Which of the following is the initial step in the management of a patient with asystole?

Check for a pulse every 30 seconds

Administer 1 mg of epinephrine

Administer a defibrillation shock

Begin chest compressions immediately

Answer and Explanation

The Correct Answer is D

Rationale:

A. In a patient with asystole, a pulse check is not performed repeatedly in 30-second intervals; the rhythm is already pulseless, so delaying intervention to check the pulse wastes critical time.

B. Epinephrine is an important medication in asystole management, but it is administered after initiating CPR, not as the first step. Immediate medication without circulation is ineffective.

C. Defibrillation is ineffective in asystole because there is no organized electrical activity to reset. Defibrillation is reserved for shockable rhythms such as ventricular fibrillation (VF) or pulseless ventricular tachycardia (VT).

D. This is the correct initial step because asystole represents a complete absence of cardiac electrical activity, and immediate high-quality CPR is essential to maintain circulation and oxygen delivery to vital organs. Early initiation of chest compressions increases the chance of survival while advanced life support measures (airway, epinephrine) are prepared.

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Correct Answer is C

Explanation

Rationale:
A. This would indicate possible fluid retention or worsening heart function, not effective diuretic therapy. Effective diuretics usually help reduce fluid overload, which may lower blood pressure in hypertensive patients.

B. Rapid weight gain is a sign of fluid retention, which suggests diuretic therapy is not effective or the patient’s heart failure is worsening.

C. These findings indicate that excess fluid is being successfully removed from the body. Decreased swelling in the extremities and improved respiratory status reflect effective diuresis and improved cardiac function, which is the goal of therapy.

D. While these can occur due to electrolyte imbalances caused by diuretics, they are adverse effects rather than indicators of effectiveness.

A. First-degree AV block is characterized by a prolonged PR interval greater than 0.20 seconds. B. First-degree AV block is a type of heart block where some atrial impulses fail to reach the ventricles. C. Patients with first-degree AV block typically present with symptoms such as syncope or dizziness. D. First-degree AV block often requires immediate treatment with a pacemaker.

Correct Answer is A

Explanation

Rationale:

A. In first-degree atrioventricular (AV) block, all atrial impulses reach the ventricles, but conduction through the AV node is delayed. This delay is reflected on the ECG as a PR interval longer than 0.20 seconds, while the QRS complex remains normal. First-degree AV block is usually asymptomatic and often does not require treatment.

B. This description fits second-degree AV block, not first-degree. In first-degree block, no impulses are blocked, only delayed.

C. First-degree AV block is generally asymptomatic, and patients rarely experience symptoms. Symptoms such as syncope are more characteristic of higher-degree AV blocks.

D. Pacemaker therapy is not indicated for first-degree AV block unless it progresses to higher-degree AV block with symptomatic bradycardia. Immediate intervention is not needed in asymptomatic patients.

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Which of the following is the initial step in the management of a patient with asystole?

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Naxlex Comprehensive Predictor Exams

A 65-year-old patient with congestive heart failure has been on diuretic therapy for the past two weeks. During a follow-up appointment, which of the following findings would indicate that the diuretic therapy is effective?

Correct Answer is C

Explanation

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Correct Answer is A

Explanation

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