PaEasy Emergency Medicine, Emergency Medicine EOR Practice, Emergency Medicine EOR Exam, ER Final, ER (All possible questions with complete answers; A+ GUARANTEED)

A 59-year-old woman presents to the accident and emergency department by ambulance with second- and third-degree burns to her head and neck, and the anterior surfaces of her upper extremities, right leg, and trunk including her genital area. Question Which of the following represents a reasonable estimation of the extent of her burns? Answer Choices 1 36% 2 37% 3 46% 4 45% 5 55% correct answers The correct answer is 55%. This estimation is based on the "rule of 9s". Body surface area is estimated at 9% for each arm, the head and neck, anterior surface of upper torso, anterior surface of lower torso, posterior surface of upper torso, posterior surface of lower torso, anterior surfaces of each leg, posterior surfaces of each leg and an additional 1% for the groin area for a total of 100%. In this case, 9% for her head and neck, 9% for the anterior surface of each arm, 9% for the anterior surface of her right leg, 9% for her anterior upper torso, 9% for her anterior lower torso, and 1% for the genital area for a total of 55%. The other answers are incorrect using the estimation by the "rule of 9s". A 45-year-old man presents with hematemesis. He has had 2 episodes of vomiting 'coffee-ground'-appearing material; the vomiting began 45 minutes prior to presentation. Additionally, he reports passing black, sticky stools for the past 3 or 4 days. Past medical history is positive for occasional headaches; they have been coming more frequenly lately. Social history reveals alcohol use (1 case of beer each weekend) and tobacco (1 pack per day). Medications include ibuprofen as needed for headaches; he has been taking 800 mg 3 times a day for the past week. You place a nasogastric tube and find bright red blood that fails to clear with saline irrigation. Hemoglobin is 8.9 g/dL. Evaluation of his blood pressure and pulse reveals orthostatic changes that resolve with an intravenous fluid bolus of 500 cc of Lactated Ringer's solution. What should you do next? Answer Choices 1 Transfuse 2 units of packed red blood cells and recheck CBC in 8 hours 2 Check serum for Helicobacter pylori antibody 3 Order a double contrast barium swallow to evaluate for a gastric ulcer 4 Refer for emergency upper endoscopy