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EXAM
1. A 65-year-old male presents with chest pain radiating to his left arm. His ECG shows ST-
segment elevation in leads II, III, and aVF. Which coronary artery is most likely
occluded?
A. Left anterior descending
B. Left circumflex
C. Right coronary artery
D. Posterior descending artery
Answer: C. Right coronary artery
Rationale: ST elevation in II, III, and aVF indicates an inferior MI, usually due to RCA
occlusion.
2. What is the primary mechanism of action of albuterol in the treatment of asthma?
A. Beta-1 agonist
B. Beta-2 agonist
C. Alpha-1 agonist
D. Muscarinic antagonist
Answer: B. Beta-2 agonist
Rationale: Albuterol selectively stimulates beta-2 receptors, causing bronchodilation.
3. During CPR, what is the recommended compression rate for adults?
A. 60–80 per minute
B. 80–100 per minute
C. 100–120 per minute
D. 120–140 per minute
Answer: C. 100–120 per minute
Rationale: High-quality adult CPR requires compressions at a rate of 100–120 per minute.
4. A patient with suspected hypoglycemia is unconscious. Which route is preferred for
glucose administration?
A. Oral
B. Intramuscular
C. Subcutaneous
D. IV or intraosseous
,Answer: D. IV or intraosseous
Rationale: Unconscious patients cannot safely take oral glucose; IV or IO access is preferred.
5. Which of the following is a contraindication for nitroglycerin administration?
A. Chest pain
B. Systolic BP < 90 mmHg
C. History of angina
D. Tachycardia
Answer: B. Systolic BP < 90 mmHg
Rationale: Nitroglycerin can cause hypotension and should be avoided if systolic BP is low.
6. A 30-year-old male was stung by a bee and is experiencing wheezing, urticaria, and
hypotension. What is the first-line treatment?
A. Diphenhydramine
B. Epinephrine IM
C. Albuterol nebulizer
D. Prednisone
Answer: B. Epinephrine IM
Rationale: Epinephrine is first-line for anaphylaxis; it addresses airway, breathing, and
circulation.
7. Which rhythm is most commonly associated with sudden cardiac arrest in adults?
A. Asystole
B. Ventricular fibrillation
C. Pulseless electrical activity
D. Sinus tachycardia
Answer: B. Ventricular fibrillation
Rationale: VF is the most common initial rhythm in sudden cardiac arrest and is shockable.
8. Which of the following medications is indicated for a patient in symptomatic bradycardia
with a pulse?
A. Atropine
B. Adenosine
C. Amiodarone
D. Epinephrine
Answer: A. Atropine
Rationale: Atropine blocks vagal stimulation to increase heart rate in symptomatic bradycardia.
9. What is the most appropriate initial treatment for a patient with an opioid overdose and
respiratory depression?
A. Naloxone
B. Flumazenil
, C. Epinephrine
D. Activated charcoal
Answer: A. Naloxone
Rationale: Naloxone is an opioid antagonist that reverses respiratory depression.
10. A patient presents with sudden onset shortness of breath and pleuritic chest pain after a
long flight. You suspect a pulmonary embolism. What is the classic triad?
A. Dyspnea, hemoptysis, pleuritic chest pain
B. Fever, cough, wheezing
C. Tachycardia, bradycardia, hypotension
D. Hypoxia, hypertension, tachypnea
Answer: A. Dyspnea, hemoptysis, pleuritic chest pain
Rationale: Classic PE triad includes sudden dyspnea, hemoptysis, and pleuritic chest pain.
11. Which electrolyte abnormality is most likely to cause peaked T waves on ECG?
A. Hypokalemia
B. Hyperkalemia
C. Hypocalcemia
D. Hypercalcemia
Answer: B. Hyperkalemia
Rationale: Elevated potassium affects cardiac conduction, causing peaked T waves.
12. Which of the following is a sign of increased intracranial pressure?
A. Bradycardia, hypertension, irregular respirations
B. Tachycardia, hypotension, shallow respirations
C. Hypotension, bradypnea, tachycardia
D. Tachypnea, hypotension, bradycardia
Answer: A. Bradycardia, hypertension, irregular respirations
Rationale: Cushing’s triad is a late sign of increased ICP.
13. The most appropriate fluid for initial resuscitation in hypovolemic shock is:
A. 0.9% Normal saline
B. Dextrose 5% in water
C. Lactated Ringer’s
D. Albumin
Answer: C. Lactated Ringer’s
Rationale: LR is isotonic and preferred for hypovolemic shock due to trauma or dehydration.
14. Which of the following is the antidote for acetaminophen overdose?
A. N-acetylcysteine
B. Naloxone
, C. Vitamin K
D. Atropine
Answer: A. N-acetylcysteine
Rationale: N-acetylcysteine replenishes glutathione to detoxify NAPQI in acetaminophen
toxicity.
15. What is the preferred method to assess airway patency in an unresponsive patient?
A. Auscultation
B. Head tilt-chin lift
C. Jaw thrust maneuver
D. Pulse oximetry
Answer: C. Jaw thrust maneuver
Rationale: In trauma, jaw thrust is preferred to maintain airway without cervical spine
movement.
16. A 45-year-old patient presents with sudden severe headache, photophobia, and neck
stiffness. What is the most likely diagnosis?
A. Migraine
B. Subarachnoid hemorrhage
C. Tension headache
D. Sinus infection
Answer: B. Subarachnoid hemorrhage
Rationale: Sudden “worst headache of life” with neck stiffness is classic for SAH.
17. Which class of medication is contraindicated in acute heart failure with reduced ejection
fraction?
A. ACE inhibitors
B. Beta-blockers (acute decompensation)
C. Loop diuretics
D. Aldosterone antagonists
Answer: B. Beta-blockers (acute decompensation)
Rationale: Beta-blockers may worsen acute decompensated heart failure initially.
18. Which of the following medications is first-line for adult status epilepticus?
A. Diazepam IV
B. Lorazepam IV
C. Phenytoin IV
D. Midazolam IM
Answer: B. Lorazepam IV
Rationale: Lorazepam is preferred due to longer duration of action and efficacy.