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SAEM M4 Exam 2024/2025 Questions With Completed & Verified Solutions.
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SAEM M4 Exam 2024/2025 Questions With Completed & Verified Solutions.
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SAEM M4 ExamTrue or False: gastric distension due to excessive volume or rate of ventilation impairing
ventilatory function is a reason to intubate a neonate - ANS False
management for nursemaid elbow injury - ANS apply pressure to the radial head while flexing
and supinating elbow
A 17 year old boy injured his right shoulder playing football. He tried to arm-tackle a player when
his right arm was pulled away from his body and back (abducted and extended). He felt a
sudden pain in his shoulder. He presents to the emergency department holding his arm in slight
abduction and external rotation by his good arm. He has severe pain with adduction or internal
rotation. What is the most common fracture associated with this injury? - ANS compression
fracture of the posterolateral aspect of the humeral head (Hill-Sachs deformity)
What are the most common heart rhythms seen in pediatric arrest? - ANS bradycardia or
asystole
risk factors for neonatal resuscitation - ANS prematurity
IUGR
multiple gestation
thick meconium
In the post-arrest setting, which of the following is the drug of choice in treating hypotension in a
child: - ANS epi
Low body temperatures in newborns can lead to severe physiologic consequences, which
include all EXCEPT:
Answers:
1. metabolic acidosis
2. increased oxygen consumption
3. hypoglycemia
4. apnea
5. hyperglycemia - ANS 3. hypoglycemia
In a newborn, bradycardia is most commonly an indicator of: - ANS hypoxemia
All the following are signs of hypoxemia in a newborn, EXCEPT:
Answers:
1.cyanosis
,2.lethargy
3.tachycardia
4.unresponsiveness
5.bradycardia - ANS 3. tachycardia
A newborn presents to the emergency department a few days after hospital discharge. The
infant has been noted to be drooling, choking, and coughing, and the mother reports seeing
bubbles at the baby's mouth. Which is the most likely explanation?
Answers:
1.osteogenesis imperfecta
2.inborn error of metabolism
3.congenital diaphragmatic hernia
4.foreign body
5.tracheoesophageal fistula - ANS 5. tracheoesophageal fistula
Which of the following pairs of maneuvers are consistent with current recommendations for
emergency care for a choking 5-month-old infant?
Answers:
1.back blow then blind finger sweep
2.back blow then chest thrust
3.chest thrust then Heimlich maneuver
4.Heimlich maneuver then blind finger sweep
5.Heimlich maneuver then chest thrust - ANS 2.back blow then chest thrust
All of these steps are involved in pediatric rapid sequence intubation (RSI) EXCEPT:
Answers:
1.If administering succinylcholine, pretreatment with atropine is always indicated in children
under age 10.
2.Lidocaine pretreatment is usually provided to children with head trauma.
3.When deciding which size endotracheal tube to use, one may approximate by using the size
of the small finger or nares as a reference.
4.Due to the fragility of the pediatric C-spine, a cervical collar should always be placed prior to
intubation for children under age ten.
5.Uncuffed endotracheal tubes are the preferred devices used in children under 6-8 years of
age. - ANS 4.Due to the fragility of the pediatric C-spine, a cervical collar should always be
placed prior to intubation for children under age ten.
A 23 year old woman is dropped off by her boyfriend after an unknown overdose. You notice
that she is has very large pupils and is sweating profusely. Her respiratory rate, blood pressure
and heart rate are elevated. Which of the following is the most likely agent to have caused her
symptoms?
, Answers:
1.Jimson weed
2.Cocaine
3.Heroin
4.Insulin - ANS 2. cocaine
A mother brings in her 4 year old child who was happily eating "blackberries" from weeds in the
garden and is now acting strangely. She has identified them as Belladonna from a quick internet
search. Which physical examination finding might you also expect to find in this child?
Answers:
1.Diaphoresis
2.Flushed skin
3.Miosis
4.Urinary incontinence - ANS 2. flushed skin
For which of the following cases is activated charcoal therapy most appropriate?
Answers:
1.Acetaminophen overdose
2.Drain cleaner ingestion
3.Iron supplement overdose
4.Lithium overdose - ANS 1. Acetaminophen overdose
A 45 year-old is brought in 8 hours after a large overdose of his lithium. What is the best
treatment method for this overdose?
Answers:
1.Activated charcoal
2.Gastric lavage
3.Hemodialysis
4.Whole bowel irrigation - ANS 3.Hemodialysis
A 42 year-old woman presents with an overdose of her Xanax (alprazolam) that her family
indicates she has been taking for years to help with her anxiety. The bottle indicates that the
prescription was filled yesterday with 90 pills and is now empty. The patient is minimally
responsive to painful stimuli and does not react when you suction secretions out of her posterior
pharynx. What is your next management step?
Answers:
1.Administration of flumazenil
2.Administration of narcan
3.Close observation
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