Advanced Cardiovascular Life Support (ACLS) Practice Exam

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What is the initial treatment for a patient with shockable rhythm and unresponsiveness?

Immediate CPR
Defibrillation
Administration of epinephrine
Chest compression

The correct answer is: Defibrillation

The initial treatment for a patient with a shockable rhythm, such as ventricular fibrillation or pulseless ventricular tachycardia, and unresponsiveness is defibrillation. This action is crucial because these rhythms are life-threatening and require immediate intervention to restore a normal heart rhythm. Defibrillation delivers an electric shock to the heart, which can effectively interrupt the chaotic electrical activity that is preventing the heart from pumping blood effectively. The goal is to reset the heart's electrical system and allow it to resume a normal rhythm, which is essential for restoring effective circulation and improving the chances of survival. In contrast, while immediate CPR and chest compressions are critical components of the overall treatment for cardiac arrest, they are performed primarily in conjunction with defibrillation, especially before or after a shock if the rhythm remains shockable. Administration of epinephrine plays a role in advanced cardiac life support but is not the immediate step when a shockable rhythm is identified. The priority is to deliver the shock as soon as possible, as each minute without defibrillation decreases the chances of survival significantly.