AMLS PRE TEST REAL EXAM|100+ ACTUAL
QUESTIONS & ANSWERS WITH RATIONALES
(2026\2027)100% GUARANTEE PASS
Question 1:
A 19-year-old female is flushed, itchy, and wheezing after eating crab legs. Her vital signs are BP
90/64 mm Hg, P 128 bpm, R 24 breaths/min. Which intervention is indicated first?
Answer Choices:
A) Diphenhydramine IV
B) Albuterol nebulizer
C) Epinephrine intramuscular
D) Normal saline bolus
Correct Answer: C) Epinephrine intramuscular
Rationale:
- Epinephrine IM (Correct): This patient is experiencing anaphylaxis with hypotension (BP 90/64),
tachycardia, and wheezing. Epinephrine is the first-line treatment for anaphylaxis as it causes
,vasoconstriction (reversing hypotension), bronchodilation (reversing wheezing), and decreases
further mediator release from mast cells. The IM route is preferred in prehospital settings for
rapid absorption.
- Diphenhydramine (Incorrect): While antihistamines are used in anaphylaxis, they work too
slowly and are not first-line. They address histamine-mediated symptoms but do not reverse
cardiovascular collapse or severe bronchospasm.
- Albuterol (Incorrect): This treats bronchospasm but does not address the life-threatening
hypotension and vasodilation. It may be used as an adjunct after epinephrine but is not the
primary intervention.
- Normal saline (Incorrect): Fluid resuscitation is important for hypotension but does not address
the underlying mast cell degranulation or bronchospasm. Epinephrine must be administered first.
Question 2:
A 2-year-old male is found chewing on berries from a lily of the valley plant. Predict his vital signs.
Answer Choices:
A) BP 100/70, P 140 bpm
B) BP 70/50, P 70 bpm
C) BP 110/80, P 100 bpm
D) BP 80/60, P 130 bpm
Correct Answer: B) BP 70/50, P 70 bpm
Rationale:
- BP 70/50, P 70 bpm (Correct): Lily of the valley contains cardiac glycosides (convallatoxin) which
have digitalis-like effects. Toxicity causes bradycardia and hypotension due to increased vagal
tone, decreased AV conduction, and negative chronotropic effects. The presentation of
hypotension with relative bradycardia is classic for cardiac glycoside toxicity.
,- BP 100/70, P 140 (Incorrect): This represents tachycardia with normal pressure, not consistent
with cardiac glycoside poisoning which causes bradycardia.
- BP 110/80, P 100 (Incorrect): Normal vital signs would not be expected in a toddler who
ingested a cardiotoxic plant.
- BP 80/60, P 130 (Incorrect): Hypotension with tachycardia suggests hypovolemia or distributive
shock, not the bradycardic effect of cardiac glycosides.
Question 3:
A 22-year-old female is found at a party unresponsive and breathing approximately 8 breaths/min.
Her skin is gray. Which of the following signs or symptoms will confirm your suspicion that the
opioid toxidrome is causing her emergency?
Answer Choices:
A) Mydriasis with nystagmus
B) Tachycardia and hypertension
C) Pupils 2 mm and equal
D) Hyperthermia and diaphoresis
Correct Answer: C) Pupils 2 mm and equal
Rationale:
- Pupils 2 mm and equal (Correct): Pinpoint (miotic) pupils are the hallmark of opioid toxicity. The
classic triad of opioid overdose includes: coma/respiratory depression, miosis (pinpoint pupils),
and respiratory depression. The equal and constricted pupils (1-2 mm) are highly specific for
opioid toxidrome.
- Mydriasis with nystagmus (Incorrect): This is characteristic of dissociative agents like PCP or
phencyclidine toxicity, not opioids.
, - Tachycardia and hypertension (Incorrect): Opioids typically cause bradycardia and hypotension
due to decreased sympathetic outflow, not tachycardia and hypertension. Sympathomimetic
toxidromes cause these findings.
- Hyperthermia and diaphoresis (Incorrect): These are associated with anticholinergic toxidrome,
serotonin syndrome, or sympathomimetic toxicity, not opioid overdose.
Question 4:
A 22-year-old male complains of a 2-day history of abdominal pain. His skin is flushed, and he has
a fruity odor on his breath. Assessment reveals BP 106/54 mm Hg, P 128, R 28, glucose 568
mg/dL. Your highest priority intervention would be to:
Answer Choices:
A) Administer insulin
B) Administer D50W
C) Infuse normal saline rapid IV
D) Administer sodium bicarbonate
Correct Answer: C) Infuse normal saline rapid IV
Rationale:
- Infuse normal saline rapid IV (Correct): This patient is in diabetic ketoacidosis (DKA) with severe
hyperglycemia, fruity breath (ketones), tachycardia, and hypotension. The most critical initial
intervention is fluid resuscitation. DKA causes profound dehydration from osmotic diuresis.
Normal saline restores intravascular volume, improves perfusion, and helps lower blood glucose
by improving renal perfusion and diluting glucose.
- Administer insulin (Incorrect): Insulin is essential for DKA but should not be given without
adequate fluid resuscitation first. In the prehospital setting, administering insulin without proper
monitoring can cause severe hypoglycemia and hypokalemia. Fluids are the priority.
