SAEM CHAPTER ONE ASSESMENT TEST 2025/2026
GRADED A+ 125 QUESTIONS WITH 100% CORRECT
ANSWERS
Parents bring in their 13-year-old girl two hours after she ingested a large amount of Acetaminophen
in suicide attempt. She tearfully refuses to drink the activated charcoal. Which of the following is
TRUE regarding your ability to administer the charcoal?
1. A court injunction is needed to force her to drink the charcoal
2. A nasogastric tube may be placed to facilitate treatment
3. You cannot force her to take the charcoal
4. You must get parental permission prior to treating her - 2. A nasogastric tube mat be place to
facilitate treatment
For which of the following cases (all of which are characterized by an ingestion history known with
certainty) is gastric lavage most likely indicated?
1. Adult patient, ibuprofen ingestion (800 mg/tab x 5 tabs, 20 minutes prior to arrival (PTA) in the ED
2. Adult patient, kerosene ingestion (8 oz, 20 minutes PTA)
3.Adult patient, metoprolol ingestion (100 mg/tab x 100 tablets, 6 hours PTA)
4.Adult patient, nortriptyline ingestion (50 mg/tab x 100 tablets, 45 minutes PTA) - 4. Adult patient,
nortriptyline ingestion (50 mg/tab x 100 tablets, 45 minutes PTA)
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?
1. Jimson weed
2. Cocaine
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 examination finding might you also expect to find in this child?
1. Diaphoresis
, 2. Flushed skin
3. Miosis
4. Urinary incontinence - 2. Flushed Skin
With which of the following substances is acute withdrawal most likely life threatening?
Answers:
1. Cocaine
2. Ethanol
3. Heroin
4. Lithium - 2. Ethanol
For which of the following cases is activated charcoal therapy most appropriate?
Answers:
1. Acetaminophen overdose
2. Drain cleaner ingestion
3. Iron supplement overdose
4. Lithium overdose - 1. Acetaminophen Overdose
A young woman presents with an amitriptyline overdose. She is agitated and confused. In overdoses
of this class of medications, an indicator of severe toxicity would include:
Answers:
1. Elevated osmolar gap > 20
2. Metabolic acidosis with a pH < 7.25
3. Prolonged QRS interval
4. Serum amitriptyline level > 200 mcg/dl - 3. Prolonged QRS interval
A 17 year-old has presented after taking a large amount of nortriptyline prescribed for migraine
prophylaxis. Clinically, you take care of stabilizing her and initiate appropriate treatment. After
reviewing reference materials you calculate that she has taken a potentially lethal dose of this
tricyclic antidepressant. Which of the following would you expect to see on her electrocardiogram?
1.Compacted QT intervals
2.Prolonged QRS intervals
GRADED A+ 125 QUESTIONS WITH 100% CORRECT
ANSWERS
Parents bring in their 13-year-old girl two hours after she ingested a large amount of Acetaminophen
in suicide attempt. She tearfully refuses to drink the activated charcoal. Which of the following is
TRUE regarding your ability to administer the charcoal?
1. A court injunction is needed to force her to drink the charcoal
2. A nasogastric tube may be placed to facilitate treatment
3. You cannot force her to take the charcoal
4. You must get parental permission prior to treating her - 2. A nasogastric tube mat be place to
facilitate treatment
For which of the following cases (all of which are characterized by an ingestion history known with
certainty) is gastric lavage most likely indicated?
1. Adult patient, ibuprofen ingestion (800 mg/tab x 5 tabs, 20 minutes prior to arrival (PTA) in the ED
2. Adult patient, kerosene ingestion (8 oz, 20 minutes PTA)
3.Adult patient, metoprolol ingestion (100 mg/tab x 100 tablets, 6 hours PTA)
4.Adult patient, nortriptyline ingestion (50 mg/tab x 100 tablets, 45 minutes PTA) - 4. Adult patient,
nortriptyline ingestion (50 mg/tab x 100 tablets, 45 minutes PTA)
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?
1. Jimson weed
2. Cocaine
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 examination finding might you also expect to find in this child?
1. Diaphoresis
, 2. Flushed skin
3. Miosis
4. Urinary incontinence - 2. Flushed Skin
With which of the following substances is acute withdrawal most likely life threatening?
Answers:
1. Cocaine
2. Ethanol
3. Heroin
4. Lithium - 2. Ethanol
For which of the following cases is activated charcoal therapy most appropriate?
Answers:
1. Acetaminophen overdose
2. Drain cleaner ingestion
3. Iron supplement overdose
4. Lithium overdose - 1. Acetaminophen Overdose
A young woman presents with an amitriptyline overdose. She is agitated and confused. In overdoses
of this class of medications, an indicator of severe toxicity would include:
Answers:
1. Elevated osmolar gap > 20
2. Metabolic acidosis with a pH < 7.25
3. Prolonged QRS interval
4. Serum amitriptyline level > 200 mcg/dl - 3. Prolonged QRS interval
A 17 year-old has presented after taking a large amount of nortriptyline prescribed for migraine
prophylaxis. Clinically, you take care of stabilizing her and initiate appropriate treatment. After
reviewing reference materials you calculate that she has taken a potentially lethal dose of this
tricyclic antidepressant. Which of the following would you expect to see on her electrocardiogram?
1.Compacted QT intervals
2.Prolonged QRS intervals
