NURS 5315 SHOCK FINAL EXAM 2026
COMPLETE STUDY GUIDE WITH VERIFIED
QUESTIONS AND ANSWERS DETAILED
RATIONALES AND EXAM SUCCESS
PREPARATION
NURS 5315 SHOCK FINAL EXAM 2026 - COMPLETE STUDY GUIDE
DOCUMENT OVERVIEW:
• This comprehensive study guide contains verified practice questions with detailed
EXPERT RATIONALE designed to reinforce shock pathophysiology, assessment,
and nursing management across all clinical shock types.
• Study this material by working through questions systematically, reviewing each
EXPERT RATIONALE thoroughly, and identifying knowledge gaps for targeted
review before the final examination.
QUESTION 1
A patient in shock presents with a blood pressure of 88/52 mmHg, heart rate
of 128 bpm, and respiratory rate of 26 breaths/minute. The patient's skin is
cool and clammy. Which stage of shock is this patient most likely
experiencing?
A) Compensatory stage
B) Progressive stage
C) Refractory stage
D) Irreversible stage
E) Initial stage
CORRECT ANSWER: B) Progressive stage
EXPERT RATIONALE: The patient is displaying signs of progressive
(decompensatory) shock with hypotension (SBP <90 mmHg), significant tachycardia
(128 bpm), tachypnea, and poor peripheral perfusion (cool, clammy skin). These
findings indicate that compensatory mechanisms have begun to fail, and tissue
,perfusion is becoming critically compromised. The initial stage would have normal
vital signs; the compensatory stage would show tachycardia and tachypnea with
maintained blood pressure; and the refractory stage would show unresponsiveness
to treatment with severe metabolic acidosis.
QUESTION 2
A 65-year-old patient suffered a massive myocardial infarction resulting in
necrosis of the left ventricular wall. The patient now presents with severe
hypotension and pulmonary edema. Which type of shock is this patient
experiencing?
A) Hypovolemic shock
B) Cardiogenic shock
C) Septic shock
D) Anaphylactic shock
E) Neurogenic shock
CORRECT ANSWER: B) Cardiogenic shock
EXPERT RATIONALE: Cardiogenic shock develops when the heart loses its ability to
pump effectively due to myocardial damage. In this case, the extensive myocardial
infarction has damaged the left ventricle, reducing cardiac output. This leads to
hypotension and backup of fluid into the pulmonary circulation, causing pulmonary
edema. The combination of acute MI with severe hypotension and pulmonary
edema is classic for cardiogenic shock. Other options would have different
etiologies (hypovolemia, infection, allergy, or neurogenic causes).
QUESTION 3
During initial assessment of a shock patient, the nurse notes increased SVR
(systemic vascular resistance), decreased CO (cardiac output), and increased
,PAWP (pulmonary artery wedge pressure). What type of shock is this most
consistent with?
A) Septic shock (warm shock phase)
B) Cardiogenic shock
C) Anaphylactic shock
D) Hypovolemic shock
E) Spinal shock
CORRECT ANSWER: B) Cardiogenic shock
EXPERT RATIONALE: Cardiogenic shock is characterized by a specific hemodynamic
pattern: decreased cardiac output (reduced pumping ability), increased systemic
vascular resistance (compensatory vasoconstriction), and increased PAWP (from
pulmonary congestion due to poor forward flow). This pattern reflects the heart's
inability to propel blood forward effectively, resulting in backward pressure
accumulation in the lungs. Septic shock initially presents with decreased SVR;
hypovolemic shock shows decreased PAWP; and anaphylactic shock shows
dramatically decreased SVR with initial preserved CO.
QUESTION 4
A 48-year-old patient presents to the ED following a motor vehicle accident
with external bleeding. Upon assessment: BP 72/45 mmHg, HR 142 bpm, RR 32
breaths/minute, urine output 5 mL/hour. Which classification of shock is this
patient in?
A) Obstructive shock
B) Distributive shock
C) Hypovolemic shock
D) Cardiogenic shock
E) Neurogenic shock
, CORRECT ANSWER: C) Hypovolemic shock
EXPERT RATIONALE: This patient has clear evidence of severe hypovolemic shock
from acute blood loss. The clinical indicators include severe hypotension, profound
tachycardia, tachypnea, and severely reduced urine output (oliguria), all indicating
poor tissue perfusion due to inadequate circulating volume. The mechanism is
direct loss of intravascular volume from hemorrhage. Obstructive shock would
result from mechanical obstruction; distributive shock from vasodilation;
cardiogenic from pump failure; and neurogenic from spinal cord injury.
QUESTION 5
A patient with gram-negative septicemia develops the following
hemodynamic values: decreased SVR, increased CO, warm extremities, and
normal or decreased PAWP. Which type of shock is this?
A) Cardiogenic shock
B) Early septic shock (warm shock)
C) Late septic shock (cold shock)
D) Hypovolemic shock
E) Obstructive shock
CORRECT ANSWER: B) Early septic shock (warm shock)
EXPERT RATIONALE: The hemodynamic profile described is classic for early (warm)
septic shock, also called high-output or distributive shock. Key features include
vasodilation (decreased SVR), increased cardiac output, warm periphery due to
cutaneous vasodilation, and normal-to-low PAWP. This occurs because bacterial
toxins and inflammatory mediators cause vasodilation and maldistribution of blood
flow. In contrast, late septic shock (cold shock) shows vasoconstriction with
decreased CO and cool extremities.