QUESTIONS & ANSWERS WITH RATIONALES
(2026\2027)100% GUARANTEE PASS
Question 1:
A 19-year-old female is flushed, itchy, and wheezing after eating crab legs. Her vital signs are BP
90/64 mm Hg, P 128 bpm, R 24 breaths/min. Which intervention is indicated first?
Answer Choices:
A) Diphenhydramine IV
B) Albuterol nebulizer
C) Epinephrine intramuscular
D) Normal saline bolus
Correct Answer: C) Epinephrine intramuscular
Rationale:
- Epinephrine IM (Correct): This patient is experiencing anaphylaxis with hypotension (BP 90/64),
tachycardia, and wheezing. Epinephrine is the first-line treatment for anaphylaxis as it causes
,vasoconstriction (reversing hypotension), bronchodilation (reversing wheezing), and decreases
further mediator release from mast cells. The IM route is preferred in prehospital settings for
rapid absorption.
- Diphenhydramine (Incorrect): While antihistamines are used in anaphylaxis, they work too
slowly and are not first-line. They address histamine-mediated symptoms but do not reverse
cardiovascular collapse or severe bronchospasm.
- Albuterol (Incorrect): This treats bronchospasm but does not address the life-threatening
hypotension and vasodilation. It may be used as an adjunct after epinephrine but is not the
primary intervention.
- Normal saline (Incorrect): Fluid resuscitation is important for hypotension but does not address
the underlying mast cell degranulation or bronchospasm. Epinephrine must be administered first.
Question 2:
A 2-year-old male is found chewing on berries from a lily of the valley plant. Predict his vital signs.
Answer Choices:
A) BP 100/70, P 140 bpm
B) BP 70/50, P 70 bpm
C) BP 110/80, P 100 bpm
D) BP 80/60, P 130 bpm
Correct Answer: B) BP 70/50, P 70 bpm
Rationale:
- BP 70/50, P 70 bpm (Correct): Lily of the valley contains cardiac glycosides (convallatoxin) which
have digitalis-like effects. Toxicity causes bradycardia and hypotension due to increased vagal
tone, decreased AV conduction, and negative chronotropic effects. The presentation of
hypotension with relative bradycardia is classic for cardiac glycoside toxicity.
,- BP 100/70, P 140 (Incorrect): This represents tachycardia with normal pressure, not consistent
with cardiac glycoside poisoning which causes bradycardia.
- BP 110/80, P 100 (Incorrect): Normal vital signs would not be expected in a toddler who
ingested a cardiotoxic plant.
- BP 80/60, P 130 (Incorrect): Hypotension with tachycardia suggests hypovolemia or distributive
shock, not the bradycardic effect of cardiac glycosides.
Question 3:
A 22-year-old female is found at a party unresponsive and breathing approximately 8 breaths/min.
Her skin is gray. Which of the following signs or symptoms will confirm your suspicion that the
opioid toxidrome is causing her emergency?
Answer Choices:
A) Mydriasis with nystagmus
B) Tachycardia and hypertension
C) Pupils 2 mm and equal
D) Hyperthermia and diaphoresis
Correct Answer: C) Pupils 2 mm and equal
Rationale:
- Pupils 2 mm and equal (Correct): Pinpoint (miotic) pupils are the hallmark of opioid toxicity. The
classic triad of opioid overdose includes: coma/respiratory depression, miosis (pinpoint pupils),
and respiratory depression. The equal and constricted pupils (1-2 mm) are highly specific for
opioid toxidrome.
- Mydriasis with nystagmus (Incorrect): This is characteristic of dissociative agents like PCP or
phencyclidine toxicity, not opioids.
, - Tachycardia and hypertension (Incorrect): Opioids typically cause bradycardia and hypotension
due to decreased sympathetic outflow, not tachycardia and hypertension. Sympathomimetic
toxidromes cause these findings.
- Hyperthermia and diaphoresis (Incorrect): These are associated with anticholinergic toxidrome,
serotonin syndrome, or sympathomimetic toxicity, not opioid overdose.
Question 4:
A 22-year-old male complains of a 2-day history of abdominal pain. His skin is flushed, and he has
a fruity odor on his breath. Assessment reveals BP 106/54 mm Hg, P 128, R 28, glucose 568
mg/dL. Your highest priority intervention would be to:
Answer Choices:
A) Administer insulin
B) Administer D50W
C) Infuse normal saline rapid IV
D) Administer sodium bicarbonate
Correct Answer: C) Infuse normal saline rapid IV
Rationale:
- Infuse normal saline rapid IV (Correct): This patient is in diabetic ketoacidosis (DKA) with severe
hyperglycemia, fruity breath (ketones), tachycardia, and hypotension. The most critical initial
intervention is fluid resuscitation. DKA causes profound dehydration from osmotic diuresis.
Normal saline restores intravascular volume, improves perfusion, and helps lower blood glucose
by improving renal perfusion and diluting glucose.
- Administer insulin (Incorrect): Insulin is essential for DKA but should not be given without
adequate fluid resuscitation first. In the prehospital setting, administering insulin without proper
monitoring can cause severe hypoglycemia and hypokalemia. Fluids are the priority.
