ABFM & KSA Shock Certification Exam 2026/2027 Practice Questions
and Answers 100% PASS
1. What is the primary hemodynamic hallmark of septic shock during its initial
‘warm’ phase?
A. Increased systemic vascular resistance
B. Decreased cardiac output
C. Decreased systemic vascular resistance
D. Decreased mixed venous oxygen saturation
Answer: C
Rationale: Septic shock is a form of distributive shock where peripheral vasodilation leads
to a significant decrease in systemic vascular resistance (SVR), often accompanied by a
compensatory increase in cardiac output.
2. In neurogenic shock, which of the following clinical findings is most
characteristic compared to other forms of shock?
A. Tachycardia
B. Bradycardia
C. Cool, clammy skin
D. Elevated central venous pressure
Answer: B
Rationale: Neurogenic shock results from the loss of sympathetic tone, leading to
vasodilation and an unopposed parasympathetic response, which causes bradycardia
rather than the compensatory tachycardia seen in most other shocks.
,3. Which of the following is the first-line vasopressor recommended for septic
shock refractory to fluid resuscitation?
A. Dopamine
B. Norepinephrine
C. Epinephrine
D. Vasopressin
Answer: B
Rationale: Per the Surviving Sepsis Campaign guidelines, Norepinephrine is the first-
choice vasopressor due to its potent alpha-1 and moderate beta-1 adrenergic effects.
4. A patient presents with hypotension, jugular venous distension, and muffled
heart sounds. What is the most likely diagnosis?
A. Tension pneumothorax
B. Myocardial infarction
C. Pulmonary embolism
D. Cardiac tamponade
Answer: D
Rationale: These three findings are known as Beck’s Triad, which is classic for cardiac
tamponade, a form of obstructive shock.
5. What is the recommended initial fluid bolus for a patient in septic shock
according to the Surviving Sepsis Campaign?
A. 30 mL/kg
B. 20 mL/kg
C. 10 mL/kg
D. 50 mL/kg
Answer: A
Rationale: The guidelines recommend at least 30 mL/kg of intravenous crystalloid fluid
within the first 3 hours of resuscitation for sepsis-induced hypoperfusion.
, 6. In hypovolemic shock, what typically happens to the Pulmonary Capillary
Wedge Pressure (PCWP)?
A. It increases
B. It initially increases then decreases
C. It remains unchanged
D. It decreases
Answer: D
Rationale: In hypovolemic shock, there is a loss of intravascular volume, leading to low
preload and consequently a low PCWP.
7. Which type of shock is characterized by a high cardiac output and low
systemic vascular resistance?
A. Distributive shock
B. Hypovolemic shock
C. Cardiogenic shock
D. Obstructive shock
Answer: A
Rationale: Distributive shock, such as septic or anaphylactic shock, typically presents with
low SVR due to vasodilation and a high or normal cardiac output (hyperdynamic state) in
the early stages.
8. Which of the following is a component of the qSOFA score?
A. Altered mental status
B. White blood cell count
C. Lactate level
D. Heart rate
Answer: A
Rationale: The qSOFA (quick SOFA) score includes: respiratory rate ≥ 22/min, altered
mentation (GCS < 15), and systolic blood pressure ≤ 100 mmHg.
and Answers 100% PASS
1. What is the primary hemodynamic hallmark of septic shock during its initial
‘warm’ phase?
A. Increased systemic vascular resistance
B. Decreased cardiac output
C. Decreased systemic vascular resistance
D. Decreased mixed venous oxygen saturation
Answer: C
Rationale: Septic shock is a form of distributive shock where peripheral vasodilation leads
to a significant decrease in systemic vascular resistance (SVR), often accompanied by a
compensatory increase in cardiac output.
2. In neurogenic shock, which of the following clinical findings is most
characteristic compared to other forms of shock?
A. Tachycardia
B. Bradycardia
C. Cool, clammy skin
D. Elevated central venous pressure
Answer: B
Rationale: Neurogenic shock results from the loss of sympathetic tone, leading to
vasodilation and an unopposed parasympathetic response, which causes bradycardia
rather than the compensatory tachycardia seen in most other shocks.
,3. Which of the following is the first-line vasopressor recommended for septic
shock refractory to fluid resuscitation?
A. Dopamine
B. Norepinephrine
C. Epinephrine
D. Vasopressin
Answer: B
Rationale: Per the Surviving Sepsis Campaign guidelines, Norepinephrine is the first-
choice vasopressor due to its potent alpha-1 and moderate beta-1 adrenergic effects.
4. A patient presents with hypotension, jugular venous distension, and muffled
heart sounds. What is the most likely diagnosis?
A. Tension pneumothorax
B. Myocardial infarction
C. Pulmonary embolism
D. Cardiac tamponade
Answer: D
Rationale: These three findings are known as Beck’s Triad, which is classic for cardiac
tamponade, a form of obstructive shock.
5. What is the recommended initial fluid bolus for a patient in septic shock
according to the Surviving Sepsis Campaign?
A. 30 mL/kg
B. 20 mL/kg
C. 10 mL/kg
D. 50 mL/kg
Answer: A
Rationale: The guidelines recommend at least 30 mL/kg of intravenous crystalloid fluid
within the first 3 hours of resuscitation for sepsis-induced hypoperfusion.
, 6. In hypovolemic shock, what typically happens to the Pulmonary Capillary
Wedge Pressure (PCWP)?
A. It increases
B. It initially increases then decreases
C. It remains unchanged
D. It decreases
Answer: D
Rationale: In hypovolemic shock, there is a loss of intravascular volume, leading to low
preload and consequently a low PCWP.
7. Which type of shock is characterized by a high cardiac output and low
systemic vascular resistance?
A. Distributive shock
B. Hypovolemic shock
C. Cardiogenic shock
D. Obstructive shock
Answer: A
Rationale: Distributive shock, such as septic or anaphylactic shock, typically presents with
low SVR due to vasodilation and a high or normal cardiac output (hyperdynamic state) in
the early stages.
8. Which of the following is a component of the qSOFA score?
A. Altered mental status
B. White blood cell count
C. Lactate level
D. Heart rate
Answer: A
Rationale: The qSOFA (quick SOFA) score includes: respiratory rate ≥ 22/min, altered
mentation (GCS < 15), and systolic blood pressure ≤ 100 mmHg.
