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Which of the following patients is in decompensated shock?
A. 28-year-old female with pale skin and rapid, shallow respirations
B. 32-year-old male with anxiety and a systolic BP of 110 mm Hg
C. 20-year-old female with absent radial pulses and dilated pupils ✅
D. 23-year-old restless male with cool, clammy skin and tachycardia
Rationale: Absent radial pulses and dilated pupils are signs of inadequate
perfusion—hallmarks of decompensated shock.
One of the primary waste products of normal cellular metabolism that must be
removed from the body by the lungs is:
A. Pyruvic acid
B. Lactic acid
C. Carbon monoxide
D. Carbon dioxide ✅
Rationale: CO₂ is a major metabolic waste product removed through respiration.
Which of the following statements regarding anaphylactic shock is MOST
correct?
A. Each subsequent exposure often produces a more severe reaction ✅
B. Anaphylactic shock occurs immediately upon first exposure
C. It is caused by immune system failure from toxins
D. Subsequent reactions are less severe
Rationale: Anaphylaxis worsens with repeated exposure due to sensitization.
When assessing a patient with signs of shock, it is MOST important to
remember that:
A. Respirations are deep in early shock
B. Multiple fractures are the leading cause of hypovolemic shock
C. Irreversible shock responds well to transfusion
D. Blood pressure is often the last measurable change ✅
Rationale: BP may remain normal until late in shock, so rely on other signs first.
When hypoperfusion is sensed, the sympathetic nervous system releases
epinephrine, causing:
A. Restlessness
,B. Vasodilation
C. Tachycardia ✅
D. Tachypnea
Rationale: Epinephrine increases heart rate to maintain perfusion.
Which of the following would MOST likely result in hemorrhagic shock?
A. Liver laceration ✅
B. Severe vomiting
C. Excessive sweating
D. Repeated diarrhea
Rationale: Liver injuries can lead to massive internal bleeding.
Cardiogenic shock may result from all of the following EXCEPT:
A. Increased afterload
B. Increased preload ✅
C. Poor contractility
D. Heart attack
Rationale: Increased preload improves cardiac output; it's not a cause of shock.
A 56-year-old male with rapid, irregular pulse, shallow respirations, and lowBP
likely has:
A. Ruptured aortic aneurysm
B. Acute MI
C. Severe septic shock
D. Cardiogenic shock ✅
Rationale: Symptoms and history suggest heart failure from MI.
If a patient in anaphylactic shock doesn’t improve after initial epinephrine, you
should:
A. Transport immediately
B. Call for paramedics
C. Consider asthma
D. Repeat epinephrine after consulting medical control ✅
Rationale: Re-administration may be necessary under medical guidance.
Which condition would NOT make you suspect shock?
A. Anaphylaxis
B. Heart attack
C. Severe infection
D. Tachycardia ✅
Rationale: Tachycardia is a sign of shock, not a cause.
Shock is the result of:
A. Blood vessel constriction
B. Hypoperfusion to cells ✅
C. Homeostasis maintenance
, D. Temporary organ dysfunction
Rationale: Shock stems from inadequate cellular perfusion.
While transporting a stable trauma patient with 20 min to hospital, you should:
A. Reassess in 5 min ✅
B. Take vitals in 15 min
C. Call for ALS
D. Do secondary assessment
Rationale: Reassessment every 5 minutes is standard for unstable or trauma
patients.
A 59-year-old male with confusion, hypotension, and absent radial pulses
needs:
A. Water to drink
B. Head-to-toe exam
C. Repeat BP in 5 mins
D. Immediate transport ✅
Rationale: These are signs of shock requiring urgent hospital care.
Septic shock develops from:
A. Poor vessel function and volume loss ✅
B. Blood vessel constriction
C. Weak heart contractions
D. Nervous system injury
Rationale: Infections cause vasodilation and capillary leakage leading to volume
loss.
A construction worker with spine injury, hypotension, and warm, dry skin
should receive:
A. Assisted ventilation, thermal management, and leg elevation ✅
B. Oxygen and blankets only
C. Oxygen and head elevation
D. Just immobilization and rapid transport
Rationale: Warm skin and bradycardia suggest neurogenic shock needing specific
support.
A woman fainted after emotional trauma. What is your first concern?
A. Take vitals
B. Persuade transport
C. Offer emotional support
D. Check for injuries from the fall ✅
Rationale: Fainting can cause trauma; assess for injuries first.
A patient with a knife impaled in chest — first priority before approach:
A. Follow standard precautions ✅
B. Get a general impression
C. Interview bystanders