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SAEM MISC Test 2025-2026. Questions
& Correct Answers. Graded A
A "BLS" ambulance differs from an "ALS" ambulance in that the BLS ambulance: Answers: 1.is staffed by one EMT crew member (and one driver) rather than two EMTs 2.is a smaller "van"-type ambulance 3.arrives at the patient first 4.operates under off-line, as opposed to on-line, medical control 5.is stocked with different supplies and equipment - ANSstocked different A 19-year-old G1P0 female, at 38 weeks EGA, presents to the emergency department complaining of headache, blurry vision and leg swelling. The physical examination reveals BP of 150/100, facial and hand edema, and hyperreflexia. Fetal heart monitoring demonstrates a reassuring pattern with no uterine contractions. Urine dipstick reveals 2+ proteinuria. Of the following, which factor is the most critical in formulating an ultimate management plan for this patient?
Answers: 1.Extent of maternal edema 2.Fetal age 3.Presence of variable decelerations on nonstress testing 4.Symptom duration - ANSfetal age A 32 year old G1P0 at 33 weeks EGA comes into the emergency department complaining of a severe headache. She has contractions every 3 minutes. She is experiencing flashes of light in front of her eyes. Her pregnancy has been uncomplicated until this time, and her only medical problem is mild asthma. Her vital signs are: T 36.5 C (97.7 F), BP 172/114, P 78, R 14, and a room air SpO2 99%. Her lungs have bilateral crackles at the bases, and her cervix is dilated at 3 cm and effaced at 50%. Her urinalysis has 2+ protein, and her complete blood count shows: WBC 8,000/mm3, hematocrit 38%, platelets 215,000/mm3. Her BUN and creatinine are normal, her AST is 250 U/L, and her ALT is 316 U/L. The electronic fetal monitor shows a reactive and variable heart tracing at a rate in the 150s. What is the appropriate next step in management for her? Answers: 1.Start PGE2 gel
that his leg is edematous, erythematous, dry and warm. The leg is also characterized by hair loss, allodynia and hyperesthesia. Of the following, which is the most appropriate emergency department course? Answers: 1.Arrange follow-up for presumed complex regional pain syndrome 2.Obtain a CT scan of his leg to rule out osteomyelitis 3.Order a venogram to rule out a deep venous thrombosis 4.Perform a femoral nerve block to control his pain - ANSfollow up CRPS A 63 year old female presents to the ED at noon, stating that she noticed marked facial swelling (see Figure - top half) upon awakening that morning. She has breast cancer, without brain metastases on a recent MRI. She has no urticaria or respiratory symptoms. A CT scan of the chest was performed from the ED (see Figure - bottom half). Regarding this patient's condition, which of the following is true? Answers: 1.Seizures are a common presenting sign. 2.The vascular component of this problem commonly poses a threat to the patient's airway integrity.
3.Schizophreniform disorder is present when a patient meets the diagnostic criteria for schizophrenia but the process has been present for less than one year 4.Elevation of the head of the patient's bed is recommended. - ANSelevation of patients head A patient with a history of difficult-to-control hypertension is now 6 to 8 weeks pregnant and presents with a hypertensive emergency. Which of the following IV antihypertensives should be avoided? Answers: 1.nitroprusside 2.hydralazine 3.esmolol 4.labetolol 5.nicardipine - ANSnitroprusside All of the following are true regarding acute hepatitis EXCEPT:
First-line interventions started by the emergency physician for suspected peptic ulcer disease (PUD) may include: Answers: 1.antacids 2.H2 blockers 3.proton pump inhibitors (PPIs) 4.stopping NSAIDs 5.all of the above - ANSall For a patient who has suffered a severe anaphylactic reaction, which of the following medications would serve little purpose if prescribed upon discharge? Answers: 1.prednisone 60mg daily for 5 days 2.benadryl 25-50mg every 4-6 hours 3.Epi-Pen
4.albuterol inhaler 2 puffs every 4 hours - ANSAlbuterol If the parents are present and refuse treatment for their child in a life- threatening emergency, prehospital care providers should: Answers: 1.Confirm the identities of the parents and follow parental wishes 2.Provide treatment for the child 3.Contact on-line medical control for physician permission to treat 4.Contact their ambulance service's legal counsel to discuss whether to treat 5.Call the police to have the parents arrested - ANSprovide treatment Regarding the diagnosis of pyelonephritis, which of the following is FALSE? Answers: 1.Patients with pyelonephritis typically have symptoms for greater than 5 days. 2.White blood cell casts on urinalysis support a diagnosis of pyelonephritis.
