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Identify the following rhythms. 1. a. Sinus arrhythmia b. Sinus rhythm with PACs c. Second degree heart block type I d. NSR with PVCs 2. a. Junctional tachycardia b. Atrial tachycardia c. Sinus tachycardia d. Supraventricular tachycardia 3. a. Sinus tachycardia with PVCs b. Supraventricular tachycardia with PVCs c. Wandering atrial pacemaker with PVCs d. Multifocal atrial tachycardia with PVCs 4. A 45 year old female comes to the ER with complaints of shortness of breath with exertion, palpitations, and dizziness. VS: 98.4-188-20. BP: 105/73. Sats: 93% on room air. She is taken to an ER room and a # 20 IV is started in her left AC and blood work drawn. She is placed on the monitor and the following rhythm is seen. Vagal maneuvers are attempted but without a change in the rhythm. The MD orders Adenosine to be given. Which of the following statements is true regarding Adenosine: a. It is an antiarrhyt

Identify the following rhythms. 1. A 34 year old female is brought by her husband to the ER with complaints of weakness, palpitations, chest pain, shortness of breath, and nausea VS 98.4-188-30. BP 90/56. Sat 92%. She is placed on the monitor and the following rhythm is noted. An IV is started and oxygen administered at 2L/min. A trial dose of adenosine 6 mg is given while setting up for cardioversion. There was is no change in the rhythm. What is the recommended initial joule setting for cardioversion of SVT? a. 50 J b. 150 J c. 200 J d. 250 J 2. During a code in the ER of a 56 year old with a history of cocaine use, you pause for a rhythm check and note the following rhythm. What is the rhythm? a. Ventricular tachycardia changing to torsades de pointes b. Ventricular tachycardia changing to ventricular fibrillation c. Ventricular tachycardia changing to atrial fibrillation d. Ventricular tachycardia changing to polymorphic VT 3. During

Identify the following rhythms. 1. a. Idioventricular rhythm b. Complete heart block c. Sinus bradycardia with a wide QRS complex d. Atrial flutter with slow ventricular response 2. a. Sinus arrhythmia b. Sinus rhythm with PACs c. Atrial fibrillation d. Wandering atrial pacemaker 3. A 70 year old with a history of persistent atrial fibrillation undergoes elective cardioversion. She receives Versed 3 mg prior to the cardioversion. Oxygen is at 2 L/min via nasal cannula. An initial attempt at 150 J shows the following rhythm changes. What is the next appropriate intervention for this patient? a. Place the defibrillator in the synch mode and cardiovert at 200 J b. Increase the joule setting to 200 J and shock again c. Check for a pulse and monitor the rhythm d. Give adenosine 6 mg IV and re-cardiovert at the same or a higher joule setting. 4. A 79 year old who lives alone is brought to the ER by her family because increas

Identify the following rhythms. 1. a. Idioventricular rhythm b. Demand ventricular rhythm c. Junctional rhythm d. Atrial paced 2. After experiencing several episodes of this rhythm, the MD orders an Amiodarone drip beginning with a bolus dose. What is the usual loading dose for an Amiodarone infusion? a. 150 mg IV over 10 minutes b. 200 mg IV over 10 minutes c. 250 mg IV over 10 minutes d. 300 mg IV over 10 minutes 3. A 75 year old arrives to the ER in cardiac arrest. CPR is in progress. He has received two shocks at 200 J and 300 J as well as two doses of epinephrine 1 mg in route. As he is transferred to the stretcher and placed on the monitor, the following rhythm is observed. What medication is indicated in the treatment of this dysrhythmia? a. Vasopressin 40 units IV b. Procainamide 20 mg/min c. Magnesium 1 -2 gm IV d. Amiodarone 150 mg IV 4. a. Sinus bradycardia b. Junctional rhythm c. Atrial fibrilla

Identify the following rhythms. 1. What initial intervention is appropriate for this pulseless rhythm? a. Transcutaneous pacing b. Epinephrine 1 mg IV/IO q 3 - 5 minutes c. Cardiopulmonary resuscitation d. Atropine 0.5 mg IV/IO q3 - 5 minutes 2. a. Demand atrial pacing b. Demand AV pacing c. Demand biventricular pacing d. Demand ventricular pacing 3. a. Sinus rhythm with unifocal PVCs b. Sinus rhythm with trigeminy c. Sinus rhythm with a triplet of PVCs d. Sinus rhythm with multiform PVCs 4. a. Idioventricular rhythm b. Accelerated idioventricular rhythm c. Ventricular paced rhythm d. Complete heart block 5. a. Sinus bradycardia b. Atrial fibrillation c. Junctional rhythm d. Complete heart block Answers 1. c. Cardiopulmonary resuscitation 2. b. Demand AV pacing. Looks like 100% ventricular paced with demand atrial pacing. It looks like the ventricular - atrial (V - A) interval The pe

