COMSAE 114 EXAM 2026/2027
COMPLETE ACCURATE TEST EXAM
ACTUAL QUESTIONS AND CORRECT
DETAILED ANSWERS WITH RATIONALES
(VERIFIED SOLUTIONS) 2026 EDITION
|BEST DOCUMENT FOR EXAM
1. A 55-year-old man presents with substernal chest pain
radiating to the left arm. ECG shows ST elevations in V2-V4.
Which artery is most likely occluded?
A. Right coronary artery
B. Left circumflex artery
C. Left anterior descending artery
D. Posterior descending artery
Answer: C – Left anterior descending artery
Rationale: ST elevations in V2-V4 indicate an anterior MI,
typically due to LAD occlusion.
2. The most appropriate initial management for suspected acute
coronary syndrome in the ED includes:
A. IV antibiotics
,B. Aspirin and nitroglycerin
C. Morphine alone
D. Oral ibuprofen
Answer: B – Aspirin & nitroglycerin
Rationale: Early antiplatelet therapy and relief of ischemia
reduce morbidity.
3. A 70-year-old presents with sudden right facial droop and
slurred speech. CT scan is negative for hemorrhage. The best
next step is:
A. Start aspirin
B. Begin tPA if within window
C. MRI brain only
D. Start warfarin
Answer: B – Begin tPA
Rationale: Ischemic stroke without hemorrhage should receive
thrombolysis within the time window if eligible.
4. A D-dimer is most useful for:
A. Confirming pulmonary embolism
B. Ruling out pulmonary embolism
C. Diagnosing MI
D. Diagnosing CHF
Answer: B – Ruling out pulmonary embolism
Rationale: High sensitivity allows D-dimer to exclude PE in
low-risk patients.
,5. A patient with COPD exacerbation is best treated initially
with:
A. Inhaled corticosteroids alone
B. Bronchodilators and oxygen
C. Antibiotics only
D. IV fluids only
Answer: B – Bronchodilators & oxygen
Rationale: Relieves airflow obstruction and corrects
hypoxemia.
6. The most common cause of community-acquired pneumonia
in adults is:
A. Mycoplasma pneumoniae
B. Streptococcus pneumoniae
C. Haemophilus influenzae
D. Legionella pneumophila
Answer: B – Streptococcus pneumoniae
Rationale: Pneumococcus is the leading pathogen in adult CAP.
7. Which physical finding is MOST suggestive of pericardial
tamponade?
A. Jugular venous distension, hypotension, muffled heart tones
B. Loud S1
C. Pulmonary crackles
D. Lower limb edema only
Answer: A – Beck’s triad
Rationale: Classic signs of cardiac tamponade.
, 8. The drug of choice for acute anaphylaxis is:
A. Prednisone
B. Diphenhydramine
C. Epinephrine
D. Albuterol
Answer: C – Epinephrine
Rationale: Reverses bronchospasm, hypotension, and
angioedema.
9. A rapid test for suspected bacterial meningitis should include:
A. Skin culture
B. Blood glucose only
C. Lumbar puncture with CSF analysis
D. EEG
Answer: C – Lumbar puncture with CSF analysis
Rationale: CSF is diagnostic for bacterial meningitis.
10. A 24-hour urine collection is the best test for:
A. Serum sodium
B. Urinary protein quantification
C. Random glucose
D. CBC
Answer: B – Urinary protein quantification
Rationale: Provides accurate measurement of proteinuria.
COMPLETE ACCURATE TEST EXAM
ACTUAL QUESTIONS AND CORRECT
DETAILED ANSWERS WITH RATIONALES
(VERIFIED SOLUTIONS) 2026 EDITION
|BEST DOCUMENT FOR EXAM
1. A 55-year-old man presents with substernal chest pain
radiating to the left arm. ECG shows ST elevations in V2-V4.
Which artery is most likely occluded?
A. Right coronary artery
B. Left circumflex artery
C. Left anterior descending artery
D. Posterior descending artery
Answer: C – Left anterior descending artery
Rationale: ST elevations in V2-V4 indicate an anterior MI,
typically due to LAD occlusion.
2. The most appropriate initial management for suspected acute
coronary syndrome in the ED includes:
A. IV antibiotics
,B. Aspirin and nitroglycerin
C. Morphine alone
D. Oral ibuprofen
Answer: B – Aspirin & nitroglycerin
Rationale: Early antiplatelet therapy and relief of ischemia
reduce morbidity.
3. A 70-year-old presents with sudden right facial droop and
slurred speech. CT scan is negative for hemorrhage. The best
next step is:
A. Start aspirin
B. Begin tPA if within window
C. MRI brain only
D. Start warfarin
Answer: B – Begin tPA
Rationale: Ischemic stroke without hemorrhage should receive
thrombolysis within the time window if eligible.
4. A D-dimer is most useful for:
A. Confirming pulmonary embolism
B. Ruling out pulmonary embolism
C. Diagnosing MI
D. Diagnosing CHF
Answer: B – Ruling out pulmonary embolism
Rationale: High sensitivity allows D-dimer to exclude PE in
low-risk patients.
,5. A patient with COPD exacerbation is best treated initially
with:
A. Inhaled corticosteroids alone
B. Bronchodilators and oxygen
C. Antibiotics only
D. IV fluids only
Answer: B – Bronchodilators & oxygen
Rationale: Relieves airflow obstruction and corrects
hypoxemia.
6. The most common cause of community-acquired pneumonia
in adults is:
A. Mycoplasma pneumoniae
B. Streptococcus pneumoniae
C. Haemophilus influenzae
D. Legionella pneumophila
Answer: B – Streptococcus pneumoniae
Rationale: Pneumococcus is the leading pathogen in adult CAP.
7. Which physical finding is MOST suggestive of pericardial
tamponade?
A. Jugular venous distension, hypotension, muffled heart tones
B. Loud S1
C. Pulmonary crackles
D. Lower limb edema only
Answer: A – Beck’s triad
Rationale: Classic signs of cardiac tamponade.
, 8. The drug of choice for acute anaphylaxis is:
A. Prednisone
B. Diphenhydramine
C. Epinephrine
D. Albuterol
Answer: C – Epinephrine
Rationale: Reverses bronchospasm, hypotension, and
angioedema.
9. A rapid test for suspected bacterial meningitis should include:
A. Skin culture
B. Blood glucose only
C. Lumbar puncture with CSF analysis
D. EEG
Answer: C – Lumbar puncture with CSF analysis
Rationale: CSF is diagnostic for bacterial meningitis.
10. A 24-hour urine collection is the best test for:
A. Serum sodium
B. Urinary protein quantification
C. Random glucose
D. CBC
Answer: B – Urinary protein quantification
Rationale: Provides accurate measurement of proteinuria.
