Emergency Medicine Final Exam | Actual Questions and
Answers Latest Updated 2026/2027 (Graded A+)
• Question
Which of the following is not true regarding distributive shock?
A. Decreased preload
B. Increased SVR
C. Mixed CO
Correct Answer: B: Decreased SVR
• Question
Which of the following is not true regarding hypovolemic shock?
A. Decreased preload
B. Decreased SVR
C. Decreased CO
Correct Answer: B: Increased SVR
• Question
Which of the following is not true regarding cardiogenic shock?
A. Increased preload
B. Increased afterload
C. Decreased SVR
D. Decreased CO
Correct Answer: C: Increased SVR
• Question
Which of the following is not true regarding obstructive shock?
A. Increased preload
B. Increased SVR
C. Decreased CO
Correct Answer: A: Decreased preload
• Question
Which of the following types of shock involves a relative decrease in intravascular
volume?
A. Cardiogenic
B. Obstructive
C. Hypovolemic
D. Distributive
Correct Answer: D: Anaphylaxis and sepsis are examples of this; the "pipe" got bigger
and now it seems as if there is less volume but really theres just more space
,• Question
Which of the following is an example of cardiogenic shock?
A. Cardiac tamponade
B. Sepsis
C. MI
D. Hemorrhage
Correct Answer: C: Cardiogenic shock occurs when the left ventricle fails to deliver
oxygenated blood to peripheral tissues.
a is obstructive (occurs when there is a decrease in venous return or cardiac
compromise b is distributive (relative decrease in intravascular volume) d is a decrease
in intravascular fluid/blood volume
• Question
When compensatory mechanisms fail in shock anaerobic metabolism occurs. This
ultimately leads to:
A. Respiratory acidosis
B. Respiratory alkalosis
C. Metabolic acidosis
D. Metabolic alkalosis
Correct Answer: C: The anaerobic metabolism leads to lactic acid build up. Normal
lactate is less than 2 and greater than 4 indicates sepsis. Serial lactate measurements
can help with resuscitation
• Question
Cryptic shock is:
Correct Answer: Shock with a normal BP
• Question
Which of the following labs is least appropriate to order with suspected shock?
A. VBG
B. Lactate
C. Urine culture
D. Coagulation studies
E. UA
Correct Answer: A: Get an ABG in suspected shock, not VBG because ABG gives us
ventilation and oxygenation data
,• Question
Which of the following imaging studies is least likely to be helpful when evaluating
suspected shock?
A. Contrast CT
B. Noncontrast CT
C. US
D. Chest Xray
Correct Answer: B: The risks and benefits of CT need to be weighed because this person
needs to be stable to go to CT. If they had renal dysfunction then noncontrast would be
necessary but it is not as good as contrast
a accurrate and noninvasive, weight risks and benefits c RUSH and ACES protocols can
be used d Portable AP xray can ID heart size, pulmonary edema, free air, pneumo,
infiltrates, or effusions
• Question
Which of the following is false with regards to determining appropriate airway
management in shock?
A. Positive pressure ventilation increases preload
B. Intubation can decrease BP
C. Consider vasoactive agents prior to intubation
D. Sedatives can lower BP
Correct Answer: A: PPV decreases preload
• Question
A 78 year old patient presents in respiratory distress with a BP of 85/45. Their skin is
cool and clammy and they are A&Ox1. You administer 1000mL of fluid over 10 minutes
and administer levofed so that their BP is 122/65 before mechanical ventilation. What
lab do you need to check after placing them on mechanical ventilation?
A. Lactate
B. ABG
C. UA
D. Coagulation studies
Correct Answer: B
• Question
MAP is calculated by:
Correct Answer: (systolic BP + 2*diastolic BP)/3
, • Question
Which of the following is not and advantage of LR in resuscitative efforts?
A. Electrolytes are balanced
B. K and Ca promote myocardial contractility
C. Can give it with blood
D. Doesn't increase Na or Cl
Correct Answer: C: LR cannot be given with blood because of Ca in the blood
• Question
Explain permissive hypotension.
Correct Answer: When using fluid resuscitation, established clots may dislodge and lead
to more blood loss. This is a reason that we leave some people hypotensive. We want to
resuscitate to adequate perfusion by at least one of the following: regaining of
consciousness palpable radial pulse SBP over 90 MAP over 60
• Question
A 34 year old patient presents with abdominal pain with associated vomiting but deny
diarrhea and hematemesis. Sitting up and leaning forward gives them relief. Their BP is
82/51, HR 122, spo2 96% and afebrile. They skin is cool and dry. They have a history of
alcoholism. and drug abuse. What do you suspect?
A. Cardiogenic shock
B. Hypovolemic shock
C. Distributive shock
D. Obstructive shock
Correct Answer: B: This patient presents with pancreatitis which is nonhemorrhagic
hypovolemic shock
• Question
The 3rd leading COD is:
A. Shock
B. Heart disease
C. Sepsis
D. Cancer
Correct Answer: C
• Question
For every hour that someone with sepsis goes without antibiotics, survival drops _____%
Correct Answer: 7.6
Answers Latest Updated 2026/2027 (Graded A+)
• Question
Which of the following is not true regarding distributive shock?
