Emerg Med Multiple Choice Questions
and answers rated A+ 2026
A - correct answer You are interviewing a new patient, a 69-year-old woman, in a geriatric clinic. She
has a history of osteoarthritis, hypertension, and complains of chronic cough. On further questioning,
she admits to smoking 1/2 to 3/4 of a pack of cigarettes per day for 38 years. She wants to quit, and has
made several attempts in the past, but wonders if quitting at my age will do any good anyway? Older
smokers like this patient
Answer Choices:
A Should be encouraged to set a quit date and learn strategies to cope with triggers to smoke
B Quit smoking at much lower rates than younger persons, even with support and appropriate tools
C Should not use nicotine replacement therapies due to increased cardiovascular risk in the elderly
D Do not have a decline in the risk of lung cancer after quitting smoking
E Are unlikely to experience any significant health benefits if they quit smoking because of advanced age
and multiple medical problems
C - correct answer You are on call when a 52-year-old man, well known to the emergency room staff, is
brought in by his wife. The patient has a long history of alcohol abuse and dependence and was
admitted several months ago for symptoms of withdrawal. The triage note today states that the patient
was found at home with increasing confusion and difficulty walking. You ask the patient's wife what
happened, and she simply states that he is drunk. After a few moments she adds that he has eaten very
little during this last binge and vomited once or twice several hours ago. Preliminary labs on the chart
show a blood glucose of 80 mg/dl, sodium of 132 mEq/L, potassium of 3.1 mEq/L, and a blood alcohol
level of 160 mg/dL. House staff have already started an IV line of D5 normal saline with 10 meq of
potassium chloride per liter at 75 cc/hour. You find the patient extremely lethargic, but you are able to
wake him. He is only able to mumble a few words and unable to cooperate with examination. You pull
open the patient's eyelids and note horizontal nystagmus and that the patient appears to be unable to
move his eyes past the midline.
Question:
,Which of the below should be the next step in management?
Answer Choices:
A Naltrexone, 50 mg now
B Increase IV fluid to 100 cc/hour
C Thiamine 100 mg IV now
D One ampule of dextrose 50 now
E Order an erythrocyte transketolase level
C - correct answer A 68-year-old white female presents to the emergency room with complaints of
dizziness and weakness. ***She has a background of congestive heart failure, hypertension, and atrial
fibrillation and had taken a handful of her heart medications 3 hours prior.*** The patient hands to the
physician a brown paper bag filled with medication bottles and loose unmarked pills. ***Her
medications include digoxin, furosemide, and potassium supplementation as well as other tablets the
names of which are difficult to read.***
Physical examination demonstrates a female at rest in bed without cyanosis. Her pulse is 48/minute,
blood pressure=90/60 mmHg, respirations of 24/minute, and temperature of 98.6 Fahrenheit. There is
no jugular venous distention, the lung exam has coarse crepitations at the bases bilaterally. The pulse is
irregular and there are no cardiac murmurs. Her electrocardiogram demonstrates a rate of 40/minute
with 3 in to 1 atrioventricular block. The chest x-ray shows cardiomegaly only.
The patient is given 2 milligrams of atropine with no clinical response. She also receives a dose of
activated charcoal premixed with sorbitol. ***The digoxin level is 6.3ng/mL which is normal.***
Question:
The next therapeutic step would be to:
,Answer Choices:
A Administer a fluid bolus of 500cc of Normal Saline
B Administer calcium gluconate
C Administer Digibind FAB fragments
D Administer glucagon
E Administer thrombolytic therapy
D - correct answer A 33-year-old white woman is brought into the emergency room by her parents. She
was found unresponsive in the bedroom of her home. She has a past medical history of depression and
her mother found an empty bottle of amitriptyline by her bedside. Otherwise, she has no other medical
or surgical history. The patient is a non-smoker and does not drink alcohol.
