SAEM TEST BANK 2026 UPDATED
QUESTIONS WITH ANSWERS GRADED A+
⩥ "Which of the following trauma patients can be managed
conservatively without immediate laparotomy in the OR?
A. 27 year old man with hemoperitoneum by bedside ultrasound;
hypotensive
B. 19 year old man with splenic laceration; peritoneal signs on exam
C. 24 year old man with liver laceration; hemodynamically stable
D. 30 year old man with a gunshot wound to the epigastrium
E. All of the above should go to the OR for exploratory laparotomy."
Answer: "C. 24 year old man with liver laceration; hemodynamically
stable"
⩥ "Which of the following is an accurate statement?
A. Bedside ultrasound is the test of choice for diagnosing solid organ
injury.
B. Diagnostic peritoneal lavage usually cannot identify the presence of
hemoperitoneum.
C. Bedside ultrasound can image the retroperitoneum.
D. Bedside ultrasound can reliably determine the etiology of
hemoperitoneum.
,E. Diagnostic peritoneal lavage cannot determine the etiology of
hemoperitoneum." Answer: "E. Diagnostic peritoneal lavage cannot
determine the etiology of hemoperitoneum.
The answer is E. Diagnostic peritoneal lavage is extremely sensitive for
the detection of hemoperitoneum and can lead to many negative
laparotomies. Neither bedside ultrasound nor diagnostic peritoneal
lavage can identify the source of the hemorrhage though. A trauma
ultrasound at the bedside can only identify fluid in the peritoneal cavity,
and CT scan is the test of choice for diagnosing solid organ injury."
⩥ "A 36 year old man is a restrained driver involved in a high speed
MVA where his car is struck on the driver's side door with significant
intrusion. His physical exam is significant for a large contusion on his
left flank. His abdominal exam is benign and rectal exam reveals a
normal prostate. A Foley catheter is placed with return of gross
hematuria. Which test is indicated to evaluate for the presence of
urologic injury?
A. CT abdomen / pelvis with IV and transurethral contrast
B. Ultrasound of the bladder
C. CT abdomen / pelvis without contrast
D. Ultrasound of the kidneys
E. CT abdomen / pelvis with IV contrast alone" Answer: "A. CT
abdomen / pelvis with IV and transurethral contrast"
,⩥ "In which of these patients is emergency department thoracotomy
indicated?
A. All of the above should undergo emergency department thoracotomy.
B. Unbelted driver in a high-speed motor vehicle crash who loses his
pulse while being extricated, and arrives at the E.D. after a 45-minute
transport
C. Patient with stab wound to the anterior chest who is dyspneic with an
oxygen saturation of 80% and a blood pressure of 168/102
D. Pedestrian struck with massive pelvic fractures who loses pulses and
blood pressure at the scene
E. Patient with a gunshot wound to the chest who upon arrival is
unconscious and pulseless, with a systolic blood pressure of 60" Answer:
"E. Patient with a gunshot wound to the chest who upon arrival is
unconscious and pulseless, with a systolic blood pressure of 60
The answer is E. Emergency Department thoracotomy is a controversial
procedure. When chosen carefully, successful resuscitation can occur.
Cardiac arrest due to blunt trauma has a dismal success rate and is
generally not considered an indication for ED thoracotomy.
Thoracotomy for penetrating chest wounds has the best success rate. An
awake patient with a relatively normal blood pressure does not need one
performed in the Emergency Department. An unconscious and pulseless
patient with a detectable blood pressure has the best chance for
survival."
⩥ "A 32 year old female is shot with a 38-caliber pistol at close range in
the right anterior chest. She presents to the emergency department
, intoxicated and yelling. Her vitals include a pulse of 92, blood pressure
of 134/84, and oxygen saturation of 97%. She has clear breath sounds
bilaterally. The entrance wound is just above the right breast and an exit
wound is noted in the right axilla. What is the most appropriate
management of this patient?
A. IV access, endotracheal intubation and simultaneous placement of a
right chest tube, bedside ultrasound, portable chest X-ray, and admission
to the ICU if stable
B. IV access, portable chest X-ray, tube thoracostomy, and exploratory
thoracotomy in the OR to search for cardiac or pulmonary vascular
injury
C. IV access, endotracheal intubation, emergency department
thoracotomy to search for cardiac or pulmonary vascular injury
D. IV access, portable chest X-ray, right c Answer: "A. IV access,
endotracheal intubation and simultaneous placement of a right chest
tube, bedside ultrasound, portable chest X-ray, and admission to the ICU
if stable"
⩥ "During a bar fight, a 42 year old man is stabbed in the left side with
an unknown weapon. He presents to the emergency department with
dyspnea, pulse of 108, blood pressure of 138/92, and oxygen saturation
of 94% on room air. He has absent breath sounds on the left side; you
note a small puncture wound in the midaxillary line at the level of the
10th rib. His abdominal exam is normal. Two large-bore IVs are
established. What is the appropriate management of this patient?