A. Decreased preload
B. Increased SVR
C. Mixed CO
Correct Answer: B: Decreased SVR
• Question
Which of the following is not true regarding hypovolemic shock?
A. Decreased preload
B. Decreased SVR
C. Decreased CO
Correct Answer: B: Increased SVR
• Question
Which of the following is not true regarding cardiogenic shock?
A. Increased preload
B. Increased afterload
C. Decreased SVR
D. Decreased CO
Correct Answer: C: Increased SVR
• Question
Which of the following is not true regarding obstructive shock?
A. Increased preload
B. Increased SVR
C. Decreased CO
Correct Answer: A: Decreased preload
• Question
Which of the following types of shock involves a relative decrease in intravascular
volume?
A. Cardiogenic
B. Obstructive
C. Hypovolemic
D. Distributive
Correct Answer: D: Anaphylaxis and sepsis are examples of this; the "pipe" got bigger
and now it seems as if there is less volume but really theres just more space
,• Question
Which of the following is an example of cardiogenic shock?
A. Cardiac tamponade
B. Sepsis
C. MI
D. Hemorrhage
Correct Answer: C: Cardiogenic shock occurs when the left ventricle fails to deliver
oxygenated blood to peripheral tissues.
a is obstructive (occurs when there is a decrease in venous return or cardiac
compromise b is distributive (relative decrease in intravascular volume) d is a decrease
in intravascular fluid/blood volume
• Question
When compensatory mechanisms fail in shock anaerobic metabolism occurs. This
ultimately leads to:
A. Respiratory acidosis
B. Respiratory alkalosis
C. Metabolic acidosis
D. Metabolic alkalosis
Correct Answer: C: The anaerobic metabolism leads to lactic acid build up. Normal
lactate is less than 2 and greater than 4 indicates sepsis. Serial lactate measurements
can help with resuscitation
• Question
Cryptic shock is:
Correct Answer: Shock with a normal BP
• Question
Which of the following labs is least appropriate to order with suspected shock?
A. VBG
B. Lactate
C. Urine culture
D. Coagulation studies
E. UA
Correct Answer: A: Get an ABG in suspected shock, not VBG because ABG gives us
ventilation and oxygenation data
,• Question
Which of the following imaging studies is least likely to be helpful when evaluating
suspected shock?
A. Contrast CT
B. Noncontrast CT
C. US
D. Chest Xray
Correct Answer: B: The risks and benefits of CT need to be weighed because this person
needs to be stable to go to CT. If they had renal dysfunction then noncontrast would be
necessary but it is not as good as contrast
a accurrate and noninvasive, weight risks and benefits c RUSH and ACES protocols can
be used d Portable AP xray can ID heart size, pulmonary edema, free air, pneumo,
infiltrates, or effusions
• Question
Which of the following is false with regards to determining appropriate airway
management in shock?
A. Positive pressure ventilation increases preload
B. Intubation can decrease BP
C. Consider vasoactive agents prior to intubation
D. Sedatives can lower BP
Correct Answer: A: PPV decreases preload
• Question
A 78 year old patient presents in respiratory distress with a BP of 85/45. Their skin is
cool and clammy and they are A&Ox1. You administer 1000mL of fluid over 10 minutes
and administer levofed so that their BP is 122/65 before mechanical ventilation. What
lab do you need to check after placing them on mechanical ventilation?
A. Lactate
B. ABG
C. UA
D. Coagulation studies
Correct Answer: B
• Question
MAP is calculated by:
Correct Answer: (systolic BP + 2*diastolic BP)/3
, • Question
Which of the following is not and advantage of LR in resuscitative efforts?
A. Electrolytes are balanced
B. K and Ca promote myocardial contractility
C. Can give it with blood
D. Doesn't increase Na or Cl
Correct Answer: C: LR cannot be given with blood because of Ca in the blood
• Question
Explain permissive hypotension.
Correct Answer: When using fluid resuscitation, established clots may dislodge and lead
to more blood loss. This is a reason that we leave some people hypotensive. We want to
resuscitate to adequate perfusion by at least one of the following: regaining of
consciousness palpable radial pulse SBP over 90 MAP over 60
• Question
A 34 year old patient presents with abdominal pain with associated vomiting but deny
diarrhea and hematemesis. Sitting up and leaning forward gives them relief. Their BP is
82/51, HR 122, spo2 96% and afebrile. They skin is cool and dry. They have a history of
alcoholism. and drug abuse. What do you suspect?
A. Cardiogenic shock
B. Hypovolemic shock
C. Distributive shock
D. Obstructive shock
Correct Answer: B: This patient presents with pancreatitis which is nonhemorrhagic
hypovolemic shock
• Question
The 3rd leading COD is:
A. Shock
B. Heart disease
C. Sepsis
D. Cancer
Correct Answer: C
• Question
For every hour that someone with sepsis goes without antibiotics, survival drops _____%
Correct Answer: 7.6
