1 | Page
SAEM M4 Exam Questions and Correct
Answers
True or False: gastric distension due to excessive volume or rate
of ventilation impairing ventilatory function is a reason to intubate
a neonate Ans: — False
management for nursemaid elbow injury Ans: — 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 emergency 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?
Ans: — compression fracture of the posteriolateral aspect of the
humeral head (Hill-Sachs deformity)
What are most common heart rhythms seen in pediatric arrest?
Ans: — bradycardia or asystole
risk factors for neonatal resuscitation Ans: — 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: Ans: — epi
Low body temperatures in newborns can lead to severe physiologic
consequences, which include all EXCEPT:
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, 2 | Page
Answers:
1. metabolic acidosis
2. increased oxygen consumption
3. hypoglycemia
4. apnea
5. hyperglycemia Ans: — 3. hypoglycemia
In a newborn, bradycardia is most commonly an indicator of: Ans:
— hypoxemia
All the following are signs of hypoxemia in a newborn, EXCEPT:
Answers:
1.cyanosis
2.lethargy
3.tachycardia
4.unresponsiveness
5.bradycardia Ans: — 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?
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, 3 | Page
Answers:
1.osteogenesis imperfecta
2.inborn error of metabolism
3.congenital diaphragmatic hernia
4.foreign body
5.tracheoesophageal fistula Ans: — 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 blind finger sweep
5.Heimlich maneuver then chest thrust Ans: — 2.back blow then
chest thrust
All of these steps are involved in pediatric rapid sequence
intubation (RSI) EXCEPT:
Answers:
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, 4 | Page
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 devices used in
children under 6-8 years of age. Ans: — 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.Cocaine
3.Heroin
4.Insulin Ans: — 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
© 2025 All rights reserved
SAEM M4 Exam Questions and Correct
Answers
True or False: gastric distension due to excessive volume or rate
of ventilation impairing ventilatory function is a reason to intubate
a neonate Ans: — False
management for nursemaid elbow injury Ans: — 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 emergency 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?
Ans: — compression fracture of the posteriolateral aspect of the
humeral head (Hill-Sachs deformity)
What are most common heart rhythms seen in pediatric arrest?
Ans: — bradycardia or asystole
risk factors for neonatal resuscitation Ans: — 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: Ans: — epi
Low body temperatures in newborns can lead to severe physiologic
consequences, which include all EXCEPT:
© 2025 All rights reserved
, 2 | Page
Answers:
1. metabolic acidosis
2. increased oxygen consumption
3. hypoglycemia
4. apnea
5. hyperglycemia Ans: — 3. hypoglycemia
In a newborn, bradycardia is most commonly an indicator of: Ans:
— hypoxemia
All the following are signs of hypoxemia in a newborn, EXCEPT:
Answers:
1.cyanosis
2.lethargy
3.tachycardia
4.unresponsiveness
5.bradycardia Ans: — 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?
© 2025 All rights reserved
, 3 | Page
Answers:
1.osteogenesis imperfecta
2.inborn error of metabolism
3.congenital diaphragmatic hernia
4.foreign body
5.tracheoesophageal fistula Ans: — 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 blind finger sweep
5.Heimlich maneuver then chest thrust Ans: — 2.back blow then
chest thrust
All of these steps are involved in pediatric rapid sequence
intubation (RSI) EXCEPT:
Answers:
© 2025 All rights reserved
, 4 | Page
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 devices used in
children under 6-8 years of age. Ans: — 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.Cocaine
3.Heroin
4.Insulin Ans: — 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
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