A. Left-sided chest tube, portable chest x-ray, and admission
QUESTIONS WITH ANSWERS GRADED A+
⩥ "Which of the following trauma patients can be managed
conservatively without immediate laparotomy in the OR?
A. 27 year old man with hemoperitoneum by bedside ultrasound;
hypotensive
B. 19 year old man with splenic laceration; peritoneal signs on exam
C. 24 year old man with liver laceration; hemodynamically stable
D. 30 year old man with a gunshot wound to the epigastrium
E. All of the above should go to the OR for exploratory laparotomy."
Answer: "C. 24 year old man with liver laceration; hemodynamically
stable"
⩥ "Which of the following is an accurate statement?
A. Bedside ultrasound is the test of choice for diagnosing solid organ
injury.
B. Diagnostic peritoneal lavage usually cannot identify the presence of
hemoperitoneum.
C. Bedside ultrasound can image the retroperitoneum.
D. Bedside ultrasound can reliably determine the etiology of
hemoperitoneum.
,E. Diagnostic peritoneal lavage cannot determine the etiology of
hemoperitoneum." Answer: "E. Diagnostic peritoneal lavage cannot
determine the etiology of hemoperitoneum.
The answer is E. Diagnostic peritoneal lavage is extremely sensitive for
the detection of hemoperitoneum and can lead to many negative
laparotomies. Neither bedside ultrasound nor diagnostic peritoneal
lavage can identify the source of the hemorrhage though. A trauma
ultrasound at the bedside can only identify fluid in the peritoneal cavity,
and CT scan is the test of choice for diagnosing solid organ injury."
⩥ "A 36 year old man is a restrained driver involved in a high speed
MVA where his car is struck on the driver's side door with significant
intrusion. His physical exam is significant for a large contusion on his
left flank. His abdominal exam is benign and rectal exam reveals a
normal prostate. A Foley catheter is placed with return of gross
hematuria. Which test is indicated to evaluate for the presence of
urologic injury?
A. CT abdomen / pelvis with IV and transurethral contrast
B. Ultrasound of the bladder
C. CT abdomen / pelvis without contrast
D. Ultrasound of the kidneys
E. CT abdomen / pelvis with IV contrast alone" Answer: "A. CT
abdomen / pelvis with IV and transurethral contrast"
,⩥ "In which of these patients is emergency department thoracotomy
indicated?
A. All of the above should undergo emergency department thoracotomy.
B. Unbelted driver in a high-speed motor vehicle crash who loses his
pulse while being extricated, and arrives at the E.D. after a 45-minute
transport
C. Patient with stab wound to the anterior chest who is dyspneic with an
oxygen saturation of 80% and a blood pressure of 168/102
D. Pedestrian struck with massive pelvic fractures who loses pulses and
blood pressure at the scene
E. Patient with a gunshot wound to the chest who upon arrival is
unconscious and pulseless, with a systolic blood pressure of 60" Answer:
"E. Patient with a gunshot wound to the chest who upon arrival is
unconscious and pulseless, with a systolic blood pressure of 60
The answer is E. Emergency Department thoracotomy is a controversial
procedure. When chosen carefully, successful resuscitation can occur.
Cardiac arrest due to blunt trauma has a dismal success rate and is
generally not considered an indication for ED thoracotomy.
Thoracotomy for penetrating chest wounds has the best success rate. An
awake patient with a relatively normal blood pressure does not need one
performed in the Emergency Department. An unconscious and pulseless
patient with a detectable blood pressure has the best chance for
survival."
⩥ "A 32 year old female is shot with a 38-caliber pistol at close range in
the right anterior chest. She presents to the emergency department
, intoxicated and yelling. Her vitals include a pulse of 92, blood pressure
of 134/84, and oxygen saturation of 97%. She has clear breath sounds
bilaterally. The entrance wound is just above the right breast and an exit
wound is noted in the right axilla. What is the most appropriate
management of this patient?
A. IV access, endotracheal intubation and simultaneous placement of a
right chest tube, bedside ultrasound, portable chest X-ray, and admission
to the ICU if stable
B. IV access, portable chest X-ray, tube thoracostomy, and exploratory
thoracotomy in the OR to search for cardiac or pulmonary vascular
injury
C. IV access, endotracheal intubation, emergency department
thoracotomy to search for cardiac or pulmonary vascular injury
D. IV access, portable chest X-ray, right c Answer: "A. IV access,
endotracheal intubation and simultaneous placement of a right chest
tube, bedside ultrasound, portable chest X-ray, and admission to the ICU
if stable"
⩥ "During a bar fight, a 42 year old man is stabbed in the left side with
an unknown weapon. He presents to the emergency department with
dyspnea, pulse of 108, blood pressure of 138/92, and oxygen saturation
of 94% on room air. He has absent breath sounds on the left side; you
note a small puncture wound in the midaxillary line at the level of the
10th rib. His abdominal exam is normal. Two large-bore IVs are
established. What is the appropriate management of this patient?
A. Left-sided chest tube, portable chest x-ray, and admission