On physical exam her pulse is 138/minute, blood pressure is 80/60 mmHg, temperature is 101.2°F
(38.4°C), and respirations 6/minute. Her heart sounds are normal and she has thready pulses. Her
breath sounds are normal but with shallow effort. The abdomen is soft and nontender. Neurologically,
she moves her limbs from painful stimuli. Her skin is flushed with no needle marks.
Her chest X-ray is normal and the electrocardiogram demonstrates a wide complex tachycardia without
ectopy. The patient is intubated and hyperventilated.
Question:
The next appropriate step of the patient's management is
Answer Choices:
A Administer intravenous lactated Ringer's solution
B Administer phenytoin
C Administer physostigmine
, D Administer sodium bicarbonate
E Hemodialysis
B - correct answer A 26-year-old white male is brought to the emergency room having been found
unresponsive in the restroom of a nightclub one hour ago. When the emergency medical services
arrived at the club, an intravenous line was placed in his right antecubital fossa and the patient was
given an infusion of normal saline. The friends are unable to tell you whether the patient had taken any
illicit substances in the club, as they had not seen him for two hours before he was discovered.
On physical exam the patient appears disheveled. His blood pressure is 110/70 mmHg, pulse 56/minute,
respirations 6/minute and a temperature 98.5 Fahrenheit (36.9celsius). The patient has shallow
breathing. His breath and heart sounds are normal. There is no evidence of trauma and his head appears
normocephalic. His neck is supple. His abdomen is soft and nontender. His tympanic membranes appear
normal, there is no bleeding from the nose or mouth and the gag reflex was absent. The patient
responds to painful stimuli only and moves all four extremities. The patient's pupils are pinpoint
approximately 1 millimeter in diameter bilaterally. The skin is cool and there are needle tracks noted in
the left antecubital fossa.
Question:
The patient is given a mixture of therapeutic agents. Which of the following medications within the
mixture would be most beneficial to this patient?
Answer Choices:
A Dextrose 50%
B Naloxone
C Flumazenil
D Sodium bicarbonate
E Thiamine
and answers rated A+ 2026
A - correct answer You are interviewing a new patient, a 69-year-old woman, in a geriatric clinic. She
has a history of osteoarthritis, hypertension, and complains of chronic cough. On further questioning,
she admits to smoking 1/2 to 3/4 of a pack of cigarettes per day for 38 years. She wants to quit, and has
made several attempts in the past, but wonders if quitting at my age will do any good anyway? Older
smokers like this patient
Answer Choices:
A Should be encouraged to set a quit date and learn strategies to cope with triggers to smoke
B Quit smoking at much lower rates than younger persons, even with support and appropriate tools
C Should not use nicotine replacement therapies due to increased cardiovascular risk in the elderly
D Do not have a decline in the risk of lung cancer after quitting smoking
E Are unlikely to experience any significant health benefits if they quit smoking because of advanced age
and multiple medical problems
C - correct answer You are on call when a 52-year-old man, well known to the emergency room staff, is
brought in by his wife. The patient has a long history of alcohol abuse and dependence and was
admitted several months ago for symptoms of withdrawal. The triage note today states that the patient
was found at home with increasing confusion and difficulty walking. You ask the patient's wife what
happened, and she simply states that he is drunk. After a few moments she adds that he has eaten very
little during this last binge and vomited once or twice several hours ago. Preliminary labs on the chart
show a blood glucose of 80 mg/dl, sodium of 132 mEq/L, potassium of 3.1 mEq/L, and a blood alcohol
level of 160 mg/dL. House staff have already started an IV line of D5 normal saline with 10 meq of
potassium chloride per liter at 75 cc/hour. You find the patient extremely lethargic, but you are able to
wake him. He is only able to mumble a few words and unable to cooperate with examination. You pull
open the patient's eyelids and note horizontal nystagmus and that the patient appears to be unable to
move his eyes past the midline.
Question:
,Which of the below should be the next step in management?
