Megacode 4

1 You are called to the patient's bedside because she is experiencing the sensation of fluttering in her chest. You perform an initial assessment and find that the 22-year-old woman is communicative and in no acute distress. The rhythm monitor on the defibrillator reveals a regular, narrow complex heart rate of 150 beats per minute. Your initial evaluation should include which of the following? 

1 You are called to the patient's bedside because she is experiencing the sensation of fluttering in her chest. You perform an initial assessment and find that the 22-year-old woman is communicative and in no acute distress. The rhythm monitor on the defibrillator reveals a regular, narrow complex heart rate of 150 beats per minute. Your initial evaluation should include which of the following? 

  • Key A
    A
  • Key B
    B
  • Key C
    C
  • Key D
    D

2 She denies chest pain or shortness of breath. Her lungs are clear to auscultation, has no jugular venous distention and no edema. A 12-lead ECG confirms a regular, narrow-complex tachyarrhythmia. Her blood pressure is 130/85 mmHg. What is your next action?

2 She denies chest pain or shortness of breath. Her lungs are clear to auscultation, has no jugular venous distention and no edema. A 12-lead ECG confirms a regular, narrow-complex tachyarrhythmia. Her blood pressure is 130/85 mmHg. What is your next action?

  • Key A
    A
  • Key B
    B
  • Key C
    C
  • Key D
    D

3 The vagal maneuver did not lower the patient's heart rate. What is your next action?

3 The vagal maneuver did not lower the patient's heart rate. What is your next action?

  • Key A
    A
  • Key B
    B
  • Key C
    C
  • Key D
    D

4 The adenosine did not lower the patient's heart rate. What is your next action?

4 The adenosine did not lower the patient's heart rate. What is your next action?

  • Key A
    A
  • Key B
    B
  • Key C
    C
  • Key D
    D

5 The patient is visibly anxious and now states that she is having chest pain. She describes the pain as a pressure in her chest. When asked about her pain, she appeared confused. Her systolic blood pressure is now 100/70. What is your next action?

5 The patient is visibly anxious and now states that she is having chest pain. She describes the pain as a pressure in her chest. When asked about her pain, she appeared confused. Her systolic blood pressure is now 100/70. What is your next action?

  • Key A
    A
  • Key B
    B
  • Key C
    C
  • Key D
    D

6 You determine that the woman's tachycardia is causing rate-related symptoms and decide to provide cardioversion. The rhythm is still narrow and regular. After administering light sedation, you provide an initial dose of energy from the defibrillation through externally placed pads. What dose of energy should you initially deliver?

6 You determine that the woman's tachycardia is causing rate-related symptoms and decide to provide cardioversion. The rhythm is still narrow and regular. After administering light sedation, you provide an initial dose of energy from the defibrillation through externally placed pads. What dose of energy should you initially deliver?

  • Key A
    A
  • Key B
    B
  • Key C
    C
  • Key D
    D

7 You deliver the energy and the patient immediately loses consciousness. You cannot find a pulse after trying for ten seconds. The heart monitor still shows a tachyarrhythmia. What is your next action?

7 You deliver the energy and the patient immediately loses consciousness. You cannot find a pulse after trying for ten seconds. The heart monitor still shows a tachyarrhythmia. What is your next action?

  • Key A
    A
  • Key B
    B
  • Key C
    C
  • Key D
    D

8 You administer a defibrillation dose (200 J biphasic) to the patient. What is your next action?

8 You administer a defibrillation dose (200 J biphasic) to the patient. What is your next action?

  • Key A
    A
  • Key B
    B
  • Key C
    C
  • Key D
    D

9 After two minutes of CPR, the patient still has no pulse and the rhythm is now ventricular fibrillation. What is your next action?

9 After two minutes of CPR, the patient still has no pulse and the rhythm is now ventricular fibrillation. What is your next action?

  • Key A
    A
  • Key B
    B
  • Key C
    C
  • Key D
    D

10 You administer the second defibrillation and resume high-quality CPR. You also administer which of the following? 

10 You administer the second defibrillation and resume high-quality CPR. You also administer which of the following? 

  • Key A
    A
  • Key B
    B
  • Key C
    C
  • Key D
    D

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