SAEM EXAM QUESTIONS 2025-2026 ACTUAL EXAM 1000 REAL
EXAM QUESTIONS AND CORRECT DETAILED (VERIFIED
ANSWERS) |ALREADY GRADED A+
Overview
Designed to mirror the complexity, depth, and clinical reasoning focus of SAEM-style
emergency medicine assessments, this comprehensive study guide includes 1,000 high-quality,
exam-style practice questions with verified, detailed explanations. Updated for the 2025–2026
cycle, it helps learners strengthen diagnostic accuracy, master rapid clinical decision-making, and
develop exam-ready confidence in emergency care principles.
─────────────────────────────
Key Features
✅ 1,000 Exam-Style Emergency Medicine Questions with Correct, Detailed Explanations
✅ Updated for SAEM-Aligned Standards 2025–2026
✅ Realistic Exam Format Built to Improve Clinical Judgment and Test Performance
✅ Covers Core EM Domains: Resuscitation, Trauma, Toxicology, Cardiology, Neurology,
Pediatrics, Procedures, and Evidence-Based Emergency Care
✅ A+ Graded, Expert-Verified Content for Accuracy and Reliability
─────────────────────────────
Purpose
• Provide an extensive emergency-medicine practice resource aligned with SAEM question styles
• Reinforce rapid clinical reasoning, differential diagnosis skills, and high-stakes decision-
making
• Support learners aiming for strong performance in emergency medicine exams and clinical
rotations
─────────────────────────────
Recommended For
• Learners preparing for SAEM-style emergency medicine exams
• Medical students, PA students, NP students, and EM residents seeking rigorous practice
• Educators and tutors building comprehensive EM study and review materials
─────────────────────────────
Your Complete SAEM Study Resource
With 1,000 expertly crafted, exam-style questions and detailed explanations, the SAEM
Emergency Medicine Study Guide 2025–2026 is your most reliable, up-to-date, and effective tool
for mastering emergency medicine concepts and preparing with confidence.
,With respect to laboratory findings in diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar
nonketotic coma (HHNC), all of the following guidelines are generally true EXCEPT:
A. Serum bicarbonate is typically severely low (<10mEq) in patients with either DKA or HHNC.
B. Serum osmolality in patients with HHNC is typically > 350 mOsm/L.
C. BUN is elevated more in patients with HHNC (>50 mg/dL) than in patients with DKA (25-50 mg/dL).
D. Patients with HHNC typically have blood glucose > 700 mg/dL, whereas patients with DKA have blood
glucose > 350 mg/dL.
E. Serum ketones are present in patients with DKA but not usually in patients with HHNC." - "A. Serum
bicarbonate is typically severely low (<10mEq) in patients with either DKA or HHNC.
The ANSWER is A. Although patients with DKA typically have profound metabolic acidosis with serum
bicarbonate < 10mEq, acidosis is typically absent in patients with HHNC and serum bicarbonate is usually
> 15 mEq."
"In a 70kg male DKA patient with serum glucose of 573 mg/dL, all of the following statements with
regard to fluid and electrolyte imbalances are true EXCEPT:
A. A normal magnesium level is reassuring and obviates the need for magnesium replacement.
B. The patient is likely to be total body phosphorus depleted.
C. Total body water deficit is approximately 5L.
D. Serum sodium of 129 mEq represents dilutional hyponatremia and the corrected value is
approximately 137 mEq.
E. Despite a serum potassium level of 4.8 mEq, the patient is probably total body potassium depleted." -
"A. A normal magnesium level is reassuring and obviates the need for magnesium replacement.
The ANSWER is A. Patients with DKA are typically severely dehydrated with a total body water deficit
of approximately 70-80 mL/kg, in addition to being total body depleted of potassium, magnesium, and
phosphorous despite initially normal serum levels of these electrolytes."
,"Regarding the treatment of hyperosmolar hypertonic nonketotic coma (HHNC) and its associated
symptoms, which of the following is correct:
A. Hyperosmolarity should be corrected within the first few hours in the emergency department.
B. Since patients are not acidotic, close monitoring of glucose is not necessary.
C. In HHNC patients with severe dehydration, bleeding diathesis is a major clinical concern.
D. Half of the fluid deficit should be corrected over the first hour and the remainder over the following 8
hours.
E. Phenytoin (Dilantin) is often ineffective for seizures associated with HHNC." - "E. Phenytoin (Dilantin)
is often ineffective for seizures associated with HHNC.