Answer Choices:
A Naltrexone, 50 mg now
B Increase IV fluid to 100 cc/hour
C Thiamine 100 mg IV now
D One ampule of dextrose 50 now
E Order an erythrocyte transketolase level
C - correct answer A 68-year-old white female presents to the emergency room with complaints of
dizziness and weakness. ***She has a background of congestive heart failure, hypertension, and atrial
fibrillation and had taken a handful of her heart medications 3 hours prior.*** The patient hands to the
physician a brown paper bag filled with medication bottles and loose unmarked pills. ***Her
medications include digoxin, furosemide, and potassium supplementation as well as other tablets the
names of which are difficult to read.***
Physical examination demonstrates a female at rest in bed without cyanosis. Her pulse is 48/minute,
blood pressure=90/60 mmHg, respirations of 24/minute, and temperature of 98.6 Fahrenheit. There is
no jugular venous distention, the lung exam has coarse crepitations at the bases bilaterally. The pulse is
irregular and there are no cardiac murmurs. Her electrocardiogram demonstrates a rate of 40/minute
with 3 in to 1 atrioventricular block. The chest x-ray shows cardiomegaly only.
The patient is given 2 milligrams of atropine with no clinical response. She also receives a dose of
activated charcoal premixed with sorbitol. ***The digoxin level is 6.3ng/mL which is normal.***
Question:
The next therapeutic step would be to:
,Answer Choices:
A Administer a fluid bolus of 500cc of Normal Saline
B Administer calcium gluconate
C Administer Digibind FAB fragments
D Administer glucagon
E Administer thrombolytic therapy
D - correct answer A 33-year-old white woman is brought into the emergency room by her parents. She
was found unresponsive in the bedroom of her home. She has a past medical history of depression and
her mother found an empty bottle of amitriptyline by her bedside. Otherwise, she has no other medical
or surgical history. The patient is a non-smoker and does not drink alcohol.
On physical exam her pulse is 138/minute, blood pressure is 80/60 mmHg, temperature is 101.2°F
(38.4°C), and respirations 6/minute. Her heart sounds are normal and she has thready pulses. Her
breath sounds are normal but with shallow effort. The abdomen is soft and nontender. Neurologically,
she moves her limbs from painful stimuli. Her skin is flushed with no needle marks.
Her chest X-ray is normal and the electrocardiogram demonstrates a wide complex tachycardia without
ectopy. The patient is intubated and hyperventilated.
Question:
The next appropriate step of the patient's management is
Answer Choices:
A Administer intravenous lactated Ringer's solution
B Administer phenytoin
C Administer physostigmine
, D Administer sodium bicarbonate
E Hemodialysis
B - correct answer A 26-year-old white male is brought to the emergency room having been found
unresponsive in the restroom of a nightclub one hour ago. When the emergency medical services
arrived at the club, an intravenous line was placed in his right antecubital fossa and the patient was
given an infusion of normal saline. The friends are unable to tell you whether the patient had taken any
illicit substances in the club, as they had not seen him for two hours before he was discovered.
On physical exam the patient appears disheveled. His blood pressure is 110/70 mmHg, pulse 56/minute,
respirations 6/minute and a temperature 98.5 Fahrenheit (36.9celsius). The patient has shallow
breathing. His breath and heart sounds are normal. There is no evidence of trauma and his head appears
normocephalic. His neck is supple. His abdomen is soft and nontender. His tympanic membranes appear
normal, there is no bleeding from the nose or mouth and the gag reflex was absent. The patient
responds to painful stimuli only and moves all four extremities. The patient's pupils are pinpoint
approximately 1 millimeter in diameter bilaterally. The skin is cool and there are needle tracks noted in
the left antecubital fossa.
Question:
The patient is given a mixture of therapeutic agents. Which of the following medications within the
mixture would be most beneficial to this patient?
Answer Choices:
A Dextrose 50%
B Naloxone
C Flumazenil
D Sodium bicarbonate
E Thiamine
