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NSG 430 Adult Health Nursing II — Exam 4 Practice Questions
Complete (Verified Update!!!!!!2026–2027)
Exam 4 Blueprint Coverage:
• Topic 12: Management of Shock States & Hemodynamics
• Topic 13: Management of SIRS, Sepsis & MODS
• Topic 14: Management of Burns & Trauma
• Topic 15: Management of Hematologic Disorders & Transfusions
• Topic 16: Management of GI Malignancies & Bariatric Surgery
SECTION 1: SHOCK STATES & HEMODYNAMICS (Questions)
Shock Fundamentals
1. A patient is in the compensatory stage of shock. Which
clinical manifestation should the nurse expect to observe?
A) Narrowing pulse pressure and tachycardia
B) Metabolic acidosis and hyperkalemia
C) Anuria and cold, mottled skin
D) Decreased level of consciousness and bradycardia
Correct Answer: A
Rationale: In the compensatory stage of shock, the body
attempts to maintain homeostasis. Clinical signs include
tachycardia, peripheral vasoconstriction, and a narrowing pulse
pressure as the body redirects blood flow to vital organs.
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Metabolic acidosis and hyperkalemia are seen in the
progressive stage, while anuria and cold, mottled skin are signs
of irreversible shock.
2. Which assessment finding is most indicative of the
progressive stage of shock?
A) Increased urinary output
B) Increased bowel sounds
C) Respiratory alkalosis
D) Weak, thready peripheral pulses
Correct Answer: D
Rationale: In the progressive stage, compensatory mechanisms
fail. Decreased cardiac output leads to poor tissue perfusion,
evidenced by weak peripheral pulses, hypotension, and altered
mental status. Increased urinary output, increased bowel
sounds, and respiratory alkalosis are not characteristic of the
progressive stage of shock.
3. What is the definition of shock?
A) A state of inadequate tissue perfusion resulting in cellular
hypoxia and organ dysfunction
B) A state of increased blood pressure
C) A state of increased cardiac output
D) A state of decreased respiratory rate
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Correct Answer: A
Rationale: Shock is a state of inadequate tissue perfusion that
results in cellular hypoxia and organ dysfunction. It is
characterized by inadequate delivery of oxygen and nutrients to
meet the metabolic demands of the tissues.
4. What are the four stages of shock progression?
A) Initial, Compensatory, Progressive, Refractory
B) Mild, Moderate, Severe, Critical
C) Primary, Secondary, Tertiary, Quaternary
D) Early, Middle, Late, End
Correct Answer: A
Rationale: The four stages of shock are Initial, Compensatory,
Progressive, and Refractory. The initial stage is characterized by
subtle changes; the compensatory stage involves activation of
homeostatic mechanisms; the progressive stage involves failing
compensation; and the refractory stage is irreversible organ
failure.
5. A patient in the initial stage of shock would likely exhibit
which finding?
A) Normal vital signs with subtle metabolic changes
B) Severe hypotension and anuria
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C) Obvious organ failure
D) Cardiac arrest
Correct Answer: A
Rationale: The initial stage of shock is characterized by subtle
changes in vital signs and metabolic function that may not be
obvious. The body is attempting to compensate, but early signs
such as elevated lactate may be present. This is the stage
where intervention is most effective.
Cardiogenic Shock
6. What is low blood flow cardiogenic shock characterized by?
A) Compromised cardiac output with systolic and diastolic
dysfunction
B) Increased cardiac output
C) Loss of sympathetic tone
D) Decreased intravascular volume
Correct Answer: A
Rationale: Low blood flow cardiogenic shock is characterized by
decreased cardiac output due to pump failure of the heart.
