[COMSAE 107 EXAM] – QUESTIONS AND ANSWERS | VERIFIED
AND WELL DETAILED ANSWERS | PLUS RATIONALES |
GUARANTEED PASS | LATEST EXAM UPDATE | EXAM PREP |
STUDY GUIDE | PRACTICE TEST
1. A 67-year-old patient with a history of chronic hypertension presents with sudden
onset chest pain radiating to the back. Blood pressure is significantly higher in the right
arm than the left. Which diagnosis should be suspected first?
A. Pulmonary embolism
B. Acute pericarditis
C. Aortic dissection
D. Stable angina
════════════════════
Correct Answer: C. Aortic dissection
Rationale:
Aortic dissection commonly presents with tearing chest pain radiating to the back and
asymmetric blood pressures between extremities. Hypertension is a major risk factor.
Pulmonary embolism and pericarditis may cause chest pain but typically do not present with
differing arm blood pressures. Stable angina usually causes exertional chest discomfort rather
than sudden severe pain.
════════════════════
2. A physician is evaluating a patient with fatigue, glossitis, and paresthesias. Laboratory
testing reveals macrocytic anemia. Which deficiency is most likely responsible?
A. Iron deficiency
B. Vitamin B12 deficiency
C. Copper deficiency
D. Vitamin C deficiency
════════════════════
Correct Answer: B. Vitamin B12 deficiency
Rationale:
Vitamin B12 deficiency causes macrocytic anemia and neurologic manifestations such as
paresthesias due to demyelination. Iron deficiency causes microcytic anemia. Vitamin C
,deficiency causes scurvy, while copper deficiency is less commonly associated with neurologic
symptoms and macrocytosis.
════════════════════
3. A hospital implements a new protocol requiring verbal read-back of all critical
laboratory values. What is the primary purpose of this protocol?
A. Reduce staffing requirements
B. Improve patient satisfaction scores
C. Minimize communication-related medical errors
D. Increase laboratory turnaround times
════════════════════
Correct Answer: C. Minimize communication-related medical errors
Rationale:
Read-back protocols are patient safety measures intended to reduce miscommunication and
prevent treatment errors associated with incorrect laboratory reporting. They are not
designed to reduce staffing or increase turnaround time. Although patient satisfaction may
improve indirectly, safety is the primary goal.
════════════════════
4. A patient with diabetes presents with confusion, diaphoresis, and tachycardia after
taking insulin without eating breakfast. What is the best immediate intervention?
A. Administer rapid-acting insulin
B. Provide oral glucose if the patient can swallow safely
C. Restrict oral intake
D. Initiate sodium bicarbonate infusion
════════════════════
Correct Answer: B. Provide oral glucose if the patient can swallow safely
Rationale:
The patient is exhibiting symptoms of hypoglycemia. Immediate treatment includes
administration of glucose if the patient is conscious and able to swallow. Additional insulin
would worsen the condition. Sodium bicarbonate is not indicated for uncomplicated
hypoglycemia.
════════════════════
, 5. A clinician suspects bacterial meningitis in a febrile patient with neck stiffness and
altered mental status. Which action should occur first if increased intracranial pressure
is suspected?
A. Immediate lumbar puncture
B. Start oral antibiotics only
C. Obtain head imaging before lumbar puncture
D. Delay all treatment until cultures return
════════════════════
Correct Answer: C. Obtain head imaging before lumbar puncture
Rationale:
Head imaging is recommended before lumbar puncture when increased intracranial pressure
is suspected to avoid potential brain herniation. Antibiotics should still be initiated promptly.
Immediate lumbar puncture without imaging may be dangerous in this scenario.
════════════════════
6. A patient develops urticaria, wheezing, and hypotension minutes after receiving
intravenous penicillin. What is the most appropriate first-line treatment?
A. Diphenhydramine alone
B. Intravenous corticosteroids only
C. Epinephrine administration
D. Observation without intervention
════════════════════
Correct Answer: C. Epinephrine administration
Rationale:
The patient is experiencing anaphylaxis. Intramuscular epinephrine is the first-line treatment
because it rapidly reverses airway edema, bronchospasm, and hypotension. Antihistamines
and corticosteroids are supportive but not substitutes for epinephrine.
════════════════════
7. A healthcare administrator notices an increase in catheter-associated urinary tract
infections (CAUTIs). Which intervention is most effective in reducing CAUTI rates?
A. Routine prophylactic antibiotics
B. Daily assessment for catheter necessity
, C. Increasing catheter size
D. Irrigating catheters every shift
════════════════════
Correct Answer: B. Daily assessment for catheter necessity
Rationale:
Reducing unnecessary catheter use is one of the most effective methods for preventing
CAUTIs. Routine antibiotics increase resistance risk. Larger catheters may increase trauma,
and routine irrigation has not shown benefit in reducing infection rates.
════════════════════
8. A patient with atrial fibrillation is at increased risk for which complication?
A. Deep vein thrombosis only
B. Pulmonary fibrosis
C. Ischemic stroke
D. Pneumothorax
════════════════════
Correct Answer: C. Ischemic stroke
Rationale:
Atrial fibrillation promotes blood stasis within the atria, increasing thrombus formation risk
and embolic stroke. Pulmonary fibrosis and pneumothorax are unrelated. Deep vein
thrombosis may occur independently but is not the primary complication associated with
atrial fibrillation.
════════════════════
9. A nurse accidentally administers the wrong medication dose but reports the error
immediately. Which ethical principle is best demonstrated by the nurse’s action?
