Clinical Nurse Leader Practice Exam

If a patient is in VFib and unresponsive, what should the CNL anticipate as the next step in treatment?

1. Amiodarone

2. Labetolol

3. Defibrillation

4. Cardiac catheterization

The correct answer is: Defibrillation

In the scenario where a patient is in ventricular fibrillation (VFib) and unresponsive, the appropriate next step in treatment is defibrillation. This is because VFib is a life-threatening cardiac arrhythmia that results in ineffective contraction of the heart, preventing adequate blood flow to vital organs. Defibrillation delivers a controlled electric shock to the heart, which can restore a normal rhythm by allowing the heart's electrical system to reset and potentially regain a coordinated electrical activity. This immediate action is crucial in the cardiovascular emergency algorithm as time is critical and reducing the duration of VFib is essential to improve the chances of survival. Implementing defibrillation promptly improves the likelihood of reestablishing a perfusing rhythm and ultimately minimizes the risk of irreversible damage to the brain and other organs due to lack of oxygen. Other treatments, such as amiodarone, can be considered after defibrillation in an attempt to stabilize the rhythm if VFib persists. However, they do not take precedence in this acute situation. Medications like labetolol are used for controlling blood pressure and heart rate, and cardiac catheterization is a procedure for assessing and treating coronary artery disease, neither of which are appropriate immediate interventions for acute VFib. Therefore,