Causes include MI, cardiomyopathy, blunt cardiac injury, severe
systemic or pulmonary hypertension, cardiac tamponade, and
myocardial depression from metabolic problems. Early
manifestations include tachycardia, hypotension, narrowed
NSG 430 Adult Health Nursing II — Exam 4 Practice Questions
Complete (Verified Update!!!!!!2026–2027)
Exam 4 Blueprint Coverage:
• Topic 12: Management of Shock States & Hemodynamics
• Topic 13: Management of SIRS, Sepsis & MODS
• Topic 14: Management of Burns & Trauma
• Topic 15: Management of Hematologic Disorders & Transfusions
• Topic 16: Management of GI Malignancies & Bariatric Surgery
SECTION 1: SHOCK STATES & HEMODYNAMICS (Questions)
Shock Fundamentals
1. A patient is in the compensatory stage of shock. Which
clinical manifestation should the nurse expect to observe?
A) Narrowing pulse pressure and tachycardia
B) Metabolic acidosis and hyperkalemia
C) Anuria and cold, mottled skin
D) Decreased level of consciousness and bradycardia
Correct Answer: A
Rationale: In the compensatory stage of shock, the body
attempts to maintain homeostasis. Clinical signs include
tachycardia, peripheral vasoconstriction, and a narrowing pulse
pressure as the body redirects blood flow to vital organs.
, Page |2
Metabolic acidosis and hyperkalemia are seen in the
progressive stage, while anuria and cold, mottled skin are signs
of irreversible shock.
2. Which assessment finding is most indicative of the
progressive stage of shock?
A) Increased urinary output
B) Increased bowel sounds
C) Respiratory alkalosis
D) Weak, thready peripheral pulses
Correct Answer: D
Rationale: In the progressive stage, compensatory mechanisms
fail. Decreased cardiac output leads to poor tissue perfusion,
evidenced by weak peripheral pulses, hypotension, and altered
mental status. Increased urinary output, increased bowel
sounds, and respiratory alkalosis are not characteristic of the
progressive stage of shock.
3. What is the definition of shock?
A) A state of inadequate tissue perfusion resulting in cellular
hypoxia and organ dysfunction
B) A state of increased blood pressure
C) A state of increased cardiac output
D) A state of decreased respiratory rate
, Page |3
Correct Answer: A
Rationale: Shock is a state of inadequate tissue perfusion that
results in cellular hypoxia and organ dysfunction. It is
characterized by inadequate delivery of oxygen and nutrients to
meet the metabolic demands of the tissues.
4. What are the four stages of shock progression?
A) Initial, Compensatory, Progressive, Refractory
B) Mild, Moderate, Severe, Critical
C) Primary, Secondary, Tertiary, Quaternary
D) Early, Middle, Late, End
Correct Answer: A
Rationale: The four stages of shock are Initial, Compensatory,
Progressive, and Refractory. The initial stage is characterized by
subtle changes; the compensatory stage involves activation of
homeostatic mechanisms; the progressive stage involves failing
compensation; and the refractory stage is irreversible organ
failure.
5. A patient in the initial stage of shock would likely exhibit
which finding?
A) Normal vital signs with subtle metabolic changes
B) Severe hypotension and anuria
, Page |4
C) Obvious organ failure
D) Cardiac arrest
Correct Answer: A
Rationale: The initial stage of shock is characterized by subtle
changes in vital signs and metabolic function that may not be
obvious. The body is attempting to compensate, but early signs
such as elevated lactate may be present. This is the stage
where intervention is most effective.
Cardiogenic Shock
6. What is low blood flow cardiogenic shock characterized by?
A) Compromised cardiac output with systolic and diastolic
dysfunction
B) Increased cardiac output
C) Loss of sympathetic tone
D) Decreased intravascular volume
Correct Answer: A
Rationale: Low blood flow cardiogenic shock is characterized by
decreased cardiac output due to pump failure of the heart.
Causes include MI, cardiomyopathy, blunt cardiac injury, severe
systemic or pulmonary hypertension, cardiac tamponade, and
myocardial depression from metabolic problems. Early
manifestations include tachycardia, hypotension, narrowed
