#june2020mccqe1
A 58-year-old man is admitted to the coronary care unit for telemetric monitoring after an episode of bradycardia. While in the unit, he suddenly loses consciousness. His pulse is undetectable and his blood pressure drops to 40 mm Hg. His airway is clear and patent, and he is still breathing on his own. An ECG shows electrical activity. Chest compressions are started and he is quickly given a bolus of intravenous sodium bicarbonate and atropine. When his tracing does not improve, the boluses are repeated twice, and finally his tracing returns to normal sinus rhythm. Moments later, when he regains consciousness, he complains of a dry mouth, blurred vision, and feeling flushed. What is the most appropriate next step in the management of this patient?
(A) This patient has atropine toxicity and requires urgent administration of a cholinergic agonist
(B) This patient has atropine toxicity and requires urgent administration of a muscarinic agonist
(C) This patient has bicarbonate toxicity and requires urgent administration of calcium citrate
(D) This patient is experiencing transient adverse effects of atropine and requires only supportive measures
(E) This patient is experiencing transient adverse effects of bicarbonate and requires only supportive measures
A 58-year-old man is admitted to the coronary care unit for telemetric monitoring after an episode of bradycardia. While in the unit, he suddenly loses consciousness. His pulse is undetectable and his blood pressure drops to 40 mm Hg. His airway is clear and patent, and he is still breathing on his own. An ECG shows electrical activity. Chest compressions are started and he is quickly given a bolus of intravenous sodium bicarbonate and atropine. When his tracing does not improve, the boluses are repeated twice, and finally his tracing returns to normal sinus rhythm. Moments later, when he regains consciousness, he complains of a dry mouth, blurred vision, and feeling flushed. What is the most appropriate next step in the management of this patient?
(A) This patient has atropine toxicity and requires urgent administration of a cholinergic agonist
(B) This patient has atropine toxicity and requires urgent administration of a muscarinic agonist
(C) This patient has bicarbonate toxicity and requires urgent administration of calcium citrate
(D) This patient is experiencing transient adverse effects of atropine and requires only supportive measures
(E) This patient is experiencing transient adverse effects of bicarbonate and requires only supportive measures