SEPSIS SEPTIC SHOCK UNFOLDING
REASONING ACTUAL TEST PAPER WITH
VERIFIED ANSWERS
●● What is the progression of untreated shock
Answer: Hypotension → decreased cardiac output → organ failure →
death
●● What happens to oxygen delivery when perfusion decreases in shock
Answer: Oxygen delivery decreases
●● What metabolic process occurs when oxygen delivery decreases in
shock
Answer: Anaerobic metabolism
●● What acid-base imbalance results from anaerobic metabolism in
shock
Answer: Lactic acidosis
●● What characterizes the initial stage of shock
Answer: Subtle vital sign changes that are difficult to detect
,●● What happens to blood pressure during the compensatory stage of
shock
Answer: It remains normal
●● What happens to heart rate and respiratory rate in the compensatory
stage of shock
Answer: Both increase
●● What hormones are released during the compensatory stage of shock
Answer: Renin and angiotensin
●● What happens to MAP during the compensatory stage of shock
Answer: It trends down 10-15 below baseline
●● What acid-base imbalance is seen in the compensatory stage of
shock
Answer: Respiratory alkalosis
●● What PaCO₂ level is seen in the compensatory stage of shock
Answer: Less than 32 mmHg
●● What causes respiratory alkalosis in the compensatory stage of shock
Answer: Tachypnea
,●● What are common mental status findings in the compensatory stage
of shock
Answer: Anxiety, confusion, agitation
●● What happens to capillary refill in the compensatory stage of shock
Answer: Delayed (>2 seconds)
●● What is urine output in the compensatory stage of shock
Answer: ≥ 0.5 mL/kg/hr
●● What characterizes the progressive stage of shock
Answer: Compensatory mechanisms begin to fail
●● What happens to blood pressure in the progressive stage of shock
Answer: Severe hypotension
●● What happens to PaO₂ in the progressive stage of shock
Answer: Less than 80 mmHg
●● What acid-base imbalance occurs in the progressive stage of shock
Answer: Metabolic acidosis
, ●● What happens to PaCO₂ in the progressive stage of shock
Answer: It increases
●● What happens to urine output in the progressive stage of shock
Answer: Less than 0.5 mL/kg/hr
●● What lung sounds may be heard in progressive shock
Answer: Crackles
●● What happens to capillary refill in progressive shock
Answer: Very delayed or absent
●● What mental status changes occur in progressive shock
Answer: Lethargy and decreased LOC
●● What characterizes the irreversible stage of shock
Answer: Widespread, permanent damage
●● What type of acidosis is seen in irreversible shock
Answer: Profound metabolic acidosis
REASONING ACTUAL TEST PAPER WITH
VERIFIED ANSWERS
●● What is the progression of untreated shock
Answer: Hypotension → decreased cardiac output → organ failure →
death
●● What happens to oxygen delivery when perfusion decreases in shock
Answer: Oxygen delivery decreases
●● What metabolic process occurs when oxygen delivery decreases in
shock
Answer: Anaerobic metabolism
●● What acid-base imbalance results from anaerobic metabolism in
shock
Answer: Lactic acidosis
●● What characterizes the initial stage of shock
Answer: Subtle vital sign changes that are difficult to detect
,●● What happens to blood pressure during the compensatory stage of
shock
Answer: It remains normal
●● What happens to heart rate and respiratory rate in the compensatory
stage of shock
Answer: Both increase
●● What hormones are released during the compensatory stage of shock
Answer: Renin and angiotensin
●● What happens to MAP during the compensatory stage of shock
Answer: It trends down 10-15 below baseline
●● What acid-base imbalance is seen in the compensatory stage of
shock
Answer: Respiratory alkalosis
●● What PaCO₂ level is seen in the compensatory stage of shock
Answer: Less than 32 mmHg
●● What causes respiratory alkalosis in the compensatory stage of shock
Answer: Tachypnea
,●● What are common mental status findings in the compensatory stage
of shock
Answer: Anxiety, confusion, agitation
●● What happens to capillary refill in the compensatory stage of shock
Answer: Delayed (>2 seconds)
●● What is urine output in the compensatory stage of shock
Answer: ≥ 0.5 mL/kg/hr
●● What characterizes the progressive stage of shock
Answer: Compensatory mechanisms begin to fail
●● What happens to blood pressure in the progressive stage of shock
Answer: Severe hypotension
●● What happens to PaO₂ in the progressive stage of shock
Answer: Less than 80 mmHg
●● What acid-base imbalance occurs in the progressive stage of shock
Answer: Metabolic acidosis
, ●● What happens to PaCO₂ in the progressive stage of shock
Answer: It increases
●● What happens to urine output in the progressive stage of shock
Answer: Less than 0.5 mL/kg/hr
●● What lung sounds may be heard in progressive shock
Answer: Crackles
●● What happens to capillary refill in progressive shock
Answer: Very delayed or absent
●● What mental status changes occur in progressive shock
Answer: Lethargy and decreased LOC
●● What characterizes the irreversible stage of shock
Answer: Widespread, permanent damage
●● What type of acidosis is seen in irreversible shock
Answer: Profound metabolic acidosis
