SAEM EXAM QUESTIONS ACTUAL EXAM 400 REAL
EXAM QUESTIONS AND CORRECT DETAILED ANSWERS
WITH RATIONALES (VERIFIED ANSWERS) |ALREADY
GRADED A+
A 23-year-old male presents after a syncopal episode. EKG findings include normal
sinus rhythm, a short PR interval (less than 0.12 seconds), QRS duration of
0.11seconds, and the presence of a "delta wave" (a slurred upstroke to the QRS
complex). What condition most likely caused the syncopal episode?
Answers:
1.Brugada syndrome
2.Dextrocardia
3.Vasovagal reaction
4.Wolff-Parkinson-White syndrome - ANSWER: 4.Wolff-Parkinson-White syndrome
Of the options below, the therapy best for symptomatic 3rd degree heart block is:
Answers:
1.lidocaine
2.transcutaneous pacer
3.atropine
4.oxygen
5.cardioversion - ANSWER: 2.transcutaneous pacer
A 54 year old female presents with palpitations. She is otherwise asymptomatic. EKG
shows atrial fibrillation. Vital signs are HR 130-150, BP 148/78, RR 16, T 36.7. What
management intervention is most important to accomplish next?
Answers:
1.Anticoagulation
2.Cardioversion
3.Pharmacologic ventricular rate control
4.Radiofrequency ablation - ANSWER: 3.Pharmacologic ventricular rate control
An 8 year old female presents with a regular, narrow-complex SVT. You diagnose AV
nodal reentrant tachycardia. Which pharmacologic agent would be most appropriate
for initial management?
,Answers:
1.Adenosine
2.Digoxin
3.Diltiazem
4.Lidocaine - ANSWER: 1.Adenosine
A 65 year old male presents to the emergency department with chest pain. Cardiac
monitoring shows a wide complex tachycardia. Past medical history is significant only
for hypertension. His BP is 100/66, HR 144, RR 24, and T. 37.5. In addition to ongoing
chest pain, he reports dyspnea. His level of consciousness is mildly decreased.
Management should proceed on the assumption that he has what abnormal
rhythm?
Answers:
1.Sinus tachycardia with LVH
2.Supraventricular tachycardia with aberrancy
3.Ventricular tachycardia
4.Wolff-Parkinson-White syndrome with retrograde conduction - ANSWER:
3.Ventricular tachycardia
The best treatment, of the options below, for a patient with second degree AV block
Mobitz Type II is:
Answers:
1.amiodarone
2.epinephrine
3.aspirin
4.transvenous pacing
5.lidocaine - ANSWER: 4.transvenous pacing
Where are the normally dominant pacemaker cells of the heart found?
Answers:
1.sinoatrial node
2.atrioventricular node
3.bundle of His
4.accessory pathway of Kent - ANSWER: 1.sinoatrial node
, A 40 year old male presents to the emergency department complaining of severe
ankle pain after inverting the foot during a soccer game. The triage nurse records the
following vital signs: temperature 98.8, pulse 94, respiratory rate 18, BP 188/118.
Which of the interventions below is the most appropriate step to take in response to
the blood pressure assessment?
Answers:
1.Administer a sublingual antihypertensive agent since the patient probably only has
an ankle sprain and will not need an intravenous line
2.Establish intravenous access in order to optimize the onset of action of parenteral
antihypertensive medications
3.Ignore the blood pressure since the patient is asymptomatic other than having
ankle pain
4.Order an antihypertensive agent to be given in the emergency department
because the patient will be discharged with a prescription for one
5.E. Take measures to relieve pain and recheck the blood pressure. - ANSWER: 5.E.
Take measures to relieve pain and recheck the blood pressure.
The blood pressure at which malignant hypertension is defined as present is:
Answers:
1.an elevated arterial pressure associated with end organ damage
2.an elevated arterial pressure that exceeds the patient's baseline by 33%
3.diastolic blood pressure of 110 or greater
4.systolic blood pressure of 170 or greater
5.systolic blood pressure of 180 or greater - ANSWER: 1.an elevated arterial pressure
associated with end organ damage
Which of the ocular findings below is associated with hypertension?