5.EMS personnel evaluate and release many patients they deem well enough not to need hospital treatment. - ANStpa standard of care The Figure below depicts laryngoscopy and endotracheal intubation (ETI) occurring in an in-flight EMS helicopter. Regarding the patient depicted, and prehospital airway management in general, which of the following is true? Answers: 1.ETI in the helicopter cabin is technically no more difficult than it would be in the hospital emergency department. 2.For the patient in the Figure, post-intubation breath sounds will be a critical component of tube placement confirmation. 3.Postponing ETI until the aircraft is en route to the receiving center should save time when a flight crew decides a community hospital patient will require the procedure. 4.If the patient in the Figure has an easy ETI with minimal requirement for manual (bag-valve-mask) ventilation, gastric decompression (e.g. with an orogastric tube) is unnecessary. 5.Flight crew ETI success rates tend to be high in part because of their enhanced drug formula - ANSflight crew ETI high due to advanced pharmacotherapy options
The pharmacologic interventions most likely to improve outcome when given in the field, as compared to those given upon arrival in the emergency department, include all of the following EXCEPT: Answers: 1.dextrose 2.epinephrine 3.albuterol 4.adenosine 5.diazepam - ANSadenosine The primary etiology of peptic ulcer disease is: Answers: 1.Helicobactor pylori 2.cigarette smoking 3.NSAID use
5.codeine - ANSKetorolac Which of the following drugs is NOT associated with potential toxic side effects related to the inner ear? Answers: 1.gentamicin 2.aspirin 3.furosemide 4.penicillin 5.phenytoin - ANSPCN Which of the following groups has an increased risk of ingested foreign body? Answers: 1.Asthmatics 2.Diabetics
3.Edentulous 4.Smokers - ANSendentulous Which of the following is FALSE concerning emergency intervention for traumatic emergencies encountered by EMS paramedics? Answers: 1.When short transport time is expected, use of pneumatic antishock garment appears to be associated with increased mortality in penetrating torso injuries. 2.Aggressive fluid resuscitation prior to surgical hemostasis is an absolute standard of care to minimize post-traumatic morbidity. 3.Severely injured patients require endotracheal intubation. 4.Intubating head injured patients may result in dental or soft tissue damage. 5.Increasing MAP to near normal levels may cause hemodilution and decreased oxygen saturation. - ANSaggressive fluids prior to surgery Which of the following is the most serious toxic effect of the use of MgSO in treatment of eclampsia?
5.Transport of a patient from a motor vehicle collision to a trauma center is termed "secondary" transport if a helicopter is used. - ANSnon-physicians crews Which of the following women are considered at increased risk for pre- eclampsia? Answers: 1.cigarette smoker 2.multiparous 3.obese 4.over 20 years old 5.woman with a single intrauterine pregnancy - ANSObese With growing regionalization of care for many patient types and conditions, the traditional province of "prehospital" care is growing to include "out-of- hospital" care. The increasing need for critical care transport to regional centers has translated into regularly-occurring out-of-hospital, intratransport utilization of all the following EXCEPT:
Answers: 1.extracorporeal membrane oxygenation (ECMO) 2.intra-aortic balloon counterpulsation 3.mechanical ventilation 4.ventilation with nitric oxide-containing gas 5.continuous propofol infusion - ANSECMO With regard to U.S. Emergency Medical Services (EMS) systems, all of the following are true EXCEPT: Answers: 1.EMS systems operated by a government agency (e.g. a city department of public health) have no malpractice liability. 2.EMS is an integral component of disaster management. 3.There is evidence that helicopter EMS transport for injured patients results in improved mortality. 4.EMS medical directors do not have to be trained, or board-certified, in emergency medicine.
Answers: 1.diabetes mellitus 2.hypertension 3.liver disease 4.habitual miscarriage 5.renal failure - ANSDM
