1. Amiodarone 300 mg - ANSA patient is in pulseless ventricular tachycardia. Two
shocks and 1 dose of epinephrine have been given. Which is the next drug/dose to
anticipate to administer?
1. Amiodarone 300 mg
2. Amiodarone 150 mg
3. Vasopressin 40 units
4. Epinephrine 3 mg
5. Lidocaine 0.5 mg/kg
1. Do not give aspirin for at least 24 hours if rtPA is administered. - ANSA 62-year-old
man suddenly experienced difficulty speaking and left-side 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?
1. Do not give aspirin for at least 24 hours if rtPA is administered.
2. Give aspirin 160 mg and clopidogrel 75 mg orally.
3. Administer heparin if CT scan is negative for hemorrhage.
4. Administer aspirin 160 to 325 mg chewed immediately.
1. Epinephrine 1 mg - ANSA 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?
1. Epinephrine 1 mg
2. Vasopressin 20 units
3. Sodium bicarbonate 50 mEq
4. Atropine 1 mg
1. Epinephrine 1 mg or vasopressin 40 units IV or IO. - ANSA 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?
1. Epinephrine 1 mg or vasopressin 40 units IV or IO.
2. Atropine 1 mg IV or IO.
3. Atropine 0.5 mg IV or IO.
4. Epinephrine 3 mg via endotracheal route.
5. Dopamine 2 to 20 mcg/kg per minute IV or IO.
, 1. Gain IV or IO access. - ANSYou 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:
1. Gain IV or IO access.
2. Place an esophageal-tracheal tube or laryngeal mask airway.
3. Attempt endotracheal intubation with minimal interruptions in CPR.
4. Call for a pulse check.
1. Give aspirin 160 to 325 mg chewed immediately. - ANSA 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 not taken by the patient because he had a
history of gastritis treated 5 years ago. Your next action is to:
1. Give aspirin 160 to 325 mg chewed immediately.
2. Give 75 mg enteric-coated aspirin orally.
3.Give 325 mg enteric-coated aspirin rectally.
4. Substitute clopidogrel 300 mg loading dose.
1. Give normal saline 250 mL to 500 mL fluid bolus. - ANSA 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:
1. Give normal saline 250 mL to 500 mL fluid bolus.
2. Give an additional 2 mg of morphine sulfate.
3. Give sublingual nitroglycerin 0.4 mg.
4. Start dopamine at 2 mcg/kg per minute and titrate to a systolic blood pressure
reading of 100 mm Hg.
1. Perform vagal maneuvers. - ANSA 35-year-old woman presents to the emergency
department with a chief compliant of palpitations. She has no chest discomfort,
shortness of breath, or light-headedness. Which of the following is indicated first?
1. Perform vagal maneuvers.
2. Give adenosine 12 mg IV slow push (over 1 to 2 minutes).
3. Give metoprolol 5 mg IV and repeat if necessary.
4. Give adenosine 3 mg IV bolus.
1. Reperfusion therapy. - ANSA patient's 12-lead ECG was transmitted by the
paramedics and showed an acute MI. The above findings are seen on rhythm strip
when a monitor is placed in emergency department. The patient had resolution of
moderate (5.10) chest pain with 3 doses of sublingual nitroglycerin. Blood pressure is
104/70 mm Hg. Which intervention below is most important, reducing in-hospital and
30-day mortality?
1. Reperfusion therapy.
2. IV nitroglycerin for 24 hours.
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