The ANSWER is E. Phenytoin (Dilantin) is contraindicated in patients with HHNC as it may impair
endogenous insulin release and is often ineffective in the management of seizures associated with
HHNC. Half of the fluid deficit should be replaced over the first 8 hours, and the remainder over the
ensuing 24 hours. Glucose must be tightly monitored as fluid resuscitation alone may normalize serum
glucose or precipitate hypoglycemia in aggressive fluid resuscitation. Too-rapid correction of
hyperosmolarity may result in development of cerebral edema, especially in children. Subcutaneous
heparin should be considered in patients with severe dehydration due to increased risk of thrombosis
from hypovolemia and hyperviscosity."
"Regarding the development of cerebral edema in patients being treated for DKA, all of the following are
true EXCEPT:
A. Mannitol and steroids should be administered immediately to any patient suspected of developing
cerebral edema.
B. Patients with serum glucose below 250 mg/dL still being treated with insulin are most likely to
develop clinically evident cerebral edema.
C. Cerebral edema typically occurs six to ten hours following onset of treatment.
D. Children have a higher incidence of cerebral edema.
E. Mortality of patients developing cerebral edema is 90%." - "A. Mannitol and steroids should be
administered immediately to any patient suspected of developing cerebral edema.
, The ANSWER is A. Steroids are not indicated for treatment of cerebral edema and may actually
worsen DKA. Mannitol 0.25-2.0 mg/kg should be administered upon any change in mental status of
children being treated for DKA as they are at high risk for developing cerebral edema especially when
being treated with insulin and serum glucose is below 250 mg/dL."
"Of the choices below, the best treatment of the patient with hyperkalemia and EKG changes is:
A. defibrillation
B. vasopressin
C. lidocaine
D. amiodarone
E. calcium" - "E. calcium
The ANSWER is E. Hyperkalemia with EKG changes is treated with calcium to stabilize cardiac
membranes. Calcium works quickly and is relatively safe unless patients are digitalized. Other
treatments for acute hyperkalemia include sodium bicarbonate and insulin/glucose."
"Which pharmacologic treatment for hyperkalemia works through stabilization of cardiac membranes?
A. Magnesium
B. Calcium
C. Bicarbonate
D. Insulin and glucose" - "B. Calcium
The ANSWER is B. "Immediate antagonism of K+ at the cardiac membrane is achieved with IV
administration of calcium chloride or gluconate. This is indicated in patients with unstable dysrhythmia
or hypotension.""
"A 55 year old female with a history of end-stage renal disease presents to the emergency
department with weakness. Her EKG is shown in the Figure, and reveals:
[image: peaked T waves]
A. hypocalcemia
EXAM QUESTIONS AND CORRECT DETAILED (VERIFIED
ANSWERS) |ALREADY GRADED A+
Overview
Designed to mirror the complexity, depth, and clinical reasoning focus of SAEM-style
emergency medicine assessments, this comprehensive study guide includes 1,000 high-quality,
exam-style practice questions with verified, detailed explanations. Updated for the 2025–2026
cycle, it helps learners strengthen diagnostic accuracy, master rapid clinical decision-making, and
develop exam-ready confidence in emergency care principles.
─────────────────────────────
Key Features
✅ 1,000 Exam-Style Emergency Medicine Questions with Correct, Detailed Explanations
✅ Updated for SAEM-Aligned Standards 2025–2026
✅ Realistic Exam Format Built to Improve Clinical Judgment and Test Performance
✅ Covers Core EM Domains: Resuscitation, Trauma, Toxicology, Cardiology, Neurology,
Pediatrics, Procedures, and Evidence-Based Emergency Care
✅ A+ Graded, Expert-Verified Content for Accuracy and Reliability
─────────────────────────────
Purpose
• Provide an extensive emergency-medicine practice resource aligned with SAEM question styles
• Reinforce rapid clinical reasoning, differential diagnosis skills, and high-stakes decision-
making
• Support learners aiming for strong performance in emergency medicine exams and clinical
rotations
─────────────────────────────
Recommended For
• Learners preparing for SAEM-style emergency medicine exams
• Medical students, PA students, NP students, and EM residents seeking rigorous practice
• Educators and tutors building comprehensive EM study and review materials
─────────────────────────────
Your Complete SAEM Study Resource
With 1,000 expertly crafted, exam-style questions and detailed explanations, the SAEM
Emergency Medicine Study Guide 2025–2026 is your most reliable, up-to-date, and effective tool
for mastering emergency medicine concepts and preparing with confidence.
,With respect to laboratory findings in diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar
nonketotic coma (HHNC), all of the following guidelines are generally true EXCEPT:
A. Serum bicarbonate is typically severely low (<10mEq) in patients with either DKA or HHNC.
B. Serum osmolality in patients with HHNC is typically > 350 mOsm/L.
C. BUN is elevated more in patients with HHNC (>50 mg/dL) than in patients with DKA (25-50 mg/dL).
D. Patients with HHNC typically have blood glucose > 700 mg/dL, whereas patients with DKA have blood
glucose > 350 mg/dL.
