SAEM M4 Exam 2024/ 2025 | Actual Questions and Answers Latest Updated 2024/2025 (Graded A+) True or False: gastric distension due to excessive volume or rate of ventilation impairing ventilatory function is a reason to intubate a neonate - ✔✔False management for nursemaid elbow injury - ✔✔apply pressure to the radial head while flexing and supinating elbow A 17 year old boy injured his right shoulder playing football. He tried to arm -tackle a player when his right arm was pulled away from his body and back (abducted and extended). He felt a sudden pain in his shoulder. He presents to the em ergency department holding his arm in slight abduction and external rotation by his good arm. He has severe pain with adduction or internal rotation. What is the most common fracture associated with this injury? - ✔✔compression fracture of the posteriolate ral aspect of the humeral head (Hill -Sachs deformity) What are most common heart rhythms seen in pediatric arrest? - ✔✔bradycardia or asystole risk factors for neonatal resuscitation - ✔✔prematurity IUGR multiple gestation thick meconium In the post -arrest setting, which of the following is the drug of choice in treating hypotension in a child: - ✔✔epi Low body temperatures in newborns can lead to severe physiologic consequences, which include all EXCEPT: Answers: 1. metabolic acidosis 2. increased oxy gen consumption 3. hypoglycemia 4. apnea 5. hyperglycemia - ✔✔3. hypoglycemia In a newborn, bradycardia is most commonly an indicator of: - ✔✔hypoxemia All the following are signs of hypoxemia in a newborn, EXCEPT: Answers: 1.cyanosis 2.lethargy 3.tachycardia 4.unresponsiveness 5.bradycardia - ✔✔3. tachycardia A newborn presents to the emergency department a few days after hospital discharge. The infant has been noted to be drooling, choking, and coughing, and the mother reports seeing bubbles at the baby's mouth. Which is the most likely explanation? Answers: 1.osteogenesis imperfecta 2.inborn error of metabolism 3.congenital diaphragmatic hernia 4.foreign body 5.tracheoesophageal fistula - ✔✔5. tracheoesophageal fistula Which of the following pairs of maneuvers are consistent with current recommendations for emergency care for a choking 5 -month -old infant? Answers: 1.back blow then blind finger sweep 2.back blow then chest thrust 3.chest thrust then Heimlich maneuver 4.Heimlich maneuver then b lind finger sweep 5.Heimlich maneuver then chest thrust - ✔✔2.back blow then chest thrust All of these steps are involved in pediatric rapid sequence intubation (RSI) EXCEPT: Answers: 1.If administering succinylcholine, pretreatment with atropine is always indicated in children under age 10. 2.Lidocaine pretreatment is usually provided to children with head trauma. 3.When deciding which size endotracheal tube to use, one may approximate by using the size of the small finger or nares as a reference. 4.Due to the fragility of the pediatric C -spine, a cervical collar should always be placed prior to intubation for children under age ten. 5.Uncuffed endotracheal tubes are the preferred devic es used in children under 6 -8 years of age. - ✔✔4.Due to the fragility of the pediatric C -spine, a cervical collar should always be placed prior to intubation for children under age ten. A 23 year old woman is dropped off by her boyfriend after an unknown overdose. You notice that she is has very large pupils and is sweating profusely. Her respiratory rate, blood pressure and heart rate are elevated. Which of the following is the most likely agent to have caused her symptoms? Answers: 1.Jimson weed 2.Coca ine 3.Heroin 4.Insulin - ✔✔2. cocaine A mother brings in her 4 year old child who was happily eating "blackberries" from weeds in the garden and is now acting strangely. She has identified them as Belladonna from a quick internet search. Which physical ex amination finding might you also expect to find in this child? Answers: 1.Diaphoresis 2.Flushed skin 3.Miosis 4.Urinary incontinence - ✔✔2. flushed skin For which of the following cases is activated charcoal therapy most appropriate? Answers: 1.Acetamin ophen overdose 2.Drain cleaner ingestion 3.Iron supplement overdose 4.Lithium overdose - ✔✔1. Acetaminophen overdose A 45 year -old is brought in 8 hours after a large overdose of his lithium. What is the best treatment method for this overdose? Answers: 1.Activated charcoal 2.Gastric lavage 3.Hemodialysis 4.Whole bowel irrigation - ✔✔3.Hemodialysis A 42 year -old woman presents with an overdose of her Xanax (alprazolam) that her family indicates she has been taking for years to help with her anxiety. The bottle indicates that the prescription was filled yesterday with 90 pills and is now empty. The patient is minimally responsive to painful stimuli and does
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