaine

24.

Signs of symptomatic bradycardia include hypotension and acute heart failure

True

False

25.

For transcutaneous pacing, the current milliamperes (mA) output should be:

set at 30 mA

set 2 mA above capture dose

set 4 mA above capture dose

set no higher than capture dose

26.

After it is determined that the patient does not have adequate perfusion your first step is to:

prepare for transcutaneous pacing

observe and monitor the patient

give atropine while awaiting transcutaneous pacer

use defibrillator set at 200 J

27.

The correct dose of dopamine given in the bradycardia algorithm is:

5-20 mcg/kg/min infusion

2-8 mcg/kg/min infusion

5-10 mcg/kg/min infusion

1-5 mcg/kg/min infusion

28.

Identify the following rhythm.

second degree av block type 1

second degree av block type 2

first degree av block

29.

What is the first-line agent for the treatment of symptomatic bradycardia?

atropine

lidocaine

epinephrine

vasopressin

30.

Identify the following rhythm.

second degree block

sinus bradycardia

complete block

sinus rhythm

Bradycardia Quiz: Pass Your ACLS Exam