E. Serum ketones are present in patients with DKA but not usually in patients with HHNC." - "A. Serum
bicarbonate is typically severely low (<10mEq) in patients with either DKA or HHNC.
The ANSWER is A. Although patients with DKA typically have profound metabolic acidosis with serum
bicarbonate < 10mEq, acidosis is typically absent in patients with HHNC and serum bicarbonate is usually
> 15 mEq."
"In a 70kg male DKA patient with serum glucose of 573 mg/dL, all of the following statements with
regard to fluid and electrolyte imbalances are true EXCEPT:
A. A normal magnesium level is reassuring and obviates the need for magnesium replacement.
B. The patient is likely to be total body phosphorus depleted.
C. Total body water deficit is approximately 5L.
D. Serum sodium of 129 mEq represents dilutional hyponatremia and the corrected value is
approximately 137 mEq.
E. Despite a serum potassium level of 4.8 mEq, the patient is probably total body potassium depleted." -
"A. A normal magnesium level is reassuring and obviates the need for magnesium replacement.
The ANSWER is A. Patients with DKA are typically severely dehydrated with a total body water deficit
of approximately 70-80 mL/kg, in addition to being total body depleted of potassium, magnesium, and
phosphorous despite initially normal serum levels of these electrolytes."
,"Regarding the treatment of hyperosmolar hypertonic nonketotic coma (HHNC) and its associated
symptoms, which of the following is correct:
A. Hyperosmolarity should be corrected within the first few hours in the emergency department.
B. Since patients are not acidotic, close monitoring of glucose is not necessary.
C. In HHNC patients with severe dehydration, bleeding diathesis is a major clinical concern.
D. Half of the fluid deficit should be corrected over the first hour and the remainder over the following 8
hours.
E. Phenytoin (Dilantin) is often ineffective for seizures associated with HHNC." - "E. Phenytoin (Dilantin)
is often ineffective for seizures associated with HHNC.
The ANSWER is E. Phenytoin (Dilantin) is contraindicated in patients with HHNC as it may impair
endogenous insulin release and is often ineffective in the management of seizures associated with
HHNC. Half of the fluid deficit should be replaced over the first 8 hours, and the remainder over the
ensuing 24 hours. Glucose must be tightly monitored as fluid resuscitation alone may normalize serum
glucose or precipitate hypoglycemia in aggressive fluid resuscitation. Too-rapid correction of
hyperosmolarity may result in development of cerebral edema, especially in children. Subcutaneous
heparin should be considered in patients with severe dehydration due to increased risk of thrombosis
from hypovolemia and hyperviscosity."
"Regarding the development of cerebral edema in patients being treated for DKA, all of the following are
true EXCEPT:
A. Mannitol and steroids should be administered immediately to any patient suspected of developing
cerebral edema.
B. Patients with serum glucose below 250 mg/dL still being treated with insulin are most likely to
develop clinically evident cerebral edema.
C. Cerebral edema typically occurs six to ten hours following onset of treatment.
D. Children have a higher incidence of cerebral edema.
E. Mortality of patients developing cerebral edema is 90%." - "A. Mannitol and steroids should be
administered immediately to any patient suspected of developing cerebral edema.
, The ANSWER is A. Steroids are not indicated for treatment of cerebral edema and may actually
worsen DKA. Mannitol 0.25-2.0 mg/kg should be administered upon any change in mental status of
children being treated for DKA as they are at high risk for developing cerebral edema especially when
being treated with insulin and serum glucose is below 250 mg/dL."
"Of the choices below, the best treatment of the patient with hyperkalemia and EKG changes is:
A. defibrillation
B. vasopressin
C. lidocaine
D. amiodarone
E. calcium" - "E. calcium
The ANSWER is E. Hyperkalemia with EKG changes is treated with calcium to stabilize cardiac
membranes. Calcium works quickly and is relatively safe unless patients are digitalized. Other
treatments for acute hyperkalemia include sodium bicarbonate and insulin/glucose."
"Which pharmacologic treatment for hyperkalemia works through stabilization of cardiac membranes?
A. Magnesium
B. Calcium
C. Bicarbonate
D. Insulin and glucose" - "B. Calcium
The ANSWER is B. "Immediate antagonism of K+ at the cardiac membrane is achieved with IV
administration of calcium chloride or gluconate. This is indicated in patients with unstable dysrhythmia
or hypotension.""
"A 55 year old female with a history of end-stage renal disease presents to the emergency
department with weakness. Her EKG is shown in the Figure, and reveals:
[image: peaked T waves]
A. hypocalcemia
