10 free, exam-style Emergency Medicine (EM) practice questions with answers and explanations. No signup required. Work through them below, then take the full free EM practice test to study every exam domain.
The EM exam has 305 questions and runs 6 hours 20 minutes.
These 10 free EM questions are organized by exam domain, so you can see how each part of the Emergency Medicine blueprint is tested. Reveal the answer and explanation under each question.
A 68-year-old man has sudden vertigo, vomiting, and difficulty walking. Exam shows nystagmus, left-sided limb ataxia, and a normal head-impulse test (no corrective saccade). Which conclusion is BEST supported by these findings?
Correct answer: B - A central cause such as cerebellar stroke should be suspected
A 74-year-old nursing-home resident has fever, confusion, and a heart rate of 118. Blood pressure is 88/50 that does not improve after a 30 mL/kg crystalloid bolus. Lactate is 4.2 mmol/L. Which term BEST describes this clinical picture?
Correct answer: A - Septic shock
A 58-year-old man has 40 minutes of chest pressure radiating to the jaw. He is diaphoretic. The ECG shows ST-segment depression in leads V1-V3 with tall R waves and upright T waves, and he remains symptomatic. Which action is MOST appropriate next?
Correct answer: B - Obtain posterior leads V7-V9 and activate the cath lab if ST elevation is present
A 46-year-old man with a history of hypertension presents with sudden, severe, tearing chest pain radiating to the back. Blood pressure is 178/96 in the right arm and 138/74 in the left arm. Which imaging study best confirms the suspected diagnosis in a hemodynamically stable patient?
Correct answer: C - CT angiography of the chest, abdomen, and pelvis
A 30-year-old woman with recent viral illness presents with dyspnea and hypotension. She has distended neck veins, muffled heart sounds, and clear lungs. Bedside ultrasound shows a large pericardial effusion with diastolic collapse of the right ventricle. Which finding would you MOST expect on physical exam?
Correct answer: A - A fall in systolic pressure greater than 10 mmHg during inspiration
A 45-year-old woman describes the sudden onset of the worst headache of her life, peaking within seconds. A noncontrast head CT performed 8 hours after onset is normal. What is the MOST appropriate next step?
Correct answer: A - Perform a lumbar puncture to evaluate for xanthochromia
A 22-year-old is brought in 6 hours after an intentional acetaminophen overdose. She is asymptomatic. A serum acetaminophen level drawn at 4 hours post-ingestion plots above the treatment line on the Rumack-Matthew nomogram. What is the MOST appropriate management?
Correct answer: C - Start N-acetylcysteine now
A patient presents obtunded after a tricyclic antidepressant overdose. The ECG shows a QRS of 130 ms with a terminal R wave in lead aVR. Which intervention MOST directly addresses the life-threatening cardiotoxicity?
Correct answer: A - Intravenous sodium bicarbonate
A trauma patient becomes acutely hypotensive with absent breath sounds on the right, tracheal deviation to the left, and distended neck veins. What is the MOST appropriate immediate intervention?
Correct answer: B - Perform immediate needle decompression or finger thoracostomy
A 9-year-old falls on an outstretched hand. Radiographs show a fracture through the growth plate and extending into the epiphysis and articular surface of the distal radius. This corresponds to which Salter-Harris classification?
Correct answer: D - Salter-Harris type IV
The EM exam also covers these domains. Drill them in the full free practice test:
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