AEMCA MCQ 2 — Questions and Answers
Question 1: A patient presents with a tension pneumothorax. Which clinical finding is most specific to this condition?
- Bilateral crackles on auscultation
- Tracheal deviation away from the affected side (Correct answer)
- Bradycardia with hypertension
- Decreased oxygen saturation alone
Correct answer: Tracheal deviation away from the affected side
Tracheal deviation away from the affected side is a classic late sign of tension pneumothorax caused by mediastinal shift from accumulating pressure.
Question 2: When using a bag-valve-mask device on an adult patient, what tidal volume should you target to avoid gastric insufflation?
- 500–600 mL delivered over 1 second (Correct answer)
- 800–1000 mL delivered rapidly
- 1200 mL delivered over 2 seconds
- 300 mL delivered over 0.5 seconds
Correct answer: 500–600 mL delivered over 1 second
A tidal volume of 500–600 mL over about 1 second is sufficient for oxygenation and minimizes the risk of gastric insufflation and aspiration.
Question 3: Which of the following is the correct initial dose of epinephrine for anaphylaxis in an adult?
- 0.1 mg IV push
- 0.3–0.5 mg IM (1:1,000) into the anterolateral thigh (Correct answer)
- 1 mg IV bolus
- 0.01 mg/kg subcutaneously into the deltoid
Correct answer: 0.3–0.5 mg IM (1:1,000) into the anterolateral thigh
The standard adult anaphylaxis dose is 0.3–0.5 mg of 1:1,000 epinephrine injected intramuscularly into the anterolateral thigh for fastest absorption.
Question 4: A 68-year-old male has a blood pressure of 80/50 mmHg, JVD, and muffled heart sounds after blunt chest trauma. What condition do these findings suggest?
- Massive hemothorax
- Cardiac tamponade (Correct answer)
- Tension pneumothorax
- Myocardial contusion
Correct answer: Cardiac tamponade
Beck's triad—hypotension, JVD, and muffled heart sounds—is classic for cardiac tamponade, where pericardial fluid compresses the heart.
Question 5: During spinal immobilization, a patient with a suspected cervical spine injury becomes combative. What is the priority action?
- Sedate the patient immediately with midazolam
- Maintain manual in-line stabilization while assessing airway and oxygenation (Correct answer)
- Apply a rigid cervical collar and release manual stabilization
- Restrain the patient's limbs to prevent movement
Correct answer: Maintain manual in-line stabilization while assessing airway and oxygenation
Manual in-line stabilization must be maintained while simultaneously assessing airway and oxygenation, since hypoxia is a common cause of combativeness.
Question 6: Which medication is the first-line treatment for a patient in symptomatic bradycardia with a pulse?
- Adenosine 6 mg IV
- Atropine 0.5 mg IV (Correct answer)
- Amiodarone 300 mg IV
- Epinephrine 1 mg IV
Correct answer: Atropine 0.5 mg IV
Atropine 0.5 mg IV is the first-line drug for symptomatic bradycardia, working by blocking vagal tone to increase heart rate.
Question 7: You arrive on scene to find a 3-year-old child who is unresponsive and apneic with a strong femoral pulse. What is the most appropriate next action?
- Begin chest compressions at 100–120/min
- Open the airway and deliver 2 rescue breaths (Correct answer)
- Attach AED pads and analyze rhythm
- Administer epinephrine 0.01 mg/kg IM
Correct answer: Open the airway and deliver 2 rescue breaths
In a pediatric patient with a pulse but no breathing, rescue breathing is initiated immediately because pediatric arrests are usually respiratory in origin.
AEMCA MCQ 2
A patient presents with a tension pneumothorax.
Which clinical finding is most specific to this condition?