QUESTION 6
COMPLETE STUDY GUIDE WITH VERIFIED
QUESTIONS AND ANSWERS DETAILED
RATIONALES AND EXAM SUCCESS
PREPARATION
NURS 5315 SHOCK FINAL EXAM 2026 - COMPLETE STUDY GUIDE
DOCUMENT OVERVIEW:
• This comprehensive study guide contains verified practice questions with detailed
EXPERT RATIONALE designed to reinforce shock pathophysiology, assessment,
and nursing management across all clinical shock types.
• Study this material by working through questions systematically, reviewing each
EXPERT RATIONALE thoroughly, and identifying knowledge gaps for targeted
review before the final examination.
QUESTION 1
A patient in shock presents with a blood pressure of 88/52 mmHg, heart rate
of 128 bpm, and respiratory rate of 26 breaths/minute. The patient's skin is
cool and clammy. Which stage of shock is this patient most likely
experiencing?
A) Compensatory stage
B) Progressive stage
C) Refractory stage
D) Irreversible stage
E) Initial stage
CORRECT ANSWER: B) Progressive stage
EXPERT RATIONALE: The patient is displaying signs of progressive
(decompensatory) shock with hypotension (SBP <90 mmHg), significant tachycardia
(128 bpm), tachypnea, and poor peripheral perfusion (cool, clammy skin). These
findings indicate that compensatory mechanisms have begun to fail, and tissue
,perfusion is becoming critically compromised. The initial stage would have normal
vital signs; the compensatory stage would show tachycardia and tachypnea with
maintained blood pressure; and the refractory stage would show unresponsiveness
to treatment with severe metabolic acidosis.
QUESTION 2
A 65-year-old patient suffered a massive myocardial infarction resulting in
necrosis of the left ventricular wall. The patient now presents with severe
hypotension and pulmonary edema. Which type of shock is this patient
experiencing?
A) Hypovolemic shock
B) Cardiogenic shock
C) Septic shock
D) Anaphylactic shock
E) Neurogenic shock
CORRECT ANSWER: B) Cardiogenic shock
EXPERT RATIONALE: Cardiogenic shock develops when the heart loses its ability to
pump effectively due to myocardial damage. In this case, the extensive myocardial
infarction has damaged the left ventricle, reducing cardiac output. This leads to
hypotension and backup of fluid into the pulmonary circulation, causing pulmonary
edema. The combination of acute MI with severe hypotension and pulmonary
edema is classic for cardiogenic shock. Other options would have different
etiologies (hypovolemia, infection, allergy, or neurogenic causes).
QUESTION 3
During initial assessment of a shock patient, the nurse notes increased SVR
(systemic vascular resistance), decreased CO (cardiac output), and increased
,PAWP (pulmonary artery wedge pressure). What type of shock is this most
consistent with?
A) Septic shock (warm shock phase)
B) Cardiogenic shock
C) Anaphylactic shock
D) Hypovolemic shock
E) Spinal shock
CORRECT ANSWER: B) Cardiogenic shock
EXPERT RATIONALE: Cardiogenic shock is characterized by a specific hemodynamic
pattern: decreased cardiac output (reduced pumping ability), increased systemic
vascular resistance (compensatory vasoconstriction), and increased PAWP (from
pulmonary congestion due to poor forward flow). This pattern reflects the heart's
inability to propel blood forward effectively, resulting in backward pressure
accumulation in the lungs. Septic shock initially presents with decreased SVR;
hypovolemic shock shows decreased PAWP; and anaphylactic shock shows
dramatically decreased SVR with initial preserved CO.
QUESTION 4
A 48-year-old patient presents to the ED following a motor vehicle accident
with external bleeding. Upon assessment: BP 72/45 mmHg, HR 142 bpm, RR 32
breaths/minute, urine output 5 mL/hour. Which classification of shock is this
patient in?
A) Obstructive shock
B) Distributive shock
C) Hypovolemic shock
D) Cardiogenic shock
E) Neurogenic shock
, CORRECT ANSWER: C) Hypovolemic shock
EXPERT RATIONALE: This patient has clear evidence of severe hypovolemic shock
from acute blood loss. The clinical indicators include severe hypotension, profound
tachycardia, tachypnea, and severely reduced urine output (oliguria), all indicating
poor tissue perfusion due to inadequate circulating volume. The mechanism is
direct loss of intravascular volume from hemorrhage. Obstructive shock would
result from mechanical obstruction; distributive shock from vasodilation;
cardiogenic from pump failure; and neurogenic from spinal cord injury.
QUESTION 5
A patient with gram-negative septicemia develops the following
hemodynamic values: decreased SVR, increased CO, warm extremities, and
normal or decreased PAWP. Which type of shock is this?
A) Cardiogenic shock
B) Early septic shock (warm shock)
C) Late septic shock (cold shock)
D) Hypovolemic shock
E) Obstructive shock
CORRECT ANSWER: B) Early septic shock (warm shock)
EXPERT RATIONALE: The hemodynamic profile described is classic for early (warm)
septic shock, also called high-output or distributive shock. Key features include
vasodilation (decreased SVR), increased cardiac output, warm periphery due to
cutaneous vasodilation, and normal-to-low PAWP. This occurs because bacterial
toxins and inflammatory mediators cause vasodilation and maldistribution of blood
flow. In contrast, late septic shock (cold shock) shows vasoconstriction with
decreased CO and cool extremities.
QUESTION 6
