Medical Emergencies Simulation Exam
150 questions, answers, and rationales
1. A patient suddenly develops severe shortness of breath and chest
pain while in the emergency department. What is the priority
intervention?
Administer oxygen and assess vital signs immediately
Rationale: Rapid assessment and oxygen administration are
critical to stabilize airway and oxygenation in acute
cardiopulmonary events.
2. A 65-year-old patient with a history of diabetes presents with
confusion, sweating, and a blood glucose of 38 mg/dL. What is the
first action?
Administer 15–20 g of fast-acting carbohydrate orally if the
patient is conscious
Rationale: Immediate correction of hypoglycemia is essential to
prevent seizures, loss of consciousness, or brain injury.
3. A patient is experiencing anaphylaxis after a bee sting. Which
medication should be given first?
Epinephrine intramuscularly into the mid-outer thigh
Rationale: Epinephrine is the first-line treatment for anaphylaxis
to reverse airway obstruction, hypotension, and shock.
4. During a code blue, the patient is in ventricular fibrillation. What
is the priority intervention?
Immediate defibrillation
Rationale: Ventricular fibrillation is a shockable rhythm, and
early defibrillation is critical for survival.
5. A patient presents with acute chest pain radiating to the left arm
and jaw. ECG shows ST-segment elevation. What is the immediate
, action?
Administer aspirin and prepare for reperfusion therapy
Rationale: Aspirin inhibits platelet aggregation and early
reperfusion therapy (PCI or thrombolysis) is key in STEMI
management.
6. A patient is choking and unable to speak. What is the correct
intervention?
Perform abdominal thrusts (Heimlich maneuver)
Rationale: Abdominal thrusts can dislodge the obstruction in the
airway and restore breathing.
7. A patient presents with sudden severe headache, nausea, and
neck stiffness. What is the initial diagnostic priority?
Perform a CT scan of the head
Rationale: Sudden severe headache and neck stiffness may
indicate subarachnoid hemorrhage; CT is rapid and noninvasive.
8. A patient with COPD presents with acute shortness of breath and
wheezing. Oxygen saturation is 88%. What is the first step?
Administer supplemental oxygen and nebulized bronchodilator
Rationale: Oxygen improves hypoxemia, while bronchodilators
relieve bronchospasm in acute exacerbation.
9. A patient develops sudden hypotension and tachycardia after
starting a new IV antibiotic. What is the priority action?
Stop the infusion and administer epinephrine if anaphylaxis
occurs
Rationale: Rapid discontinuation prevents further exposure;
epinephrine treats severe allergic reactions.
10. A patient is found unresponsive with no pulse and not
breathing. What is the first step?
, Start CPR immediately
Rationale: Early initiation of CPR maintains circulation and
oxygenation, improving survival outcomes in cardiac arrest.
11. During a seizure, the patient falls to the floor and begins
convulsing. What is the priority nursing action?
Protect the patient from injury and maintain airway
Rationale: Ensuring safety and airway patency reduces risk of
trauma and hypoxia during a seizure.
12. A patient presents with acute stroke symptoms (facial
droop, arm weakness, slurred speech) within 2 hours of onset.
What is the first intervention?
Call the stroke team and prepare for thrombolytic therapy
Rationale: Early identification and rapid initiation of
thrombolytic therapy improve outcomes in ischemic stroke.
13. A patient experiences sudden shortness of breath and
hemoptysis after recent surgery. What should be suspected?
Pulmonary embolism
Rationale: Postoperative patients are at high risk for venous
thromboembolism, and prompt recognition is essential for
treatment.
14. A patient presents with severe hypotension, cool clammy
skin, and tachycardia following a traumatic injury. What is the
priority management?
Rapid IV fluid resuscitation and control of bleeding
Rationale: Hypovolemic shock requires restoration of circulating
volume and stopping ongoing blood loss.
15. A patient with suspected meningitis is confused, febrile, and
has a purpuric rash. What is the priority intervention?
