Certified Emergency Nurse (CEN) Practice Test

In the presence of pulseless wide complex tachycardia, what is the recommended immediate intervention?

1. Cardioversion

2. Defibrillation

3. Ventricular pacing

4. IV medication administration

The correct answer is: Defibrillation

In the scenario of pulseless wide complex tachycardia, defibrillation is the recommended immediate intervention. This type of tachycardia can indicate a life-threatening rhythm such as ventricular fibrillation or pulseless ventricular tachycardia, both of which require prompt defibrillation to restore an effective heartbeat. Defibrillation delivers an electrical shock to the heart, which can help reset its rhythm. In cases of pulseless tachycardia, the priority is to address the lack of effective circulation. While medications and other interventions can be important in the management of tachyarrhythmias, they are not appropriate as first-line treatments in this specific situation when immediate electrical intervention can potentially save the patient's life. Other interventions, such as cardioversion, are more appropriate for patients with a pulse, and ventricular pacing and IV medications take more time and may not provide the immediate resuscitation needed in emergencies where circulation has ceased.