Identify the following rhythms. 1. a. Idioventricular rhythm b. Accelerated idioventricular rhythm c. Ventricular paced rhythm d. Complete heart block 2. a. Sinus bradycardia b. Atrial fibrillation c. Junctional rhythm d. Complete heart block 3. After experiencing several episodes of this rhythm, the MD orders an Amiodarone drip beginning with a bolus dose. What is the usual loading dose for an Amiodarone infusion? a. 150 mg IV over 10 minutes b. 200 mg IV over 10 minutes c. 250 mg IV over 10 minutes d. 300 mg IV over 10 minutes 4. A 75 year old arrives to the ER in cardiac arrest. CPR is in progress. He has received two shocks at 200 J and 300 J as well as two doses of epinephrine 1 mg in route. As he is transferred to the stretcher and placed on the monitor, the following rhythm is observed. What medication is indicated in the treatment of this arrhythmia? a. Vasopressin 40 units IV b. Procainamide

Identify the following rhythms. 1. a. Accelerated junctional rhythm b. Accelerated idioventricular rhythm c. First degree heart block d. Normal sinus rhythm 2. a. Ventricular tachycardia b. Ventricular fibrillation c. Polymorphic ventricular tachycardia d. Accelerated idioventricular rhythm 3. a. Ventricular tachycardia b. Ventricular fibrillation c. Polymorphic ventricular tachycardia d. Torsades de pointes 4. a. Idioventricular rhythm b. Complete heart block c. Junctional rhythm d. Sinus bradycardia 5. a. Demand atrial pacing b. Demand AV pacing c. Demand biventricular pacing d. Demand ventricular pacing Answers 1. a. Accelerated junctional rhythm. The rhythm is regular. The rate is 65 bpm. No P waves are seen. The QRS complexes are narrow. No ectopic beats are seen. PR: ---, QRS: .08 sec, QT: .52 sec 2. a. Ventricular tachycardia. The QRS complexes are fairly uniform 3. b. Vent

Identify the following rhythms. 1.Which of the following medications can be used to treat this rhythm: a. Magnesium 1 -2 g IV/IO b. Cardizem 0.25 mg/kg IV/IO c. Epinephrine 1 mg IV/IO d. Amiodarone 300 mg IV/IO 2. During a cardiac arrest a patient receives a third shock at 300 J. A brief review of the post shock rhythm shows the patient to be in refractory VF. What antiarrhythmic can be given.  a. Vasopressin 40 units IV/IO  b. Amiodarone 300 mg IV/IO  c. Epinephrine 1 mg IV/IO  d. Sodium bicarbonate 1 mEq/kg IV/IO 3. What is wrong with this picture? a. It shows failure to capture of polymorphic VT b. It shows inappropriate pacing of VF c, It shows inappropriate synchronization of TDP d. It shows failure to sense during pacing of CHB 4. What is wrong with this picture? a. It shows appropriate cardioversion of supraventricular tachycardia b. It shows inappropriate defibrillation of atrial fibrillation c. It shows ap

Identify the following rhythms. 1. a. Sinus rhythm with sinus arrest b. Sinus arrhythmia c. Atrial fibrillation with slow ventricular response d. Complete heart block 2. a. Atrial paced b. Dual paced c. Biventricular paced d. Ventricular paced 3. a. First degree block b. Sinus tachycardia c. Sinus rhythm d. Sinus arrhythmia 4. a. Sinus rhythm with monofocal PVCs b. Sinus rhythm with a triplet of PVCs c. Sinus rhythm with trigeminal PVCs d. Sinus rhythm with multifocal PVCs 5. What initial intervention is appropriate for this pulseless rhythm? a. Transcutaneous pacing b. Epinephrine 1 mg IV/IO q 3 - 5 minutes c. Cardiopulmonary resuscitation d. Atropine 0.5 mg IV/IO q3 - 5 minutes. Answers 1.A. Sinus rhythm with sinus arrest. The rhythm is irregular. The rate is 40 bpm. There are positive P waves that are paired with QRS complexes. The QRS complexes are narrow. No ectopic beats are s

Identify the following rhythms. 1. a. Second degree heart block type II b. Second degree heart block type I c. Third degree heart block d. First degree heart block 2. a. Atrial pacing b. AV pacing with biventricular pacing c. Biventricular pacing d. Ventricular pacing 3.A 35 year old with a 2 day history of her "heart racing" comes to the ER with shortness of breath and dizziness. She is alert and oriented. VS: 98.2-167-23. BP 107/67. Sats 94% on room air. After placing her on the monitor the following rhythm is seen. An IV is started in her left AV and oxygen at 2 L/min via nasal cannula is started. What is the next appropriate intervention? a. Give Cardizem 0.35 mg/kg IV b. Attempt vagal maneuvers c. Give Adenosine 6 mg IV d. Cardioversion at 50 J 4. a. Atrial fibrillation b. Junctional rhythm c. Idioventricular rhythm d. Sinus bradycardia 5. a. Sinus rhythm with unifocal PVCs b. S