FCCS - Shock Exam Questions With
Detailed Solutions Graded A+
What is the initial therapy for most forms of shock? - CORRECT ANSWER-fluid
replacement
Name 2 types of solutions that can be used to replenish intravascular volume in the
patient who is not anemic. - CORRECT ANSWER-crystalloids and colloids
Name 2 advantages of crystalloids over colloids. - CORRECT ANSWER-1) less
expensive
2) accomplish the same goal as colloid
What 2 crystalloid solutions are used for volume resuscitation? What is the initial bolus
dose range? - CORRECT ANSWER-normal saline and lactated ringers; 500-1000 ml iv
bolus initially and repeated as needed
Why are D5W and 1/2NS not appropriate for volume expansion? - CORRECT
ANSWER-they are quickly distributed throughout body fluid compartments and so do
not offer any expansion of intravascular volume
Name 3 colloid solutions for volume expansion. What is the initial bolus dose range? -
CORRECT ANSWER-hetastarch, albumin, gelatins; 300-500 ml iv bolus initially and
repeated as needed
What is the indication for packed red blood cells? - CORRECT ANSWER-to increase
oxygen carrying capacity in a patient with significant bleeding or anemia
What is the indication for fresh frozen plasma? - CORRECT ANSWER-correction of a
coagulopathy
What is the first target endpoint in fluid resuscitation? The second? - CORRECT
ANSWER-1) correction of hypotension
, 2) decreased heart rate and correction of hypoperfusion abnormalities
What happens if fluid resuscitation is overly aggressive? - CORRECT ANSWER-
deterioration of oxygenation d/t increase in pulmonary capillary pressure and resultant
pulmonary edema
Name 5 vasoactive agents used in shock treatment. - CORRECT ANSWER-1)
dopamine
2) norepinephrine
3) epinephrine
4) vasopressin
5) dobutamine
Define inotropic effect. - CORRECT ANSWER-alters the strength of the contraction of
heart muscle
Define vasopressor effect. - CORRECT ANSWER-causes vasoconstriction and
elevates mean arterial pressure (MAP)
Define chronotropic effect. - CORRECT ANSWER-alters the heart rate
Dopamine (low infusion rate) - CORRECT ANSWER-2-3mcg/kg/min; modest inotropic
and chronotropic effects; acts on dopaminergic receptors in the kidney and may
increase urine output, but it's use for renal effect is not recommended b/c it doesn't
prevent renal dysfxn or improve outcomes
Dopamine (intermediate infusion rate) - CORRECT ANSWER-4-10mcg/kg/min;
primarily inotropic effects; loses it's effect on the kidneys
Dopamine (high infusion rate) - CORRECT ANSWER-greater than 10mcg/kg/min;
significant alpha agonist effects that produce dose related vasoconstriction
Detailed Solutions Graded A+
What is the initial therapy for most forms of shock? - CORRECT ANSWER-fluid
replacement
Name 2 types of solutions that can be used to replenish intravascular volume in the
patient who is not anemic. - CORRECT ANSWER-crystalloids and colloids
Name 2 advantages of crystalloids over colloids. - CORRECT ANSWER-1) less
expensive
2) accomplish the same goal as colloid
What 2 crystalloid solutions are used for volume resuscitation? What is the initial bolus
dose range? - CORRECT ANSWER-normal saline and lactated ringers; 500-1000 ml iv
bolus initially and repeated as needed
Why are D5W and 1/2NS not appropriate for volume expansion? - CORRECT
ANSWER-they are quickly distributed throughout body fluid compartments and so do
not offer any expansion of intravascular volume
Name 3 colloid solutions for volume expansion. What is the initial bolus dose range? -
CORRECT ANSWER-hetastarch, albumin, gelatins; 300-500 ml iv bolus initially and
repeated as needed
What is the indication for packed red blood cells? - CORRECT ANSWER-to increase
oxygen carrying capacity in a patient with significant bleeding or anemia
What is the indication for fresh frozen plasma? - CORRECT ANSWER-correction of a
coagulopathy
What is the first target endpoint in fluid resuscitation? The second? - CORRECT
ANSWER-1) correction of hypotension
, 2) decreased heart rate and correction of hypoperfusion abnormalities
What happens if fluid resuscitation is overly aggressive? - CORRECT ANSWER-
deterioration of oxygenation d/t increase in pulmonary capillary pressure and resultant
pulmonary edema
Name 5 vasoactive agents used in shock treatment. - CORRECT ANSWER-1)
dopamine
2) norepinephrine
3) epinephrine
4) vasopressin
5) dobutamine
Define inotropic effect. - CORRECT ANSWER-alters the strength of the contraction of
heart muscle
Define vasopressor effect. - CORRECT ANSWER-causes vasoconstriction and
elevates mean arterial pressure (MAP)
Define chronotropic effect. - CORRECT ANSWER-alters the heart rate
Dopamine (low infusion rate) - CORRECT ANSWER-2-3mcg/kg/min; modest inotropic
and chronotropic effects; acts on dopaminergic receptors in the kidney and may
increase urine output, but it's use for renal effect is not recommended b/c it doesn't
prevent renal dysfxn or improve outcomes
Dopamine (intermediate infusion rate) - CORRECT ANSWER-4-10mcg/kg/min;
primarily inotropic effects; loses it's effect on the kidneys
Dopamine (high infusion rate) - CORRECT ANSWER-greater than 10mcg/kg/min;
significant alpha agonist effects that produce dose related vasoconstriction