A. Nonmaleficence
B. Fidelity
C. Justice
D. Veracity
════════════════════
Correct Answer: D. Veracity
Rationale:
AND WELL DETAILED ANSWERS | PLUS RATIONALES |
GUARANTEED PASS | LATEST EXAM UPDATE | EXAM PREP |
STUDY GUIDE | PRACTICE TEST
1. A 67-year-old patient with a history of chronic hypertension presents with sudden
onset chest pain radiating to the back. Blood pressure is significantly higher in the right
arm than the left. Which diagnosis should be suspected first?
A. Pulmonary embolism
B. Acute pericarditis
C. Aortic dissection
D. Stable angina
════════════════════
Correct Answer: C. Aortic dissection
Rationale:
Aortic dissection commonly presents with tearing chest pain radiating to the back and
asymmetric blood pressures between extremities. Hypertension is a major risk factor.
Pulmonary embolism and pericarditis may cause chest pain but typically do not present with
differing arm blood pressures. Stable angina usually causes exertional chest discomfort rather
than sudden severe pain.
════════════════════
2. A physician is evaluating a patient with fatigue, glossitis, and paresthesias. Laboratory
testing reveals macrocytic anemia. Which deficiency is most likely responsible?
A. Iron deficiency
B. Vitamin B12 deficiency
C. Copper deficiency
D. Vitamin C deficiency
════════════════════
Correct Answer: B. Vitamin B12 deficiency
Rationale:
Vitamin B12 deficiency causes macrocytic anemia and neurologic manifestations such as
paresthesias due to demyelination. Iron deficiency causes microcytic anemia. Vitamin C
,deficiency causes scurvy, while copper deficiency is less commonly associated with neurologic
symptoms and macrocytosis.
════════════════════
3. A hospital implements a new protocol requiring verbal read-back of all critical
laboratory values. What is the primary purpose of this protocol?
A. Reduce staffing requirements
B. Improve patient satisfaction scores
C. Minimize communication-related medical errors
D. Increase laboratory turnaround times
════════════════════
Correct Answer: C. Minimize communication-related medical errors
Rationale:
Read-back protocols are patient safety measures intended to reduce miscommunication and
prevent treatment errors associated with incorrect laboratory reporting. They are not
designed to reduce staffing or increase turnaround time. Although patient satisfaction may
improve indirectly, safety is the primary goal.
════════════════════
4. A patient with diabetes presents with confusion, diaphoresis, and tachycardia after
taking insulin without eating breakfast. What is the best immediate intervention?
A. Administer rapid-acting insulin
B. Provide oral glucose if the patient can swallow safely
C. Restrict oral intake
D. Initiate sodium bicarbonate infusion
════════════════════
Correct Answer: B. Provide oral glucose if the patient can swallow safely
Rationale:
The patient is exhibiting symptoms of hypoglycemia. Immediate treatment includes
administration of glucose if the patient is conscious and able to swallow. Additional insulin
would worsen the condition. Sodium bicarbonate is not indicated for uncomplicated
hypoglycemia.
════════════════════
, 5. A clinician suspects bacterial meningitis in a febrile patient with neck stiffness and
altered mental status. Which action should occur first if increased intracranial pressure
is suspected?
A. Immediate lumbar puncture
B. Start oral antibiotics only
C. Obtain head imaging before lumbar puncture
D. Delay all treatment until cultures return
════════════════════
Correct Answer: C. Obtain head imaging before lumbar puncture
Rationale:
Head imaging is recommended before lumbar puncture when increased intracranial pressure
is suspected to avoid potential brain herniation. Antibiotics should still be initiated promptly.
Immediate lumbar puncture without imaging may be dangerous in this scenario.
════════════════════
6. A patient develops urticaria, wheezing, and hypotension minutes after receiving
intravenous penicillin. What is the most appropriate first-line treatment?
A. Diphenhydramine alone
B. Intravenous corticosteroids only
C. Epinephrine administration
D. Observation without intervention
════════════════════
Correct Answer: C. Epinephrine administration
Rationale:
The patient is experiencing anaphylaxis. Intramuscular epinephrine is the first-line treatment
because it rapidly reverses airway edema, bronchospasm, and hypotension. Antihistamines
and corticosteroids are supportive but not substitutes for epinephrine.
════════════════════
7. A healthcare administrator notices an increase in catheter-associated urinary tract
infections (CAUTIs). Which intervention is most effective in reducing CAUTI rates?
A. Routine prophylactic antibiotics
B. Daily assessment for catheter necessity
, C. Increasing catheter size
D. Irrigating catheters every shift
════════════════════
Correct Answer: B. Daily assessment for catheter necessity
Rationale:
Reducing unnecessary catheter use is one of the most effective methods for preventing
CAUTIs. Routine antibiotics increase resistance risk. Larger catheters may increase trauma,
and routine irrigation has not shown benefit in reducing infection rates.
════════════════════
8. A patient with atrial fibrillation is at increased risk for which complication?
A. Deep vein thrombosis only
B. Pulmonary fibrosis
C. Ischemic stroke
D. Pneumothorax
════════════════════
Correct Answer: C. Ischemic stroke
Rationale:
Atrial fibrillation promotes blood stasis within the atria, increasing thrombus formation risk
and embolic stroke. Pulmonary fibrosis and pneumothorax are unrelated. Deep vein
thrombosis may occur independently but is not the primary complication associated with
atrial fibrillation.
════════════════════
9. A nurse accidentally administers the wrong medication dose but reports the error
immediately. Which ethical principle is best demonstrated by the nurse’s action?
A. Nonmaleficence
B. Fidelity
C. Justice
D. Veracity
════════════════════
Correct Answer: D. Veracity
Rationale:
