Perfusion and Shock Practice Questions

68 multiple-choice questions on Perfusion and shock for paramedic and EMT students, from Chapter 9 (Pathophysiology). Read each question, pick your answer, then tap Show answer to check it and read the explanation.

68 practice questions

1. Perfusion is:

   1. A. The cardiac output per minute
   2. B. The systolic blood pressure reading
   3. C. Blood flow delivering oxygen to tissues
   4. D. The oxygen content of arterial blood
   Show answer

   Answer: C. Blood flow delivering oxygen to tissues

   Perfusion is circulation through tissues, delivering oxygen and nutrients and removing waste. Blood pressure is only one indicator of perfusion.

2. The three components required for adequate perfusion are:

   1. A. A working pump, volume, and intact vessels
   2. B. Heart rate, respiratory rate, and temperature
   3. C. Adequate oxygen, glucose, and water intake
   4. D. Preload, afterload, and heart rate
   Show answer

   Answer: A. A working pump, volume, and intact vessels

   Shock results when any one of them fails.

3. Oxygen delivery to tissues depends on:

   1. A. Blood pressure and heart rate alone
   2. B. Output, hemoglobin, and saturation
   3. C. Hemoglobin concentration alone
   4. D. Respiratory rate and tidal volume
   Show answer

   Answer: B. Output, hemoglobin, and saturation

   Delivery depends on cardiac output, hemoglobin concentration, and oxygen saturation. Anemia lowers delivery even with a normal saturation.

4. Shock is best defined as:

   1. A. Inadequate perfusion for cellular needs
   2. B. Systolic pressure below 90 mm Hg
   3. C. A sustained heart rate above 100
   4. D. Loss of consciousness from low flow
   Show answer

   Answer: A. Inadequate perfusion for cellular needs

   A patient can be in shock with a normal blood pressure.

5. In compensated shock, the body maintains blood pressure by:

   1. A. Dilating vessels to reduce afterload
   2. B. Slowing the heart to improve filling
   3. C. Raising heart rate and constricting vessels
   4. D. Slowing respirations to save energy
   Show answer

   Answer: C. Raising heart rate and constricting vessels

   Contractility also increases. Narrowed pulse pressure and cool, pale skin are early clues.

6. Which finding suggests decompensated shock?

   1. A. Anxiety with a normal blood pressure
   2. B. Hypotension with altered mental status
   3. C. Mild tachycardia with a normal blood pressure
   4. D. Cool, pale skin with normal pressure
   Show answer

   Answer: B. Hypotension with altered mental status

   Hypotension is a late finding, especially in young patients.

7. Irreversible shock refers to the stage in which:

   1. A. The patient stabilizes on fluids
   2. B. Compensatory mechanisms are first activated
   3. C. Organ damage persists despite treatment
   4. D. Blood pressure returns to normal
   Show answer

   Answer: C. Organ damage persists despite treatment

   Cellular and organ damage is so extensive that recovery does not occur. Preventing progression is the entire point of early recognition.

8. Baroreceptors respond to falling blood pressure by:

   1. A. Slowing the respiratory rate
   2. B. Increasing sympathetic output
   3. C. Decreasing sympathetic tone
   4. D. Increasing vagal output to the heart
   Show answer

   Answer: B. Increasing sympathetic output

   This raises heart rate and vascular tone. They sit in the carotid sinus and aortic arch. Vagal output falls when pressure drops, letting the heart rate rise.

9. The renin-angiotensin-aldosterone system responds to hypoperfusion by:

   1. A. Dilating vessels to lower afterload
   2. B. Lowering pressure to protect the heart
   3. C. Increasing urine output to clear acid
   4. D. Vasoconstriction and sodium retention
   Show answer

   Answer: D. Vasoconstriction and sodium retention

   It causes vasoconstriction and sodium and water retention. It is a slower but powerful compensation.

10. Hypovolemic shock results from:

    1. A. Failure of the heart muscle
    2. B. Widespread vasodilation from sepsis
    3. C. Loss of blood or fluid volume
    4. D. Obstruction of blood flow
    Show answer

    Answer: C. Loss of blood or fluid volume

    Hemorrhage, vomiting, diarrhea, and burns are common causes.

11. Cardiogenic shock results from:

    1. A. Failure of the heart to pump
    2. B. Air trapped in the chest
    3. C. Widespread vasodilation from infection
    4. D. Loss of circulating volume
    Show answer

    Answer: A. Failure of the heart to pump

    Large myocardial infarctions are the classic cause.

12. Distributive shock is characterized by:

    1. A. Failure of the heart to pump
    2. B. Loss of circulating volume
    3. C. Widespread vasodilation
    4. D. Mechanical obstruction to flow
    Show answer

    Answer: C. Widespread vasodilation

    Vasodilation creates relative hypovolemia. Septic, neurogenic, and anaphylactic shock are all distributive.

13. Neurogenic shock typically presents with:

    1. A. Tachycardia with cool, pale, clammy skin
    2. B. Bounding pulses with hypertension
    3. C. Hypotension with a normal or slow pulse
    4. D. Narrow pulse pressure with pallor
    Show answer

    Answer: C. Hypotension with a normal or slow pulse

    Skin is warm and dry below the injury. Loss of sympathetic tone from spinal cord injury causes it.

14. Anaphylactic shock involves:

    1. A. Slow onset over several days after exposure
    2. B. Blood loss into the tissues and body cavities
    3. C. Histamine-driven vasodilation and leak
    4. D. Pump failure from damage to the heart muscle
    Show answer

    Answer: C. Histamine-driven vasodilation and leak

    Massive histamine release causes vasodilation, capillary leak, and bronchoconstriction. Epinephrine addresses all three problems.

15. Septic shock develops when:

    1. A. Bacteria physically block small vessels
    2. B. The heart is compressed by fluid
    3. C. Fluid is lost externally through the skin
    4. D. Infection triggers vasodilation and leak
    Show answer

    Answer: D. Infection triggers vasodilation and leak

    Infection triggers widespread inflammation, vasodilation, and capillary leak. Early recognition and fluids plus antibiotics change outcomes.

16. Obstructive shock is caused by:

    1. A. Loss of plasma into burned tissue
    2. B. Loss of sympathetic tone after injury
    3. C. Mechanical obstruction to blood flow
    4. D. Widespread vasodilation from toxins
    Show answer

    Answer: C. Mechanical obstruction to blood flow

    Examples are tension pneumothorax, cardiac tamponade, and pulmonary embolism. Treatment must relieve the obstruction.

17. Lactic acid accumulates in shock because:

    1. A. Cells switch to anaerobic metabolism
    2. B. Ventilation increases and retains acid
    3. C. The liver produces too much lactate
    4. D. Blood glucose falls, starving the cells
    Show answer

    Answer: A. Cells switch to anaerobic metabolism

    Oxygen delivery is inadequate. Rising lactate is a marker of tissue hypoperfusion.

18. Multiple organ dysfunction syndrome occurs when:

    1. A. Shock is reversed with fluids
    2. B. An infection resolves but leaves scarring
    3. C. Two or more organ systems fail
    4. D. A single organ fails after injury
    Show answer

    Answer: C. Two or more organ systems fail

    Progressive failure follows severe illness or injury. Mortality rises sharply with each organ that fails.

19. Adequate perfusion requires all EXCEPT:

    1. A. A high heart rate
    2. B. A functioning heart
    3. C. Adequate blood volume
    4. D. Intact vessels with appropriate tone
    Show answer

    Answer: A. A high heart rate

    Rate is a compensation, not a requirement.

20. A trauma patient has an SpO2 of 99% but a hemoglobin of 5 g/dL. Why may his tissues still be hypoxic?

    1. A. There is too little hemoglobin to carry enough oxygen
    2. B. SpO2 is always inaccurate in trauma
    3. C. Oxygen delivery depends only on SpO2
    4. D. Low hemoglobin shifts the curve to the left
    Show answer

    Answer: A. There is too little hemoglobin to carry enough oxygen

    Oxygen delivery depends on cardiac output, hemoglobin, and saturation. SpO2 only shows what percentage of the available hemoglobin is saturated, so a 99% saturation of very little hemoglobin still carries little oxygen. SpO2 is not always inaccurate in trauma, and anemia does not shift the curve left.

21. In which situation does oxygen consumption exceed delivery?

    1. A. Mild hypothermia without shivering
    2. B. Breathing supplemental oxygen at rest
    3. C. Shock, sepsis, or extreme exertion
    4. D. Light activity in a healthy adult
    Show answer

    Answer: C. Shock, sepsis, or extreme exertion

    In shock, sepsis, or extreme exertion, tissue demand outstrips what the circulation delivers, so cells shift to anaerobic metabolism and an oxygen debt accumulates. Cooling without shivering lowers metabolic oxygen use, extra oxygen at rest raises delivery without raising consumption, and light activity in a healthy adult is easily matched by a rise in cardiac output.

22. Mean arterial pressure needed for organ perfusion is approximately:

    1. A. About 40 mm Hg
    2. B. At least 120 mm Hg
    3. C. Roughly 100 to 110 mm Hg
    4. D. At least 60 to 65 mm Hg
    Show answer

    Answer: D. At least 60 to 65 mm Hg

    Below that, autoregulation fails.

23. Blood pressure is a poor measure of perfusion because:

    1. A. It is unrelated to perfusion
    2. B. It is difficult to measure accurately
    3. C. It always overstates true perfusion
    4. D. Compensation keeps it normal until late
    Show answer

    Answer: D. Compensation keeps it normal until late

    Look at the whole patient.

24. Early signs of shock include:

    1. A. Hypotension and altered mental status
    2. B. Bradycardia with warm, flushed skin
    3. C. Anxiety, tachycardia, and cool skin
    4. D. Warm, flushed, dry skin
    Show answer

    Answer: C. Anxiety, tachycardia, and cool skin

    Delayed capillary refill and pale skin also appear. Compensation signs.

25. Which finding best marks the shift from compensated to decompensated hemorrhagic shock?

    1. A. Rising heart rate
    2. B. Cool, pale skin
    3. C. Anxiety and restlessness
    4. D. Falling systolic pressure
    Show answer

    Answer: D. Falling systolic pressure

    Hypotension appears when compensation can no longer maintain pressure, and it signals decompensated shock with substantial blood loss. Tachycardia, cool pale skin, and anxiety are early compensated signs that appear before the pressure falls.

26. A patient with a pelvic fracture is pale and cool, with a heart rate of 124 and BP 118/88. What explains the normal blood pressure?

    1. A. He has not lost a significant amount of blood yet
    2. B. The pelvic fracture itself raises blood pressure
    3. C. Parasympathetic activation is increasing his pressure
    4. D. Sympathetic tachycardia and vasoconstriction compensate
    Show answer

    Answer: D. Sympathetic tachycardia and vasoconstriction compensate

    In compensated shock, sympathetic activity raises the heart rate and constricts vessels, which keeps blood pressure normal while perfusion falls. The narrowed pulse pressure and cool skin show it. A normal BP does not rule out major blood loss. Parasympathetic activity would slow the heart.

27. Shunting of blood during shock prioritizes:

    1. A. Skeletal muscle and skin
    2. B. Skin, gut, and kidneys
    3. C. Kidneys and liver
    4. D. Heart, brain, and lungs
    Show answer

    Answer: D. Heart, brain, and lungs

    The skin becomes cool and pale.

28. Reduced renal perfusion in shock causes:

    1. A. Increased output of dilute urine
    2. B. Gross hematuria from kidney injury
    3. C. Oliguria and RAAS activation
    4. D. Unchanged urine output until death
    Show answer

    Answer: C. Oliguria and RAAS activation

    The renin-angiotensin-aldosterone system activates. Urine output is a perfusion marker.

29. Antidiuretic hormone in shock:

    1. A. Retains water and constricts vessels
    2. B. Increases urine output to clear toxins
    3. C. Is suppressed and plays no role
    4. D. Lowers pressure to protect the heart
    Show answer

    Answer: A. Retains water and constricts vessels

    Vasopressin is another name.

30. Children compensate for shock by:

    1. A. Raising heart rate and constricting vessels
    2. B. Lowering heart rate to fill better
    3. C. Mainly increasing stroke volume
    4. D. Dilating vessels to cool the skin
    Show answer

    Answer: A. Raising heart rate and constricting vessels

    They maintain pressure until sudden collapse. Hypotension is very late in children.

31. Older adults compensate for shock:

    1. A. Better than young adults do
    2. B. Exactly as young adults do
    3. C. Poorly, with less cardiac reserve
    4. D. Always with a marked tachycardia
    Show answer

    Answer: C. Poorly, with less cardiac reserve

    Medications such as beta blockers blunt the response. A normal heart rate may be misleading.

32. Pregnant patients in shock:

    1. A. May lose much volume before showing signs
    2. B. Show signs of shock earlier than others
    3. C. Typically develop bradycardia as they bleed
    4. D. Cannot be assessed reliably in the field
    Show answer

    Answer: A. May lose much volume before showing signs

    Expanded blood volume masks the loss. The fetus is compromised first.

33. Hemorrhagic shock class I involves blood loss of:

    1. A. 30 to 40 percent
    2. B. 15 to 30 percent
    3. C. Up to 15 percent
    4. D. Over 40 percent
    Show answer

    Answer: C. Up to 15 percent

    Signs are minimal, like donating blood.

34. Hemorrhagic shock class II involves:

    1. A. Under 15 percent with minimal signs
    2. B. Over 40 percent with obtundation
    3. C. 15 to 30 percent with tachycardia
    4. D. 30 to 40 percent with hypotension
    Show answer

    Answer: C. 15 to 30 percent with tachycardia

    Narrowed pulse pressure also appears. Compensated.

35. Hemorrhagic shock class III involves:

    1. A. 15 to 30 percent with normal pressure
    2. B. Under 15 percent with no signs
    3. C. Over 40 percent with no urine output
    4. D. 30 to 40 percent with hypotension
    Show answer

    Answer: D. 30 to 40 percent with hypotension

    Altered mental status also appears. Decompensation begins.

36. Hemorrhagic shock class IV involves:

    1. A. Under 15 percent, minimal signs
    2. B. About 30 percent, mild tachycardia
    3. C. About 15 percent, well compensated
    4. D. Over 40 percent, life-threatening
    Show answer

    Answer: D. Over 40 percent, life-threatening

    It is immediately life-threatening. Requires immediate blood.

37. Nonhemorrhagic hypovolemic shock results from:

    1. A. Vomiting, diarrhea, and burns
    2. B. Internal bleeding into the abdomen
    3. C. Failure of the heart to pump
    4. D. Widespread vasodilation
    Show answer

    Answer: A. Vomiting, diarrhea, and burns

    Excessive diuresis is another cause. Fluid rather than blood loss.

38. The initial treatment for hemorrhagic shock is:

    1. A. Bleeding control
    2. B. Vasopressor infusion
    3. C. IV fluid boluses
    4. D. High-flow oxygen alone
    Show answer

    Answer: A. Bleeding control

    Replacing blood that keeps leaking is futile.

39. Permissive hypotension means:

    1. A. Targeting a lower pressure in hemorrhage
    2. B. Giving fluids until pressure is normal
    3. C. Ignoring blood pressure readings entirely
    4. D. Withholding all IV fluids in trauma
    Show answer

    Answer: A. Targeting a lower pressure in hemorrhage

    A lower target is accepted in uncontrolled hemorrhage until surgical control. Excess pressure disrupts clots.

40. A patient with a large anterior MI has BP 78/50, crackles to the lung apices, and cool skin. Which type of shock is this?

    1. A. Hypovolemic
    2. B. Distributive
    3. C. Cardiogenic
    4. D. Obstructive
    Show answer

    Answer: C. Cardiogenic

    Pump failure from extensive LV infarction lowers cardiac output, and blood backs up into the lungs. Hypotension plus pulmonary edema after MI is cardiogenic shock. Hypovolemic shock has clear lungs and flat neck veins. Distributive shock has vasodilation, often with warm skin. Obstructive shock comes from a mechanical block such as tamponade or tension pneumothorax.

41. Cardiogenic shock presents with:

    1. A. Flat neck veins and clear lungs
    2. B. Hypotension, JVD, and pulmonary edema
    3. C. Hypertension with dry, clear lungs
    4. D. Warm skin and bounding pulses
    Show answer

    Answer: B. Hypotension, JVD, and pulmonary edema

    Skin is cool and clammy. Fluid backs up while forward flow fails.

42. Fluid administration in cardiogenic shock:

    1. A. Requires caution; it may worsen edema
    2. B. Is always indicated in large volumes
    3. C. Is absolutely contraindicated in all cases
    4. D. Is the primary and definitive treatment
    Show answer

    Answer: A. Requires caution; it may worsen edema

    Inotropes and vasopressors are often needed.

43. A trauma patient has hypotension, distended neck veins, absent left breath sounds, and tracheal deviation. Which type of shock is this?

    1. A. Cardiogenic
    2. B. Obstructive
    3. C. Hypovolemic
    4. D. Distributive
    Show answer

    Answer: B. Obstructive

    A tension pneumothorax raises intrathoracic pressure and blocks venous return to the heart, which is obstructive shock. It needs immediate decompression. Cardiogenic shock is pump failure. Hypovolemic shock causes flat neck veins. Distributive shock comes from vasodilation.

44. Tension pneumothorax causes shock by:

    1. A. Bleeding into the pleural space
    2. B. Reducing venous return to the heart
    3. C. Direct failure of the heart muscle
    4. D. Vasodilation from hypoxia
    Show answer

    Answer: B. Reducing venous return to the heart

    It compresses the heart and great vessels. Needle decompression.

45. Cardiac tamponade causes shock by:

    1. A. Blood loss from the circulation
    2. B. Preventing ventricular filling
    3. C. Vasodilation from inflammation
    4. D. Failure of a heart valve
    Show answer

    Answer: B. Preventing ventricular filling

    Pericardiocentesis.

46. Massive pulmonary embolism causes shock by:

    1. A. Blocking pulmonary blood flow
    2. B. Systemic vasodilation from clot
    3. C. Bleeding into the alveoli
    4. D. Primary left ventricular failure
    Show answer

    Answer: A. Blocking pulmonary blood flow

    It also causes right heart failure. Sudden dyspnea and hypotension.

47. After a bee sting, a patient has hives, wheezing, and BP 70/40 with warm skin. Which category of shock is this?

    1. A. Hypovolemic
    2. B. Distributive
    3. C. Cardiogenic
    4. D. Obstructive
    Show answer

    Answer: B. Distributive

    Anaphylaxis releases mediators that dilate vessels throughout the body and make capillaries leak, so blood volume is maldistributed. That is distributive shock, and the skin is often warm and flushed. Hypovolemic, cardiogenic, and obstructive shock usually cause cool skin from vasoconstriction.

48. Septic shock early phase presents with:

    1. A. Warm, flushed skin with bounding pulses
    2. B. Severe hypertension and headache
    3. C. Cold, mottled skin and weak pulses
    4. D. Marked bradycardia and pallor
    Show answer

    Answer: A. Warm, flushed skin with bounding pulses

    Pulse pressure widens. Warm shock.

49. Septic shock late phase presents with:

    1. A. Warm, flushed, dry skin
    2. B. Cool, mottled skin
    3. C. Marked bradycardia
    4. D. Severe hypertension
    Show answer

    Answer: B. Cool, mottled skin

    Skin cools as compensation fails. Cold shock.

50. Why is epinephrine, not diphenhydramine, first-line in anaphylactic shock?

    1. A. It reverses vasodilation, airway edema, and bronchospasm
    2. B. It blocks histamine receptors more strongly than antihistamines
    3. C. It acts more slowly than diphenhydramine but lasts longer
    4. D. It treats only the hives and itching, not the airway
    Show answer

    Answer: A. It reverses vasodilation, airway edema, and bronchospasm

    Epinephrine's alpha-1 effects restore vascular tone and reduce edema, its beta-1 effects support the heart, and its beta-2 effects relax bronchi and stabilize mast cells. Antihistamines relieve itching and hives but do not reverse shock or airway obstruction. Epinephrine acts quickly but is short-acting.

51. Neurogenic shock results from:

    1. A. Loss of sympathetic tone
    2. B. Excess vasoconstriction
    3. C. Isolated traumatic brain injury
    4. D. Volume loss from bleeding
    Show answer

    Answer: A. Loss of sympathetic tone

    It usually follows spinal cord injury above T6. Vasodilation without compensation.

52. Neurogenic shock differs from spinal shock in that spinal shock refers to:

    1. A. Bradycardia from unopposed vagal tone
    2. B. Warm, dry skin below the injury
    3. C. Hypotension from lost vascular tone
    4. D. Temporary loss of cord reflexes
    Show answer

    Answer: D. Temporary loss of cord reflexes

    Reflexes and function are lost below the injury. Neurogenic shock is hemodynamic; spinal shock is neurologic.

53. Psychogenic shock, or vasovagal syncope, results from:

    1. A. Sudden hidden blood loss
    2. B. An acute allergic reaction
    3. C. A bloodstream infection
    4. D. A sudden parasympathetic surge
    Show answer

    Answer: D. A sudden parasympathetic surge

    The surge causes vasodilation and bradycardia. Usually brief and self-limited.

54. Adrenal insufficiency can cause shock because:

    1. A. Cortisol and aldosterone are deficient
    2. B. Cortisol is produced in excess
    3. C. Blood glucose rises to toxic levels
    4. D. Catecholamines are released in great excess
    Show answer

    Answer: A. Cortisol and aldosterone are deficient

    This impairs vascular tone and volume. Patients on chronic steroids are at risk.

55. Compensated shock is treated by:

    1. A. Vasopressors as first-line therapy
    2. B. Fluids alone, regardless of cause
    3. C. Early recognition and treating the cause
    4. D. Waiting until decompensation occurs
    Show answer

    Answer: C. Early recognition and treating the cause

    The window is before hypotension.

56. Decompensated shock requires:

    1. A. Delayed transport until vitals stabilize
    2. B. Observation with repeat vital signs
    3. C. High-flow oxygen as the sole treatment
    4. D. Immediate aggressive intervention
    Show answer

    Answer: D. Immediate aggressive intervention

    The patient is close to irreversible shock. Minutes matter. Waiting on scene for vitals to improve loses time, and oxygen alone does not restore volume or treat the cause.

57. After prolonged shock, a patient's BP normalizes with transfusion, but over the next days he develops kidney failure, ARDS, and DIC. This reflects:

    1. A. Compensated shock that has not yet been recognized
    2. B. A normal and expected response to the transfusion
    3. C. Cell damage that persisted after perfusion was restored
    4. D. Neurogenic shock from an unrecognized spine injury
    Show answer

    Answer: C. Cell damage that persisted after perfusion was restored

    When ischemia lasts long enough, cell and organ injury continues after circulation is restored. This is the irreversible stage, which leads to multiple organ dysfunction. Compensated shock has normal organ function. This is not a normal transfusion response, and neurogenic shock is loss of sympathetic tone after cord injury.

58. Lactate level reflects:

    1. A. Arterial oxygen content
    2. B. Systolic blood pressure
    3. C. Heart rate variability
    4. D. Anaerobic metabolism
    Show answer

    Answer: D. Anaerobic metabolism

    It reflects tissue hypoperfusion. Some systems measure it in the field.

59. Capillary refill time over 2 seconds suggests:

    1. A. Normal peripheral perfusion
    2. B. Impaired peripheral perfusion
    3. C. Peripheral vasodilation with warm skin
    4. D. Increased cardiac output
    Show answer

    Answer: B. Impaired peripheral perfusion

    Affected by temperature and age. Vasodilation and a higher cardiac output speed capillary refill rather than slowing it.

60. Narrowing pulse pressure in shock reflects:

    1. A. Widespread vasodilation
    2. B. Increased stroke volume from fluid
    3. C. Vasoconstriction as stroke volume falls
    4. D. Bradycardia from vagal stimulation
    Show answer

    Answer: C. Vasoconstriction as stroke volume falls

    Vasoconstriction raises diastolic pressure. An early sign often missed.

61. Widening pulse pressure occurs in:

    1. A. Hemorrhagic shock from trauma
    2. B. Obstructive shock from tamponade
    3. C. Cardiogenic shock after MI
    4. D. Early sepsis and raised ICP
    Show answer

    Answer: D. Early sepsis and raised ICP

    Different mechanisms.

62. Orthostatic vital signs assess:

    1. A. Respiratory function
    2. B. Neurologic function
    3. C. Cardiac contractility
    4. D. Volume status
    Show answer

    Answer: D. Volume status

    Lying and standing pressures and rates are compared. A rise in heart rate of 20 or more is positive.

63. Shock index is calculated as:

    1. A. Respiratory rate multiplied by heart rate
    2. B. Pulse pressure divided by heart rate
    3. C. Systolic blood pressure divided by heart rate
    4. D. Heart rate divided by systolic BP
    Show answer

    Answer: D. Heart rate divided by systolic BP

    A value above about 0.9 suggests significant hemorrhage.

64. The chain of survival for shock begins with:

    1. A. Fluid administration
    2. B. Early recognition
    3. C. Rapid transport
    4. D. Vasopressor therapy
    Show answer

    Answer: B. Early recognition

    You cannot treat what you do not recognize.

65. Oxygen in shock should be:

    1. A. Given only if cyanosis appears
    2. B. Withheld to avoid oxygen toxicity
    3. C. Given at maximum flow in all cases
    4. D. Titrated to adequate saturation
    Show answer

    Answer: D. Titrated to adequate saturation

    Delivery depends on it. Avoid hyperoxia but never allow hypoxia.

66. Positioning a shock patient should:

    1. A. Trendelenburg in all cases
    2. B. Prone to protect the airway
    3. C. Supine or position of comfort
    4. D. Sitting fully upright
    Show answer

    Answer: C. Supine or position of comfort

    Attend to airway and breathing. Trendelenburg has fallen out of favor.

67. Temperature management in shock is important because:

    1. A. Cooling usefully lowers oxygen demand
    2. B. Hypothermia worsens bleeding and acidosis
    3. C. Fever improves immune clearance
    4. D. Temperature has little effect on the outcome
    Show answer

    Answer: B. Hypothermia worsens bleeding and acidosis

    The lethal triad: hypothermia, acidosis, coagulopathy.

68. Multiple organ dysfunction syndrome mortality:

    1. A. Is near zero with treatment
    2. B. Is unrelated to organ count
    3. C. Rises with each organ involved
    4. D. Is low with modern care
    Show answer

    Answer: C. Rises with each organ involved

    Prevention is key.