Advanced Cardiovascular Life Support (ACLS) Practice Exam

A patient presents with a heart rate of 35/min and a blood pressure of 70/50 mm Hg. What is the appropriate first medication?

1. Adrenaline 1 mg

2. Atropine 0.5 mg

3. Dopamine 2-10 mcg/kg/min

4. Amiodarone 300 mg

The correct answer is: Atropine 0.5 mg

In a scenario where a patient presents with bradycardia, characterized by a heart rate of 35 beats per minute and significant hypotension (blood pressure of 70/50 mm Hg), the first-line treatment involves the administration of atropine. Atropine functions as an anticholinergic agent that inhibits the effects of the vagus nerve on the heart, leading to an increase in heart rate. It is particularly effective in addressing symptomatic bradycardia, which is critical in this case due to the presence of hypotension. The symptoms of bradycardia, especially when accompanied by hemodynamic instability as indicated by the low blood pressure, necessitate prompt treatment to prevent further compromise of cardiac output. While the other medications listed have roles in different situations of cardiac arrest or severe bradycardia, they are not the first-line treatment for this specific clinical presentation. Adrenaline is typically used during advanced cardiac life support in cases such as cardiac arrest rather than symptomatic bradycardia with hypotension. Dopamine might be an option if atropine is ineffective or in situations requiring inotropic support, but it is not the initial medication of choice in this scenario. Amiodarone is primarily utilized for ventricular arrhythmias