Advanced Cardiovascular Life Support (ACLS) Practice Exam

In a patient with dizziness and a blood pressure of 68/30 mm Hg, what is the first intervention?

1. Administer IV fluids

2. Administer atropine 0.5 mg

3. Perform a CT scan

4. Initiate CPR

The correct answer is: Administer atropine 0.5 mg

In a patient presenting with dizziness and a low blood pressure of 68/30 mm Hg, it is crucial to recognize the physiological significance of bradycardia that may be causing the hypotension. Administering atropine 0.5 mg is the first step because it addresses potential symptomatic bradycardia. Atropine works to block vagal effects on the heart, thereby increasing heart rate which can help in restoring an adequate blood pressure. This intervention can be especially important if the underlying cause of the hypotension is related to a slow heart rate (bradycardia) leading to insufficient cardiac output. The administration of atropine should be within the guidelines for treating bradycardic-induced hypotension, as it can improve the patient's hemodynamics rapidly. While IV fluids can be important in managing shock or dehydration, and other interventions like CPR or imaging might be relevant depending on the clinical context, they do not directly address the immediate problem of symptomatic bradycardia. Thus, in a scenario where the heart rate is the critical issue, atropine becomes the priority intervention to stabilize the patient's condition effectively.