Shock Quiz: Can You Recognize It Early?

1. A patient's urine output drops to 0.3 mL/kg/hr during shock. What does this indicate?

Adequate renal perfusion

Decreased renal perfusion and risk of acute kidney injury

Normal compensatory response

Fluid overload

2. A patient in shock has SpO2 85% despite oxygen therapy. What intervention is most critical?

Increase oxygen flow only

Intubation and mechanical ventilation to improve oxygenation

Fluid bolus

Diuretic administration

3. In septic shock, broad-spectrum antibiotics should be administered within ____ minutes of recognition.

30

60

120

240

4. Which sign suggests decompensatory shock rather than early compensatory shock?

Tachycardia with normal BP

Hypotension with altered mental status

Increased respiratory rate

Pale skin with normal perfusion

5. In shock, anaerobic metabolism produces which acid-base disturbance?

Respiratory alkalosis

Metabolic alkalosis

Metabolic acidosis

Respiratory acidosis

6. A patient receiving fluid resuscitation shows JVD, crackles, and dyspnea. What complication is occurring?

Hypovolemia

Pulmonary edema from fluid overload

Septic shock progression

Anaphylaxis

7. In distributive shock from sepsis, what causes hypotension despite normal or increased cardiac output?

Decreased myocardial contractility

Massive peripheral vasodilation and increased capillary permeability

Severe fluid loss

Coronary artery occlusion

8. A patient in shock has cold, mottled extremities and weak pedal pulses. What does this indicate?

Peripheral vasodilation

Peripheral vasoconstriction and poor tissue perfusion

Normal skin findings

Improved circulation

9. Which organ system is most vulnerable to failure in prolonged shock?

Skeletal muscle

Brain and kidneys due to critical oxygen demands

Skin

Bone

10. In sepsis, which systemic inflammatory response is characteristic?

Temperature 36.5°C, HR 60, RR 14

Temperature >38°C or

Hypothermia with bradycardia

Normal vital signs

11. A patient presents with pale, cool skin; rapid weak pulse; and systolic BP 85 mmHg. What type of shock is most likely?

Cardiogenic shock

Hypovolemic shock

Septic shock

Anaphylactic shock

12. In anaphylactic shock, which medication is administered first?

Antihistamine

Corticosteroid

Epinephrine IM

Oxygen therapy alone

13. What is the primary goal of initial fluid resuscitation in shock?

Lower heart rate

Restore circulating volume and tissue perfusion

Increase urine output above 200 mL/hr

Reduce respiratory rate

14. A patient in septic shock has warm, flushed skin with a bounding pulse. What does this indicate?

Vasoconstriction

Vasodilation with maldistribution of blood flow

Normal compensatory response

Improved perfusion

15. In cardiogenic shock post-MI, what is the primary pathophysiology?

Fluid loss from the intravascular space

Decreased myocardial contractility reducing cardiac output

Vasodilation and increased capillary permeability

Anaphylactic immune response

16. Which clinical sign is an early indicator of sepsis-induced shock?

Core temperature 38.5°C with tachycardia

Hypotension with bradycardia

Bradypnea

Decreased capillary refill

17. A trauma patient loses 30% blood volume. What compensatory mechanism maintains cardiac output initially?

Decreased heart rate

Sympathetic activation increasing heart rate and contractility

Vasodilation

Decreased oxygen demand

18. In septic shock, which vasodilator is most commonly used for refractory hypotension after fluid resuscitation?

Norepinephrine

Hydralazine

Nitroprusside

Dopamine

19. A patient with sepsis develops lactate 4.2 mEq/L and altered mentation. What does elevated lactate indicate?