BCEMP Practice Exam Study Guide | Medical Physics Board Exam Questions &
Answers 2026
JD is a 65-year-old male presenting to the emergency department (ED) via emergency medical
services (EMS) transport from home for shortness of breath and difficulty breathing. His wife
reports that JD's condition has progressively worsened over the past 12 hours, he has become
more altered, and he is difficult to arouse. The EMS staff report an initial oxygen saturation
(SpO2) of 74%. His vital signs on arrival at the ED are BP 178/109 mm Hg, HR 105 bpm, SpO2
97% on non-rebreather mask, and temp 37.1°C. JD is currently unarousable by voice and
noxious stimuli. The only available past medical history is chronic obstructive pulmonary disease
(COPD) secondary to cigarette smoking and end-stage renal disease (ESRD) from an unknown
cause. He is on dialysis but has missed his last two dialysis sessions. The medical team is
preparing for intubation and asks for rapid sequence induction (RSI) medications to be drawn up
for a - ANS ✔✔A) Etomidate 20 mg and rocuronium 80 mg
The pharmacy leadership at your institution is currently considering changes to the automated
dispensing cabinet (ADC) workflow. Currently, all medications stored in ADCs in the emergency
department (ED) are available "on override" (i.e., access may be gained by overriding system
prompts for authorization). Your input about whether to allow overrides for medications stored
in the ADCs used specifically to treat anaphylaxis in the ED has been solicited. Which of the
following is the most appropriate response?
A) Epinephrine should be kept available by override because of the need for rapid access to the
drug and potential for respiratory or cardiac arrest within minutes if prompt treatment is not
provided.
B) Epinephrine should be removed from override because of the multiple available
concentrations and routes of administration, which could contribute to medication errors.
C) Methylprednisolone should be kept availa - ANS ✔✔A) Epinephrine should be kept available
by override because of the need for rapid access to the drug and potential for respiratory or
cardiac arrest within minutes if prompt treatment is not provided.
MR is a 44-year-old female who presented to the emergency department in acute respiratory
distress with hypoxia. She was subsequently intubated using etomidate and rocuronium for
, impending respiratory failure and worsening mental status approximately 5 minutes ago. Based
on X-ray imaging results and the history of present illness, the treatment team believes this
patient's condition is most likely the result of a viral respiratory illness. Prior to intubation, MR's
blood pressure was 155/102 mm Hg and heart rate was 105 bpm. Her current blood pressure is
81/48 mm Hg and heart rate is 116 bpm. Which of the following strategies is most appropriate
to address this patient's acute blood pressure change and post-intubation management needs?
A) Initiate a norepinephrine IV infusion but do not initiate post-intubation analgesia and
sedation until the blood pressure normalizes.
B) Initiate a norepinephrine IV infusion immed - ANS ✔✔D) Administer a crystalloid IV fluid
bolus immediately followed by post-intubation analgesia and sedation.
HM is a 35-year-old female recently diagnosed with a urinary tract infection by her primary care
provider. Sulfamethoxazole/trimethoprim 800 mg/160 mg orally twice daily was prescribed by
her primary care provider. Approximately 15 minutes after taking her first dose, HM developed
a diffuse rash, urticaria, and wheezing. Her husband called 9-1-1 for help and while paramedics
were loading HM into the ambulance for transport, she had two episodes of vomiting. Based on
the Gell and Coombs classification, which of the following categories of immunologic drug
reactions is HM experiencing?
