Paramedic Readiness Exam 4 Practice Test

When a patient has a tachyarrhythmia with a pulse and is hemodynamically stable, the best first-line option is an antiarrhythmic that can cover wide-complex tachycardias, such as amiodarone. Amiodarone is effective for ventricular tachycardia with a pulse and for various wide-complex tachycardias, and it tends to have a safer profile in the emergency setting compared with other agents. Adenosine is designed to terminate narrow-complex, AV-nodal tachycardias like certain SVTs, and it can be dangerous or ineffective if the rhythm is VT or a wide-complex tachycardia. Diltiazem is another option for stable narrow-complex SVTs or rapid AF with RVR but can worsen VT or hemodynamics if the rhythm is actually VT. Lidocaine can be used for VT, especially in ischemic contexts, but amiodarone has broader efficacy and is often preferred as initial therapy for suspected VT with a pulse. So, given the scenario of a stable, anxious patient with a tachyarrhythmia and a palpable pulse, amiodarone is the most appropriate choice.