Shock, Sepsis & Trauma Med-Surg
Practice Exam
100 Questions, Answers, and Rationales
1. A patient in hypovolemic shock has a BP of 78/42 mmHg and a HR
of 132 bpm. What is the priority action?
A. Apply warm blankets
B. Administer isotonic IV fluids rapidly
C. Give oral rehydration
D. Place the patient in high Fowler’s
Rationale: Rapid fluid replacement with isotonic crystalloids is the first
intervention to restore circulating volume in hypovolemic shock.
2. A nurse suspects septic shock in a postoperative client. Which
finding supports this?
A. Bradycardia
B. Widened pulse pressure
C. Decreased respiratory rate
D. Dry skin
Rationale: Early sepsis may show warm, flushed skin and a widened
pulse pressure due to vasodilation.
3. A patient with anaphylactic shock presents with wheezing and
hypotension. What is the first medication to administer?
A. Diphenhydramine
B. Methylprednisolone
C. Epinephrine IM
D. Albuterol
,Rationale: Epinephrine is the first-line medication for anaphylaxis
because it reverses bronchoconstriction and vasodilation.
4. A trauma patient is bleeding heavily and shows signs of shock. The
nurse should expect which IV fluid initially?
A. D5W
B. Normal saline
C. 0.45% NS
D. Albumin
Rationale: Isotonic crystalloids like NS are first-line for trauma-related
hypovolemic shock.
5. Which assessment best indicates improved shock status?
A. Increased HR
B. Decreased urine output
C. Increased MAP above 65 mmHg
D. Cool, pale skin
Rationale: A MAP ≥ 65 mmHg shows adequate perfusion and
improved hemodynamics.
6. Priority lab in suspected septic shock:
A. Amylase
B. BNP
C. Lactate
D. Hemoglobin
Rationale: Elevated serum lactate indicates tissue hypoperfusion and
is a key marker in sepsis.
7. In neurogenic shock, which finding is expected?
A. Tachycardia
B. Bradycardia
,C. Increased BP
D. Cool extremities
Rationale: Loss of sympathetic tone causes bradycardia and
hypotension.
8. A patient with major trauma develops paradoxical chest
movement. The nurse suspects:
A. Hemothorax
B. Pneumonia
C. Flail chest
D. ARDS
Rationale: Flail chest produces paradoxical chest motion due to rib
fractures.
9. First priority for a patient with an open abdominal wound:
A. Insert Foley catheter
B. Administer analgesics
C. Cover wound with sterile moist dressing
D. Give antibiotics
Rationale: Moist sterile dressings reduce contamination and organ
drying.
10. Most important initial action in septic shock:
A. Administer steroids
B. Start broad-spectrum antibiotics
C. Give diuretics
D. Restrict fluids
Rationale: Early antibiotic therapy greatly reduces mortality in septic
shock.
, (Items 11–100 continue below)
11. Which assessment indicates decompensated shock?
A. Warm skin
B. BP 118/76
C. Confusion
D. Strong pulses
Rationale: Altered mental status signals decreased cerebral perfusion.
12. Burn patient with suspected hypovolemia: priority assessment?
A. Oxygen saturation
B. Temperature
C. Urine output
D. Bowel sounds
Rationale: Urine output reflects kidney perfusion and fluid status.
13. Priority in tension pneumothorax:
A. Chest x-ray
B. Needle decompression
C. ABG
D. Pain control
Rationale: Immediate decompression is lifesaving by relieving
pressure.
14. The nurse identifies obstructive shock in:
A. MI
B. Stroke
C. Cardiac tamponade
D. Sepsis
Practice Exam
100 Questions, Answers, and Rationales
1. A patient in hypovolemic shock has a BP of 78/42 mmHg and a HR
of 132 bpm. What is the priority action?
A. Apply warm blankets
B. Administer isotonic IV fluids rapidly
C. Give oral rehydration
D. Place the patient in high Fowler’s
Rationale: Rapid fluid replacement with isotonic crystalloids is the first
intervention to restore circulating volume in hypovolemic shock.
2. A nurse suspects septic shock in a postoperative client. Which
finding supports this?
A. Bradycardia
B. Widened pulse pressure
C. Decreased respiratory rate
D. Dry skin
Rationale: Early sepsis may show warm, flushed skin and a widened
pulse pressure due to vasodilation.
3. A patient with anaphylactic shock presents with wheezing and
hypotension. What is the first medication to administer?
A. Diphenhydramine
B. Methylprednisolone
C. Epinephrine IM
D. Albuterol
,Rationale: Epinephrine is the first-line medication for anaphylaxis
because it reverses bronchoconstriction and vasodilation.
4. A trauma patient is bleeding heavily and shows signs of shock. The
nurse should expect which IV fluid initially?
A. D5W
B. Normal saline
C. 0.45% NS
D. Albumin
Rationale: Isotonic crystalloids like NS are first-line for trauma-related
hypovolemic shock.
5. Which assessment best indicates improved shock status?
A. Increased HR
B. Decreased urine output
C. Increased MAP above 65 mmHg
D. Cool, pale skin
Rationale: A MAP ≥ 65 mmHg shows adequate perfusion and
improved hemodynamics.
6. Priority lab in suspected septic shock:
A. Amylase
B. BNP
C. Lactate
D. Hemoglobin
Rationale: Elevated serum lactate indicates tissue hypoperfusion and
is a key marker in sepsis.
7. In neurogenic shock, which finding is expected?
A. Tachycardia
B. Bradycardia
,C. Increased BP
D. Cool extremities
Rationale: Loss of sympathetic tone causes bradycardia and
hypotension.
8. A patient with major trauma develops paradoxical chest
movement. The nurse suspects:
A. Hemothorax
B. Pneumonia
C. Flail chest
D. ARDS
Rationale: Flail chest produces paradoxical chest motion due to rib
fractures.
9. First priority for a patient with an open abdominal wound:
A. Insert Foley catheter
B. Administer analgesics
C. Cover wound with sterile moist dressing
D. Give antibiotics
Rationale: Moist sterile dressings reduce contamination and organ
drying.
10. Most important initial action in septic shock:
A. Administer steroids
B. Start broad-spectrum antibiotics
C. Give diuretics
D. Restrict fluids
Rationale: Early antibiotic therapy greatly reduces mortality in septic
shock.
, (Items 11–100 continue below)
11. Which assessment indicates decompensated shock?
A. Warm skin
B. BP 118/76
C. Confusion
D. Strong pulses
Rationale: Altered mental status signals decreased cerebral perfusion.
12. Burn patient with suspected hypovolemia: priority assessment?
A. Oxygen saturation
B. Temperature
C. Urine output
D. Bowel sounds
Rationale: Urine output reflects kidney perfusion and fluid status.
13. Priority in tension pneumothorax:
A. Chest x-ray
B. Needle decompression
C. ABG
D. Pain control
Rationale: Immediate decompression is lifesaving by relieving
pressure.
14. The nurse identifies obstructive shock in:
A. MI
B. Stroke
C. Cardiac tamponade
D. Sepsis