150 questions, answers, and rationales
1. A patient suddenly develops severe shortness of breath and chest
pain while in the emergency department. What is the priority
intervention?
Administer oxygen and assess vital signs immediately
Rationale: Rapid assessment and oxygen administration are
critical to stabilize airway and oxygenation in acute
cardiopulmonary events.
2. A 65-year-old patient with a history of diabetes presents with
confusion, sweating, and a blood glucose of 38 mg/dL. What is the
first action?
Administer 15–20 g of fast-acting carbohydrate orally if the
patient is conscious
Rationale: Immediate correction of hypoglycemia is essential to
prevent seizures, loss of consciousness, or brain injury.
3. A patient is experiencing anaphylaxis after a bee sting. Which
medication should be given first?
Epinephrine intramuscularly into the mid-outer thigh
Rationale: Epinephrine is the first-line treatment for anaphylaxis
to reverse airway obstruction, hypotension, and shock.
4. During a code blue, the patient is in ventricular fibrillation. What
is the priority intervention?
Immediate defibrillation
Rationale: Ventricular fibrillation is a shockable rhythm, and
early defibrillation is critical for survival.
5. A patient presents with acute chest pain radiating to the left arm
and jaw. ECG shows ST-segment elevation. What is the immediate
, action?
Administer aspirin and prepare for reperfusion therapy
Rationale: Aspirin inhibits platelet aggregation and early
reperfusion therapy (PCI or thrombolysis) is key in STEMI
management.
6. A patient is choking and unable to speak. What is the correct
intervention?
Perform abdominal thrusts (Heimlich maneuver)
Rationale: Abdominal thrusts can dislodge the obstruction in the
airway and restore breathing.
7. A patient presents with sudden severe headache, nausea, and
neck stiffness. What is the initial diagnostic priority?
Perform a CT scan of the head
Rationale: Sudden severe headache and neck stiffness may
indicate subarachnoid hemorrhage; CT is rapid and noninvasive.
8. A patient with COPD presents with acute shortness of breath and
wheezing. Oxygen saturation is 88%. What is the first step?
Administer supplemental oxygen and nebulized bronchodilator
Rationale: Oxygen improves hypoxemia, while bronchodilators
relieve bronchospasm in acute exacerbation.
9. A patient develops sudden hypotension and tachycardia after
starting a new IV antibiotic. What is the priority action?
Stop the infusion and administer epinephrine if anaphylaxis
occurs
Rationale: Rapid discontinuation prevents further exposure;
epinephrine treats severe allergic reactions.
10. A patient is found unresponsive with no pulse and not
breathing. What is the first step?
, Start CPR immediately
Rationale: Early initiation of CPR maintains circulation and
oxygenation, improving survival outcomes in cardiac arrest.
11. During a seizure, the patient falls to the floor and begins
convulsing. What is the priority nursing action?
Protect the patient from injury and maintain airway
Rationale: Ensuring safety and airway patency reduces risk of
trauma and hypoxia during a seizure.
12. A patient presents with acute stroke symptoms (facial
droop, arm weakness, slurred speech) within 2 hours of onset.
What is the first intervention?
Call the stroke team and prepare for thrombolytic therapy
Rationale: Early identification and rapid initiation of
thrombolytic therapy improve outcomes in ischemic stroke.
13. A patient experiences sudden shortness of breath and
hemoptysis after recent surgery. What should be suspected?
Pulmonary embolism
Rationale: Postoperative patients are at high risk for venous
thromboembolism, and prompt recognition is essential for
treatment.
14. A patient presents with severe hypotension, cool clammy
skin, and tachycardia following a traumatic injury. What is the
priority management?
Rapid IV fluid resuscitation and control of bleeding
Rationale: Hypovolemic shock requires restoration of circulating
volume and stopping ongoing blood loss.
15. A patient with suspected meningitis is confused, febrile, and
has a purpuric rash. What is the priority intervention?
