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Tachycardia and Bradycardia Algorithms Flashcards

7 cards from real ACLS practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

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  1. A patient with wide-complex tachycardia at 180 bpm is stable. Adenosine is given and does not convert the rhythm. What does this suggest?

    Answer: The rhythm is likely ventricular tachycardia

    Failure to terminate with adenosine in a stable wide-complex tachycardia suggests the rhythm is ventricular tachycardia rather than SVT with aberrancy.

  2. Which rhythm does NOT require synchronized cardioversion?

    Answer: Ventricular fibrillation

    Ventricular fibrillation is a disorganized rhythm with no discernible R wave, so it requires unsynchronized defibrillation, not synchronized cardioversion.

  3. A patient receiving transcutaneous pacing for symptomatic bradycardia shows electrical capture but remains bradycardic and hypotensive. What is the next step?

    Answer: Check for mechanical capture by palpating a pulse

    Electrical capture (pacing spikes with QRS complexes) must be confirmed to have mechanical capture by assessing the pulse and blood pressure.

  4. Which of the following best describes polymorphic VT (Torsades de Pointes) compared to monomorphic VT in ACLS management?

    Answer: Torsades may require magnesium sulfate; amiodarone can worsen it

    Torsades de Pointes is treated with magnesium sulfate 1–2 g IV, while amiodarone may prolong the QT further and worsen the arrhythmia.

  5. In the ACLS tachycardia algorithm, what heart rate threshold generally prompts evaluation for treatment?

    Answer: Greater than 150 bpm

    The ACLS tachycardia algorithm is typically initiated when heart rate exceeds 150 bpm, as rates below this rarely cause hemodynamic compromise.

  6. A patient with known WPW syndrome presents with atrial fibrillation at 220 bpm. Which drug is contraindicated?

    Answer: Adenosine

    Adenosine blocks the AV node but can promote conduction down the accessory pathway in WPW, potentially accelerating the ventricular rate and causing VF.

  7. What is the recommended initial dose of dopamine infusion for hemodynamically significant bradycardia when atropine fails?

    Answer: 2–10 mcg/kg/min

    Dopamine is initiated at 2–10 mcg/kg/min as a chronotropic agent for symptomatic bradycardia refractory to atropine.