A) Type I
B) Type II
C) Type III
D) Type IV - ANS ✔✔A) Type I
HM, the 35-year-old female recently diagnosed with a urinary tract infection who experienced a
reaction to sulfamethoxazole/trimethoprim at home, presents to the emergency department
(ED) via ambulance approximately 10 minutes after paramedics arrived on the scene. She
received two 0.3-mg intramuscular (IM) doses of epinephrine in the anterolateral aspect of her
thigh during transport with the last dose given 3 minutes ago. The emergency medical services
staff were able to obtain peripheral intravenous (IV) access prior to arrival at the ED. On initial
evaluation in the ED, HM has a diffuse rash and urticaria that worsened during transport. She
Answers 2026
JD is a 65-year-old male presenting to the emergency department (ED) via emergency medical
services (EMS) transport from home for shortness of breath and difficulty breathing. His wife
reports that JD's condition has progressively worsened over the past 12 hours, he has become
more altered, and he is difficult to arouse. The EMS staff report an initial oxygen saturation
(SpO2) of 74%. His vital signs on arrival at the ED are BP 178/109 mm Hg, HR 105 bpm, SpO2
97% on non-rebreather mask, and temp 37.1°C. JD is currently unarousable by voice and
noxious stimuli. The only available past medical history is chronic obstructive pulmonary disease
(COPD) secondary to cigarette smoking and end-stage renal disease (ESRD) from an unknown
cause. He is on dialysis but has missed his last two dialysis sessions. The medical team is
preparing for intubation and asks for rapid sequence induction (RSI) medications to be drawn up
for a - ANS ✔✔A) Etomidate 20 mg and rocuronium 80 mg
The pharmacy leadership at your institution is currently considering changes to the automated
dispensing cabinet (ADC) workflow. Currently, all medications stored in ADCs in the emergency
department (ED) are available "on override" (i.e., access may be gained by overriding system
prompts for authorization). Your input about whether to allow overrides for medications stored
in the ADCs used specifically to treat anaphylaxis in the ED has been solicited. Which of the
following is the most appropriate response?
A) Epinephrine should be kept available by override because of the need for rapid access to the
drug and potential for respiratory or cardiac arrest within minutes if prompt treatment is not
provided.
B) Epinephrine should be removed from override because of the multiple available
concentrations and routes of administration, which could contribute to medication errors.
C) Methylprednisolone should be kept availa - ANS ✔✔A) Epinephrine should be kept available
by override because of the need for rapid access to the drug and potential for respiratory or
cardiac arrest within minutes if prompt treatment is not provided.
MR is a 44-year-old female who presented to the emergency department in acute respiratory
distress with hypoxia. She was subsequently intubated using etomidate and rocuronium for
, impending respiratory failure and worsening mental status approximately 5 minutes ago. Based
on X-ray imaging results and the history of present illness, the treatment team believes this
patient's condition is most likely the result of a viral respiratory illness. Prior to intubation, MR's
blood pressure was 155/102 mm Hg and heart rate was 105 bpm. Her current blood pressure is
81/48 mm Hg and heart rate is 116 bpm. Which of the following strategies is most appropriate
to address this patient's acute blood pressure change and post-intubation management needs?
A) Initiate a norepinephrine IV infusion but do not initiate post-intubation analgesia and
sedation until the blood pressure normalizes.
B) Initiate a norepinephrine IV infusion immed - ANS ✔✔D) Administer a crystalloid IV fluid
bolus immediately followed by post-intubation analgesia and sedation.
HM is a 35-year-old female recently diagnosed with a urinary tract infection by her primary care
provider. Sulfamethoxazole/trimethoprim 800 mg/160 mg orally twice daily was prescribed by
her primary care provider. Approximately 15 minutes after taking her first dose, HM developed
a diffuse rash, urticaria, and wheezing. Her husband called 9-1-1 for help and while paramedics
were loading HM into the ambulance for transport, she had two episodes of vomiting. Based on
the Gell and Coombs classification, which of the following categories of immunologic drug
reactions is HM experiencing?
A) Type I
B) Type II
C) Type III
D) Type IV - ANS ✔✔A) Type I
HM, the 35-year-old female recently diagnosed with a urinary tract infection who experienced a
reaction to sulfamethoxazole/trimethoprim at home, presents to the emergency department
(ED) via ambulance approximately 10 minutes after paramedics arrived on the scene. She
received two 0.3-mg intramuscular (IM) doses of epinephrine in the anterolateral aspect of her
thigh during transport with the last dose given 3 minutes ago. The emergency medical services
staff were able to obtain peripheral intravenous (IV) access prior to arrival at the ED. On initial
evaluation in the ED, HM has a diffuse rash and urticaria that worsened during transport. She
