Welcome to the next episode of The Reveal where we take you inside the mind of a test-taker to deconstruct and connect the dots of a board-style question so you can become a better student, transform how you learn, and excel not only on high-stakes exams, but also in your general medical knowledge. Let’s get started.

A 61-year-old woman with no past medical history or family history or heart disease presents with a trimalleolar ankle fracture after a fall. As part of her preoperative workup, an electrocardiogram is obtained. A portion of the rhythm strip is shown above. Which of the following is the most appropriate?

A) Administer intravenous calcium chloride, insulin, glucose, and sodium bicarbonate

B) Order serial cardiac biomarkers and admit to cardiology

C) Place transcutaneous pacer pads and make arrangements for a transvenous pacemaker

D) Reassure the patient and the orthopedic surgeon that no treatment is necessary

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