Answers:
1.arterio-venous nicking
2.cherry red spot
3.increased cup-to-disk ratio
4.retinal nevus
5.Roth spots - ANSWER: 1.arterio-venous nicking
EXAM QUESTIONS AND CORRECT DETAILED ANSWERS
WITH RATIONALES (VERIFIED ANSWERS) |ALREADY
GRADED A+
A 23-year-old male presents after a syncopal episode. EKG findings include normal
sinus rhythm, a short PR interval (less than 0.12 seconds), QRS duration of
0.11seconds, and the presence of a "delta wave" (a slurred upstroke to the QRS
complex). What condition most likely caused the syncopal episode?
Answers:
1.Brugada syndrome
2.Dextrocardia
3.Vasovagal reaction
4.Wolff-Parkinson-White syndrome - ANSWER: 4.Wolff-Parkinson-White syndrome
Of the options below, the therapy best for symptomatic 3rd degree heart block is:
Answers:
1.lidocaine
2.transcutaneous pacer
3.atropine
4.oxygen
5.cardioversion - ANSWER: 2.transcutaneous pacer
A 54 year old female presents with palpitations. She is otherwise asymptomatic. EKG
shows atrial fibrillation. Vital signs are HR 130-150, BP 148/78, RR 16, T 36.7. What
management intervention is most important to accomplish next?
Answers:
1.Anticoagulation
2.Cardioversion
3.Pharmacologic ventricular rate control
4.Radiofrequency ablation - ANSWER: 3.Pharmacologic ventricular rate control
An 8 year old female presents with a regular, narrow-complex SVT. You diagnose AV
nodal reentrant tachycardia. Which pharmacologic agent would be most appropriate
for initial management?
,Answers:
1.Adenosine
2.Digoxin
3.Diltiazem
4.Lidocaine - ANSWER: 1.Adenosine
A 65 year old male presents to the emergency department with chest pain. Cardiac
monitoring shows a wide complex tachycardia. Past medical history is significant only
for hypertension. His BP is 100/66, HR 144, RR 24, and T. 37.5. In addition to ongoing
chest pain, he reports dyspnea. His level of consciousness is mildly decreased.
Management should proceed on the assumption that he has what abnormal
rhythm?
Answers:
1.Sinus tachycardia with LVH
2.Supraventricular tachycardia with aberrancy
3.Ventricular tachycardia
4.Wolff-Parkinson-White syndrome with retrograde conduction - ANSWER:
3.Ventricular tachycardia
The best treatment, of the options below, for a patient with second degree AV block
Mobitz Type II is:
Answers:
1.amiodarone
2.epinephrine
3.aspirin
4.transvenous pacing
5.lidocaine - ANSWER: 4.transvenous pacing
Where are the normally dominant pacemaker cells of the heart found?
Answers:
1.sinoatrial node
2.atrioventricular node
3.bundle of His
4.accessory pathway of Kent - ANSWER: 1.sinoatrial node
, A 40 year old male presents to the emergency department complaining of severe
ankle pain after inverting the foot during a soccer game. The triage nurse records the
following vital signs: temperature 98.8, pulse 94, respiratory rate 18, BP 188/118.
Which of the interventions below is the most appropriate step to take in response to
the blood pressure assessment?
Answers:
1.Administer a sublingual antihypertensive agent since the patient probably only has
an ankle sprain and will not need an intravenous line
2.Establish intravenous access in order to optimize the onset of action of parenteral
antihypertensive medications
3.Ignore the blood pressure since the patient is asymptomatic other than having
ankle pain
4.Order an antihypertensive agent to be given in the emergency department
because the patient will be discharged with a prescription for one
5.E. Take measures to relieve pain and recheck the blood pressure. - ANSWER: 5.E.
Take measures to relieve pain and recheck the blood pressure.
The blood pressure at which malignant hypertension is defined as present is:
Answers:
1.an elevated arterial pressure associated with end organ damage
2.an elevated arterial pressure that exceeds the patient's baseline by 33%
3.diastolic blood pressure of 110 or greater
4.systolic blood pressure of 170 or greater
5.systolic blood pressure of 180 or greater - ANSWER: 1.an elevated arterial pressure
associated with end organ damage
Which of the ocular findings below is associated with hypertension?
Answers:
1.arterio-venous nicking
2.cherry red spot
3.increased cup-to-disk ratio
4.retinal nevus
5.Roth spots - ANSWER: 1.arterio-venous nicking
