1 | Page
SAEM M4 Exam Questions and
Answers Latest 2026
True or False: gastric distension due to excessive volume
or rate of ventilation impairing ventilatory function is a
reason to intubate a neonate Ans: False
management for nursemaid elbow injury Ans: apply
pressure to the radial head while flexing and supinating
elbow
A 17 year old boy injured his right shoulder playing
football. He tried to arm-tackle a player when his right
arm was pulled away from his body and back (abducted
and extended). He felt a sudden pain in his shoulder. He
presents to the emergency department holding his arm in
slight abduction and external rotation by his good arm.
He has severe pain with adduction or internal rotation.
What is the most common fracture associated with this
injury? Ans: compression fracture of the posteriolateral
aspect of the humeral head (Hill-Sachs deformity)
What are most common heart rhythms seen in pediatric
arrest? Ans: bradycardia or asystole
risk factors for neonatal resuscitation Ans: prematurity
IUGR
multiple gestation
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thick meconium
In the post-arrest setting, which of the following is the
drug of choice in treating hypotension in a child: Ans: epi
Low body temperatures in newborns can lead to severe
physiologic consequences, which include all EXCEPT:
Answers:
1. metabolic acidosis
2. increased oxygen consumption
3. hypoglycemia
4. apnea
5. hyperglycemia Ans: 3. hypoglycemia
In a newborn, bradycardia is most commonly an indicator
of: Ans: hypoxemia
All the following are signs of hypoxemia in a newborn,
EXCEPT:
Answers:
1.cyanosis
2.lethargy
3.tachycardia
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4.unresponsiveness
5.bradycardia Ans: 3. tachycardia
A newborn presents to the emergency department a few
days after hospital discharge. The infant has been noted
to be drooling, choking, and coughing, and the mother
reports seeing bubbles at the baby's mouth. Which is the
most likely explanation?
Answers:
1.osteogenesis imperfecta
2.inborn error of metabolism
3.congenital diaphragmatic hernia
4.foreign body
5.tracheoesophageal fistula Ans: 5. tracheoesophageal
fistula
Which of the following pairs of maneuvers are consistent
with current recommendations for emergency care for a
choking 5-month-old infant?
Answers:
1.back blow then blind finger sweep
2.back blow then chest thrust
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3.chest thrust then Heimlich maneuver
4.Heimlich maneuver then blind finger sweep
5.Heimlich maneuver then chest thrust Ans: 2.back blow
then chest thrust
All of these steps are involved in pediatric rapid
sequence intubation (RSI) EXCEPT:
Answers:
1.If administering succinylcholine, pretreatment with
atropine is always indicated in children under age 10.
2.Lidocaine pretreatment is usually provided to children
with head trauma.
3.When deciding which size endotracheal tube to use, one
may approximate by using the size of the small finger or
nares as a reference.
4.Due to the fragility of the pediatric C-spine, a cervical
collar should always be placed prior to intubation for
children under age ten.
5.Uncuffed endotracheal tubes are the preferred devices
used in children under 6-8 years of age. Ans: 4.Due to the
fragility of the pediatric C-spine, a cervical collar should
always be placed prior to intubation for children under
age ten.
© 2025 All rights reserved
SAEM M4 Exam Questions and
Answers Latest 2026
True or False: gastric distension due to excessive volume
or rate of ventilation impairing ventilatory function is a
reason to intubate a neonate Ans: False
management for nursemaid elbow injury Ans: apply
pressure to the radial head while flexing and supinating
elbow
A 17 year old boy injured his right shoulder playing
football. He tried to arm-tackle a player when his right
arm was pulled away from his body and back (abducted
and extended). He felt a sudden pain in his shoulder. He
presents to the emergency department holding his arm in
slight abduction and external rotation by his good arm.
He has severe pain with adduction or internal rotation.
What is the most common fracture associated with this
injury? Ans: compression fracture of the posteriolateral
aspect of the humeral head (Hill-Sachs deformity)
What are most common heart rhythms seen in pediatric
arrest? Ans: bradycardia or asystole
risk factors for neonatal resuscitation Ans: prematurity
IUGR
multiple gestation
© 2025 All rights reserved
, 2 | Page
thick meconium
In the post-arrest setting, which of the following is the
drug of choice in treating hypotension in a child: Ans: epi
Low body temperatures in newborns can lead to severe
physiologic consequences, which include all EXCEPT:
Answers:
1. metabolic acidosis
2. increased oxygen consumption
3. hypoglycemia
4. apnea
5. hyperglycemia Ans: 3. hypoglycemia
In a newborn, bradycardia is most commonly an indicator
of: Ans: hypoxemia
All the following are signs of hypoxemia in a newborn,
EXCEPT:
Answers:
1.cyanosis
2.lethargy
3.tachycardia
© 2025 All rights reserved
, 3 | Page
4.unresponsiveness
5.bradycardia Ans: 3. tachycardia
A newborn presents to the emergency department a few
days after hospital discharge. The infant has been noted
to be drooling, choking, and coughing, and the mother
reports seeing bubbles at the baby's mouth. Which is the
most likely explanation?
Answers:
1.osteogenesis imperfecta
2.inborn error of metabolism
3.congenital diaphragmatic hernia
4.foreign body
5.tracheoesophageal fistula Ans: 5. tracheoesophageal
fistula
Which of the following pairs of maneuvers are consistent
with current recommendations for emergency care for a
choking 5-month-old infant?
Answers:
1.back blow then blind finger sweep
2.back blow then chest thrust
© 2025 All rights reserved
, 4 | Page
3.chest thrust then Heimlich maneuver
4.Heimlich maneuver then blind finger sweep
5.Heimlich maneuver then chest thrust Ans: 2.back blow
then chest thrust
All of these steps are involved in pediatric rapid
sequence intubation (RSI) EXCEPT:
Answers:
1.If administering succinylcholine, pretreatment with
atropine is always indicated in children under age 10.
2.Lidocaine pretreatment is usually provided to children
with head trauma.
3.When deciding which size endotracheal tube to use, one
may approximate by using the size of the small finger or
nares as a reference.
4.Due to the fragility of the pediatric C-spine, a cervical
collar should always be placed prior to intubation for
children under age ten.
5.Uncuffed endotracheal tubes are the preferred devices
used in children under 6-8 years of age. Ans: 4.Due to the
fragility of the pediatric C-spine, a cervical collar should
always be placed prior to intubation for children under
age ten.
© 2025 All rights reserved
