Drag each rhythm-and-circulation cluster to the immediate response pathway it requires.
Matrix Multiple Choice
Choose your responses, then check the answer.
Explanation
Pulseless ventricular fibrillation and pulseless ventricular tachycardia require CPR and prompt defibrillation. Pulseless electrical activity and asystole are nonshockable arrest rhythms requiring CPR, epinephrine, and evaluation of reversible causes. Unstable tachyarrhythmia with a pulse requires immediate expert escalation and synchronized cardioversion when indicated. A perfusing, stable atrial fibrillation pattern requires focused assessment, 12-lead confirmation, cause evaluation, and prescribed rate or rhythm management rather than arrest treatment.
Quick answer Pulse first: shock VF/pVT arrest; do not shock PEA/asystole; synchronize an unstable tachycardia with a pulse; assess and treat stable atrial fibrillation.
Clinical judgment The same monitor rate can lead to different actions depending on pulse and perfusion. Confirm responsiveness and pulse rapidly, start high-quality CPR for arrest, and do not delay indicated defibrillation.
NCLEX decision rule Treat the client and circulation state, not a monitor label in isolation.
References
1AHA 2025 Adult Advanced Life Support
2AHA 2025 Adult Basic Life Support
Rhythm plus perfusionThe monitor findings have been confirmed and artifact has been excluded. Classify the whole clinical state, including whether a pulse is present, rather than naming the rhythm alone.
Shockable Rhythm — A cardiac-arrest rhythm for which unsynchronized defibrillation is indicated, such as ventricular fibrillation or pulseless ventricular tachycardia.
Pulseless Electrical Activity — Organized electrical activity without a palpable pulse or effective mechanical circulation.
Synchronized Cardioversion — A shock timed to the QRS complex for selected unstable tachyarrhythmias when a pulse is present.