SAEM UPDATED EXAMS SCRIPT QUESTIONS AND
ANSWERS SURE A+
✔✔A 32 year old female is shot with a 38-caliber pistol at close range in the right
anterior chest. She presents to the emergency department intoxicated and yelling. Her
vitals include a pulse of 92, blood pressure of 134/84, and oxygen saturation of 97%.
She has clear breath sounds bilaterally. The entrance wound is just above the right
breast and an exit wound is noted in the right axilla. What is the most appropriate
management of this patient?
A. IV access, endotracheal intubation and simultaneous placement of a right chest
tube, bedside ultrasound, portable chest X-ray, and admission to the ICU if stable
B. IV access, portable chest X-ray, tube thoracostomy, and exploratory thoracotomy in
the OR to search for cardiac or pulmonary vascular injury
C. IV access, endotracheal intubation, emergency department thoracotomy to search
for cardiac or pulmonary vascular injury
D. IV access, portable chest X-ray, right ch - ✔✔A. IV access, endotracheal intubation
and simultaneous placement of a right chest tube, bedside ultrasound, portable chest X-
ray, and admission to the ICU if stable
✔✔During a bar fight, a 42 year old man is stabbed in the left side with an unknown
weapon. He presents to the emergency department with dyspnea, pulse of 108, blood
pressure of 138/92, and oxygen saturation of 94% on room air. He has absent breath
sounds on the left side; you note a small puncture wound in the midaxillary line at the
level of the 10th rib. His abdominal exam is normal. Two large-bore IVs are established.
What is the appropriate management of this patient?
A. Left-sided chest tube, portable chest x-ray, and admission
B. Left-sided chest tube, portable chest x-ray, diagnostic peritoneal lavage, and
admission
C. Endotracheal intubation, left-sided chest tube, portable chest x-ray, and admission
D. Endotracheal intubation, portable chest x-ray, exploratory laparotomy in the OR, and
admission
E. Left-sided chest tube, portable chest x-ray, and abdominal CT scan - ✔✔E. Left-
sided chest tube, portable chest x-ray, and abdominal CT scan
✔✔Which is the most common associated neurological finding with a distal radius
fracture?
A. Weakness with flexion at the finger MCP joints
B. Wrist drop
C. Decreased sensation over the hypothenar eminance
D. Weakness of finger adduction
E. Decreased sensation over the thenar eminance - ✔✔E. Decreased sensation over
the thenar eminance
The answer is E. This finding is due to median nerve injury.
ANSWERS SURE A+
✔✔A 32 year old female is shot with a 38-caliber pistol at close range in the right
anterior chest. She presents to the emergency department intoxicated and yelling. Her
vitals include a pulse of 92, blood pressure of 134/84, and oxygen saturation of 97%.
She has clear breath sounds bilaterally. The entrance wound is just above the right
breast and an exit wound is noted in the right axilla. What is the most appropriate
management of this patient?
A. IV access, endotracheal intubation and simultaneous placement of a right chest
tube, bedside ultrasound, portable chest X-ray, and admission to the ICU if stable
B. IV access, portable chest X-ray, tube thoracostomy, and exploratory thoracotomy in
the OR to search for cardiac or pulmonary vascular injury
C. IV access, endotracheal intubation, emergency department thoracotomy to search
for cardiac or pulmonary vascular injury
D. IV access, portable chest X-ray, right ch - ✔✔A. IV access, endotracheal intubation
and simultaneous placement of a right chest tube, bedside ultrasound, portable chest X-
ray, and admission to the ICU if stable
✔✔During a bar fight, a 42 year old man is stabbed in the left side with an unknown
weapon. He presents to the emergency department with dyspnea, pulse of 108, blood
pressure of 138/92, and oxygen saturation of 94% on room air. He has absent breath
sounds on the left side; you note a small puncture wound in the midaxillary line at the
level of the 10th rib. His abdominal exam is normal. Two large-bore IVs are established.
What is the appropriate management of this patient?
A. Left-sided chest tube, portable chest x-ray, and admission
B. Left-sided chest tube, portable chest x-ray, diagnostic peritoneal lavage, and
admission
C. Endotracheal intubation, left-sided chest tube, portable chest x-ray, and admission
D. Endotracheal intubation, portable chest x-ray, exploratory laparotomy in the OR, and
admission
E. Left-sided chest tube, portable chest x-ray, and abdominal CT scan - ✔✔E. Left-
sided chest tube, portable chest x-ray, and abdominal CT scan
✔✔Which is the most common associated neurological finding with a distal radius
fracture?
A. Weakness with flexion at the finger MCP joints
B. Wrist drop
C. Decreased sensation over the hypothenar eminance
D. Weakness of finger adduction
E. Decreased sensation over the thenar eminance - ✔✔E. Decreased sensation over
the thenar eminance
The answer is E. This finding is due to median nerve injury.
