• MCQ Pilot Examination Items and Stimuli

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    1. A 34-year-old man presents by EMS with diffuse abdominal pain
    following a motor vehicle crash. His vital signs are BP, 128/72; P, 82; R, 18; and T, 37.0º C (98.6º F). He has diffuse abdominal tenderness without rebound, rigidity, or guarding. A FAST exam is shown. What is the most appropriate next step?

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    (A) abdominal/pelvis CT scan                                                                                                            
    (B) admit to ICU with surgical consultation

    (C) admit to OR with surgical consultation

    (D) repeat FAST exam in 6 hours

           
           
                 
           

    2. A 45-year-old man presents after being found on the sidewalk. He smells of alcohol and admits to chronic use. His vital signs are BP, 90/60; P, 125; R, 24; and T, 38.0º C (101.5º F). An ultrasound of his abdomen is shown.  What test is most likely to be diagnostic?

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    see the video. If you are having difficulty viewing the video, please click here.)

    (A) arterial blood gas

    (B) CT scan of the abdomen

    (C) paracentesis

    (D) serum transaminase levels

           
           
                 
           

    3. A 64-year-old man presents by ambulance feeling light-headed after a syncopal episode. His cardiac rhythm is shown. Vital signs are BP, 94/78; P, 147; R, 18; and T, 37.1º C (98.7º F). Which of the following is the appropriate intervention?

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    (A) adenosine

    (B) defibrillation

    (C) lidocaine

    (D) synchronous shock

           
           
                 
           

    4. A 30-year-old man presents with difficulty breathing and swallowing, hoarseness, and a swelling in his anterior neck that has progressively enlarged over the past three days. Examination reveals a large, soft, nontender mass in the anterior neck. His vital signs are BP, 130/94; P, 120; R, 22; and T, 38.0º C (100.4º F). Pulse oximetry is 90% on O2 6 L/min. His breath sounds are provided. What is the most appropriate next intervention?

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    (A) cricothyrotomy

    (B) fiberoptic intubation

    (C) laryngeal mask airway

    (D) rapid sequence intubation with propofol

           
           
                 
           

    5. A 55-year-old man presents after a fall. He is intoxicated and his vital signs are BP, 136/84; P, 88; R, 16; and T, 37.3º C (99.1º F). The patient opens his eyes spontaneously, speaks in complete sentences, and moves all of his extremities equally. His head CT scan is shown. What is the most appropriate next step?

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    the CT images. You may pause or restart the video on any frame by clicking the pause or play button. If you are having difficulty viewing the stimulus image, please click here.)

    (A) emergent neurosurgical consultation

    (B) fosphenytoin

    (C) intracranial pressure monitoring

    (D) rapid sequence intubation

           
           
                 
           

    6. A 50-year-old man presents with dizziness. His cardiac rhythm, blood pressure, and pulse oximetry are shown. What is the most appropriate next step?

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    (A) administer atropine

    (B) administer epinephrine

    (C) place a transvenous pacemaker

    (D) place pads for an external pacemaker