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SAEM M4 EXAM NEWEST 2026 2027
COMPLETE QUESTIONS AND CORRECT
DETAILED CORRECT ANSWERSS VERIFIED
CORRECT ANSWERSS BRAND NEW VERSION
HIGH YIELD STUDY GUIDE ACTUAL UPDATED
PRACTICE QUESTIONS EXAM PREPARATION
GRADED A+ SUCCESS REVIEW
With respect to laboratory findings in diabetic ketoacidosis (DKA) and
hyperglycemic hyperosmolar nonketotic coma (HHNC), all of the
following guidelines are generally true EXCEPT:
CORRECT ANSWERSs:
1.Patients with HHNC typically have blood glucose > 700 mg/dL,
whereas patients with DKA have blood glucose > 350 mg/dL.
2.Serum ketones are present in patients with DKA but not usually in
patients with HHNC.
3.Serum bicarbonate is typically severely low (<10mEq) in patients with
either DKA or HHNC.
4.Serum osmolality in patients with HHNC is typically > 350 mOsm/L.
5.BUN is elevated more in patients with HHNC (>50 mg/dL) than in
patients with DKA (25-50 mg/dL). - CORRECT ANSWERS-3.Serum
bicarbonate is typically severely low (<10mEq) in patients with either DKA
or HHNC.
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Regarding the treatment of hyperosmolar hypertonic nonketotic coma
(HHNC) and its associated symptoms, which of the following is correct:
CORRECT ANSWERSs:
1.Half of the fluid deficit should be corrected over the first hour and the
remainder over the following 8 hours.
2.Since patients are not acidotic, close monitoring of glucose is not
necessary.
3.Hyperosmolarity should be corrected within the first few hours in the
emergency department.
4.Phenytoin (Dilantin) is often ineffective for seizures associated with
HHNC.
5.In HHNC patients with severe dehydration, bleeding diathesis is a
major clinical concern. - CORRECT ANSWERS-4.Phenytoin
(Dilantin) is often ineffective for seizures associated with HHNC.
Regarding the development of cerebral edema in patients being treated
for DKA, all of the following are true EXCEPT:
CORRECT ANSWERSs:
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1.Cerebral edema typically occurs six to ten hours following onset of
treatment.
2.Children have a higher incidence of cerebral edema.
3.Mannitol and steroids should be administered immediately to any
patient suspected of developing cerebral edema.
4.Mortality of patients developing cerebral edema is 90%.
5.Patients with serum glucose below 250 mg/dL still being treated with
insulin are most likely to develop clinically evident cerebral edema. -
CORRECT ANSWERS-3.Mannitol and steroids should be
administered immediately to any patient suspected of developing
cerebral edema.
Metabolic abnormalities often seen with hypothyroidism include all of
thefollowing EXCEPT:
CORRECT ANSWERSs:
1.hyponatremia
2.hyperglycemia
3.hypercholesterolemia
4.respiratory acidosis from hypoventilation
5.anemia - CORRECT ANSWERS-2.hyperglycemia
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Laboratory abnormalities typically seen with adrenal insufficiency
include all of the following EXCEPT:
CORRECT ANSWERSs:
1.hypoglycemia
2.hyponatremia
3.hypokalemia
4.hypercalcemia
5.azotemia - CORRECT ANSWERS-3.hypokalemia
Regarding the treatment of suspected but not confirmed adrenal
insufficiency, which of the following is most appropriate?
CORRECT ANSWERSs:
1.cosyntropin 0.25mg IV x 1
2.dexamthasone 4mg IV every 6 hours
3.hydrocortisone 100mg IV every 6 hours
4.cortisone 100mg IM every 6 hours
5.withholding of steroids until confirmation of the diagnosis of adrenal
insufficiency - CORRECT ANSWERS-2.dexamthasone 4mg IV every 6
hours
SAEM M4 EXAM NEWEST 2026 2027
COMPLETE QUESTIONS AND CORRECT
DETAILED CORRECT ANSWERSS VERIFIED
CORRECT ANSWERSS BRAND NEW VERSION
HIGH YIELD STUDY GUIDE ACTUAL UPDATED
PRACTICE QUESTIONS EXAM PREPARATION
GRADED A+ SUCCESS REVIEW
With respect to laboratory findings in diabetic ketoacidosis (DKA) and
hyperglycemic hyperosmolar nonketotic coma (HHNC), all of the
following guidelines are generally true EXCEPT:
CORRECT ANSWERSs:
1.Patients with HHNC typically have blood glucose > 700 mg/dL,
whereas patients with DKA have blood glucose > 350 mg/dL.
2.Serum ketones are present in patients with DKA but not usually in
patients with HHNC.
3.Serum bicarbonate is typically severely low (<10mEq) in patients with
either DKA or HHNC.
4.Serum osmolality in patients with HHNC is typically > 350 mOsm/L.
5.BUN is elevated more in patients with HHNC (>50 mg/dL) than in
patients with DKA (25-50 mg/dL). - CORRECT ANSWERS-3.Serum
bicarbonate is typically severely low (<10mEq) in patients with either DKA
or HHNC.
,2 | Page
Regarding the treatment of hyperosmolar hypertonic nonketotic coma
(HHNC) and its associated symptoms, which of the following is correct:
CORRECT ANSWERSs:
1.Half of the fluid deficit should be corrected over the first hour and the
remainder over the following 8 hours.
2.Since patients are not acidotic, close monitoring of glucose is not
necessary.
3.Hyperosmolarity should be corrected within the first few hours in the
emergency department.
4.Phenytoin (Dilantin) is often ineffective for seizures associated with
HHNC.
5.In HHNC patients with severe dehydration, bleeding diathesis is a
major clinical concern. - CORRECT ANSWERS-4.Phenytoin
(Dilantin) is often ineffective for seizures associated with HHNC.
Regarding the development of cerebral edema in patients being treated
for DKA, all of the following are true EXCEPT:
CORRECT ANSWERSs:
,3 | Page
1.Cerebral edema typically occurs six to ten hours following onset of
treatment.
2.Children have a higher incidence of cerebral edema.
3.Mannitol and steroids should be administered immediately to any
patient suspected of developing cerebral edema.
4.Mortality of patients developing cerebral edema is 90%.
5.Patients with serum glucose below 250 mg/dL still being treated with
insulin are most likely to develop clinically evident cerebral edema. -
CORRECT ANSWERS-3.Mannitol and steroids should be
administered immediately to any patient suspected of developing
cerebral edema.
Metabolic abnormalities often seen with hypothyroidism include all of
thefollowing EXCEPT:
CORRECT ANSWERSs:
1.hyponatremia
2.hyperglycemia
3.hypercholesterolemia
4.respiratory acidosis from hypoventilation
5.anemia - CORRECT ANSWERS-2.hyperglycemia
, 4 | Page
Laboratory abnormalities typically seen with adrenal insufficiency
include all of the following EXCEPT:
CORRECT ANSWERSs:
1.hypoglycemia
2.hyponatremia
3.hypokalemia
4.hypercalcemia
5.azotemia - CORRECT ANSWERS-3.hypokalemia
Regarding the treatment of suspected but not confirmed adrenal
insufficiency, which of the following is most appropriate?
CORRECT ANSWERSs:
1.cosyntropin 0.25mg IV x 1
2.dexamthasone 4mg IV every 6 hours
3.hydrocortisone 100mg IV every 6 hours
4.cortisone 100mg IM every 6 hours
5.withholding of steroids until confirmation of the diagnosis of adrenal
insufficiency - CORRECT ANSWERS-2.dexamthasone 4mg IV every 6
hours
