The best answer is D, 1 and 3 only.

Here's Why: Lidocaine is administered at 1.0 - 1.5 mg/kg IV boluses. These can be repeated at one half the initial dose up to a total of 3.0 mg/kg. If lidocaine is effective, a continuous infusion can be initiated at 40 mcg/kg/minute. (50 kg pt. = 2 mg/min; 75 kg pt. = 3 mg/min; and 100 kg pt. = 4 mg/min)

The best answer is C, Morphine sulfate.

Here's Why: Many practitioners mistakenly reach for benzodiazepam agents such as diazepam or midazolam. Neither of these drugs provide analgesia for the patient. The TCP produces significant pain in many patients, thus, the use of carefully titrated IV narcotic analgesia is recommended. In unstable patients, oral drugs should not be given.

The best answer is A, True.

Here's Why: Best treatment of ventricular fibrillation or unstable or pulseless ventricular tachycardia is electrical counter-shock. Although some patients with ventricular tachycardia will convert when a fist crashes down on their chest at high velocity, the poor number of conversions coupled with the potential for chest trauma makes shocking the patient more sensible.

The best answer is D: All of the above.

Here's Why: Lidocaine (class 1B) is a pure sodium channel blocker that has been shown to be effective in treating ischemic ventricular arrhythmias. Procainamide (class 1A), in ventricular muscle and Purkinje fibers, suppresses phase 4 diastolic depolarization, hence reduces the automaticity of all pacemakers. It also slows intra-ventricular conduction, suppressing re-entry arrhythmias. If there is ischemic tissue and conduction is already slowed, procainamide may further slow conduction and produce bi-directional block and may terminate re-entry arrhythmias. Amiodarone (class III) is effective in both supraventricular and ventricular arrhythmias, however, it takes protracted periods of time to obtain therapeutic blood levels; has a very long half-life; and, has a long list of serious potential side-effects. Many practitioners believe that its use should be a bridge to definitive therapy such as radio-frequency ablation.

The best answer is B: Regardless of treatment, there is remote likelihood of a positive response (no benefit to the patient).

Here's Why: Medical futility is a state in which the patient exists based on the presence of an untreatable disease which will progress to the patient's death. Simply stated, treatment is futile, thus, treatment would provide no benefit to the patient.