SAEM M4 Emergency Medicine Questions
And Correct Answers (Verified Answers)
Plus Rationales 2026 Q&A | Instant
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1. A 25-year-old male presents after a high-speed motor vehicle
collision. He is hypotensive and tachycardic. FAST exam shows free
fluid in the abdomen. What is the next best step?
a) CT scan of the abdomen
b) Diagnostic peritoneal lavage
c) Emergent laparotomy
d) Observation
In unstable patients with suspected intra-abdominal bleeding,
immediate surgical intervention is indicated rather than imaging
or observation.
2. Which of the following is most sensitive for detecting a
pneumothorax in a trauma patient?
a) Chest X-ray
b) Physical exam
c) Point-of-care ultrasound
d) CT scan
Ultrasound has higher sensitivity for pneumothorax than chest X-
ray and is faster than CT in unstable patients.
, 3. A 30-year-old male presents with an open fracture of the tibia
after a fall. What is the most important initial management step?
a) Immediate internal fixation
b) Irrigation and antibiotic administration
c) Cast immobilization
d) Pain control only
Open fractures require early irrigation, antibiotic prophylaxis, and
stabilization to reduce infection risk.
4. A patient presents with a pelvic fracture and hypotension. Which
of the following is the first step in hemorrhage control?
a) Surgery
b) Embolization
c) Pelvic binder application
d) Blood transfusion
Pelvic binders stabilize the pelvis and reduce venous bleeding,
often as a first step before definitive interventions.
5. In blunt abdominal trauma, which organ is most commonly
injured?
a) Spleen
b) Liver
c) Kidney
d) Spleen
The spleen is the most frequently injured organ in blunt abdominal
trauma, particularly from motor vehicle collisions.
Shock
6. A 60-year-old patient presents with hypotension, tachycardia, and
cold extremities. Labs show elevated lactate. What type of shock
, is most likely?
a) Distributive
b) Cardiogenic
c) Hypovolemic
d) Obstructive
Hypovolemic shock presents with hypotension, tachycardia, poor
perfusion, and elevated lactate due to decreased circulating
volume.
7. Which of the following is the preferred vasopressor for septic
shock?
a) Dopamine
b) Phenylephrine
c) Norepinephrine
d) Epinephrine
Norepinephrine is the first-line vasopressor for septic shock
according to current ACLS/Sepsis guidelines.
8. A patient presents with hypotension and muffled heart sounds
after chest trauma. What is the most likely diagnosis?
a) Cardiogenic shock
b) Pulmonary embolism
c) Cardiac tamponade
d) Tension pneumothorax
The classic Beck’s triad—hypotension, muffled heart sounds, and
jugular venous distension—suggests cardiac tamponade.
9. Which of the following fluids is preferred for initial resuscitation in
hypovolemic shock?
a) Crystalloids
, b) Colloids
c) Blood products only
d) Hypertonic saline
Crystalloids such as normal saline or lactated Ringer’s are first-line
for initial volume resuscitation in hypovolemic shock.
10. A 70-year-old patient with STEMI develops hypotension and
pulmonary edema. Which shock type is likely?
a) Hypovolemic
b) Distributive
c) Cardiogenic
d) Obstructive
Cardiogenic shock results from primary cardiac dysfunction,
commonly after acute MI, presenting with hypotension and
pulmonary congestion.
Cardiac Arrest & EKGs
11. The first-line medication in pulseless VT/VF cardiac arrest is:
a) Amiodarone
b) Epinephrine
c) Lidocaine
d) Atropine
Epinephrine is administered every 3–5 minutes during cardiac
arrest, with antiarrhythmics used after defibrillation attempts.
12. A patient presents with a heart rate of 35 bpm and
hypotension. EKG shows complete dissociation between P waves
and QRS complexes. What is the rhythm?
a) Second-degree AV block type I
b) Second-degree AV block type II
And Correct Answers (Verified Answers)
Plus Rationales 2026 Q&A | Instant
Download Pdf
1. A 25-year-old male presents after a high-speed motor vehicle
collision. He is hypotensive and tachycardic. FAST exam shows free
fluid in the abdomen. What is the next best step?
a) CT scan of the abdomen
b) Diagnostic peritoneal lavage
c) Emergent laparotomy
d) Observation
In unstable patients with suspected intra-abdominal bleeding,
immediate surgical intervention is indicated rather than imaging
or observation.
2. Which of the following is most sensitive for detecting a
pneumothorax in a trauma patient?
a) Chest X-ray
b) Physical exam
c) Point-of-care ultrasound
d) CT scan
Ultrasound has higher sensitivity for pneumothorax than chest X-
ray and is faster than CT in unstable patients.
, 3. A 30-year-old male presents with an open fracture of the tibia
after a fall. What is the most important initial management step?
a) Immediate internal fixation
b) Irrigation and antibiotic administration
c) Cast immobilization
d) Pain control only
Open fractures require early irrigation, antibiotic prophylaxis, and
stabilization to reduce infection risk.
4. A patient presents with a pelvic fracture and hypotension. Which
of the following is the first step in hemorrhage control?
a) Surgery
b) Embolization
c) Pelvic binder application
d) Blood transfusion
Pelvic binders stabilize the pelvis and reduce venous bleeding,
often as a first step before definitive interventions.
5. In blunt abdominal trauma, which organ is most commonly
injured?
a) Spleen
b) Liver
c) Kidney
d) Spleen
The spleen is the most frequently injured organ in blunt abdominal
trauma, particularly from motor vehicle collisions.
Shock
6. A 60-year-old patient presents with hypotension, tachycardia, and
cold extremities. Labs show elevated lactate. What type of shock
, is most likely?
a) Distributive
b) Cardiogenic
c) Hypovolemic
d) Obstructive
Hypovolemic shock presents with hypotension, tachycardia, poor
perfusion, and elevated lactate due to decreased circulating
volume.
7. Which of the following is the preferred vasopressor for septic
shock?
a) Dopamine
b) Phenylephrine
c) Norepinephrine
d) Epinephrine
Norepinephrine is the first-line vasopressor for septic shock
according to current ACLS/Sepsis guidelines.
8. A patient presents with hypotension and muffled heart sounds
after chest trauma. What is the most likely diagnosis?
a) Cardiogenic shock
b) Pulmonary embolism
c) Cardiac tamponade
d) Tension pneumothorax
The classic Beck’s triad—hypotension, muffled heart sounds, and
jugular venous distension—suggests cardiac tamponade.
9. Which of the following fluids is preferred for initial resuscitation in
hypovolemic shock?
a) Crystalloids
, b) Colloids
c) Blood products only
d) Hypertonic saline
Crystalloids such as normal saline or lactated Ringer’s are first-line
for initial volume resuscitation in hypovolemic shock.
10. A 70-year-old patient with STEMI develops hypotension and
pulmonary edema. Which shock type is likely?
a) Hypovolemic
b) Distributive
c) Cardiogenic
d) Obstructive
Cardiogenic shock results from primary cardiac dysfunction,
commonly after acute MI, presenting with hypotension and
pulmonary congestion.
Cardiac Arrest & EKGs
11. The first-line medication in pulseless VT/VF cardiac arrest is:
a) Amiodarone
b) Epinephrine
c) Lidocaine
d) Atropine
Epinephrine is administered every 3–5 minutes during cardiac
arrest, with antiarrhythmics used after defibrillation attempts.
12. A patient presents with a heart rate of 35 bpm and
hypotension. EKG shows complete dissociation between P waves
and QRS complexes. What is the rhythm?
a) Second-degree AV block type I
b) Second-degree AV block type II
