FISDAP Medical Emergencies 4

Question 1

A 35-year-old male with a history of depression ingested an unknown quantity of tricyclic antidepressants (TCAs). He is now unresponsive with a wide QRS complex on ECG. Which treatment is most immediately indicated?

Accepted Answer

Sodium bicarbonate IV to narrow the QRS

Answer

Sodium bicarbonate alkalinizes the blood, reducing TCA binding to sodium channels and narrowing the QRS complex in TCA-induced cardiotoxicity.

Question 2

You respond to a patient with a history of hypertension presenting with a BP of 220/130 mmHg, headache, and visual disturbances. He has no new neurologic deficits. How should this be classified?

Accepted Answer

Hypertensive urgency

Answer

Hypertensive urgency is severely elevated BP without acute end-organ damage; hypertensive emergency requires evidence of organ damage (e.g., neurologic, cardiac, renal).

Question 3

A patient with congestive heart failure presents with acute respiratory distress, pink frothy sputum, and crackles bilaterally. SpO2 is 88%. Which intervention provides the most immediate benefit?

Accepted Answer

CPAP at 5–10 cmH2O with high-flow oxygen

Answer

CPAP rapidly reduces preload, improves oxygenation, and decreases the work of breathing in acute pulmonary edema, providing faster benefit than IV medications alone.

Question 4

Which finding differentiates obstructive shock from cardiogenic shock in a trauma patient?

Accepted Answer

Distended neck veins with absent breath sounds unilaterally

Answer

Obstructive shock from tension pneumothorax or cardiac tamponade presents with distended neck veins; absent unilateral breath sounds specifically indicate tension pneumothorax.

Question 5

A patient with known epilepsy is post-ictal and unresponsive. His wife states he seized for approximately 3 minutes and then 'stopped.' He is breathing 12/min with SpO2 of 95%. What is the priority intervention?

Accepted Answer

Place in recovery position and monitor airway

Answer

A post-ictal patient who is breathing adequately should be placed in the recovery position to protect the airway from aspiration while being monitored closely.

(FISDAP) Field Internship Student Data Acquisition Project Practice Test

(FISDAP) Field Internship Student Data Acquisition Project Practice Test

FISDAP Medical Emergencies 4