EMT Ch. 10: Shock questions and answers
When perfusion to the core of the body decreases: a. Blood is shunted away from the skin. b. Decreased cardiac contractility occurs. c. Blood is diverted to the gastrointestinal tract. d. The voluntary nervous system releases hormones.
a. Blood is shunted away from the skin.
Pulmonary edema and impaired ventilation occur during: a. Cardiogenic shock. b. Neurogenic shock. c. Septic shock. d. Anaphylactic shock.
a. Cardiogenic shock.
Hypovolemic shock caused by severe burns is the result of a loss of: a. Plasma b. Platelets c. Whole blood d. Red blood cells
a. Plasma
Which of the following clinical signs is unique to anaphylactic shock? a. Pallor b. Dizziness c. Wheezing d. Hypotension
c. Wheezing
In an acute setting, neurogenic shock is commonly accompanied by: a. Hypovolemia b. Tachycardia c. Diaphoresis d. Hypothermia
d. Hypothermia
neurogenic shock occurs when A)failure of the nervous system causes widespread vasodilation B) the spinal cord is severed and causes massive hemorrhaging C)There is too much blood to fill a smaller vascular container D)massive vasoconstriction occurs distal to a spinal cord injury.
failure of the nervous system causes widespread vasodilation.
Pulmonary edema and impaired ventilation occur during: Choose one answer. a. neurogenic shock. b. anaphylactic shock. c. septic shock. d. cardiogenic shock.
D
which of the following patients is in decompensated shock A)a female with absent radial pulses and dilated pupils B)restless male with cool, clammy skin and tachycardia C)Female with pale skin and rapid, shallow respirations Male with anxiety and systolic blood pressure of 110mm hg
a female with absent radial pulses and dilated pupils
Which of the following patients should you place in the recovery position? a. A 31-year-old semiconscious male with low blood sugar and adequate breathing b. A 24-year-old unconscious female who overdosed and has a reduced tidal volume c. A 40-year-old conscious female with a possible neck injury and regular respirations d. A 19-year-old conscious male with a closed head injury and normal respirations
a. A 31-year-old semiconscious male with low blood sugar and adequate breathing
When perfusion to the core of the body decreases: a. Blood is shunted away from the skin b. Decreased cardiac contractility occurs c. Blood is diverted to the gastrointestinal tract d. The voluntary nervous system releases hormones
a. Blood is shunted away from the skin
The nasopharyngeal airway is MOST beneficial because it: a. Can maintain a patent airway in a semiconscious patient with a gag reflex. b. Effectively maintains the airway of a patient in cardiopulmonary arrest. c. Can effectively stabilize fractured nasal bones if it is inserted properly. d. Is generally well tolerated in conscious patients with an intact gag reflex.
a. Can maintain a patent airway in a semiconscious patient with a gag reflex.
Neurogenic shock occurs when: a. Failure of the nervous system causes widespread vasodilation b. The spinal cord is severed and causes massive hemorrhaging c. There is too much blood to fill a smaller vascular container d. Massive vasoconstriction occurs distal to a spinal cord injury
a. Failure of the nervous system causes widespread vasodilation
Shock is the result of: a. Hypoperfusion to the cells of the body b. The body's maintenance of homeostasis c. Temporary dysfunction of a major organ d. Widespread constriction of the blood vessels
a. Hypoperfusion to the cells of the body
A 25-year-old unrestrained female struck the steering wheel with her chest when her car hit a tree while traveling at a high rate of speed. She has signs and symptoms of shock, which you suspect are the result of intrathoracic bleeding. Which of the following interventions will provide this patient with the greatest chance for survival? a. Rapid transport to a trauma center b. 100% oxygen administration c. Full immobilization of her spine d. Application of the pneumatic antishock garment (PASG)
a. Rapid transport to a trauma center
you respond to a residence for a patient with a severe leg injury following an accident with a chainsaw. when you arrive, you find the patient, a 44-year-old male, lying supine in the backyard. He has a partial amputation of his right lower leg that is actively bleeding. The patient is conscious and breathing adequately; however, he is restless and his skin is diaphoretic, you should: A) immediately evaluate his airway B) apply direct pressure to the wound C)assess the rate and quality of his pulse D) administer 100% supplemental exygen
apply direct pressure to the wound
a construction worker fell approximately 30 feet. He is semiconscious with rapid, shallow respirations. Further assessment reveals deformity to the thoracic region of his spine. His blood pressure is 70/50mm hg, his pulse is 66 beats/min and weak, and his skin is warm and dry. In addition to spinal immobilization and rapid transport, The most appropriate treatment for this patients include A)oxygen via nonrebreather mask, blankets for warmth and elevation of his head B)assisted ventilation, thermal management, and elevation of the lower extremities C)oxygen via nonrebreather mask, thermal management, and elevation of his legs D)assisted ventilation, preventing hyperthermia, and elevating his lower extremities
assisted ventilation, thermal management, and elevation of the lower extremities.
Clinical signs of compensated shock include all of the following, EXCEPT: a. Cool and clammy skin b. Absent peripheral pulses c. Restlessness or anxiety d. Rapid, shallow breathing
b. Absent peripheral pulses
You respond to a residence for a patient with a severe leg injury following an accident with a chainsaw. When you arrive, you find the patient, a 44-year-old male, lying supine in the backyard. He has a partial amputation of his right lower leg that is actively bleeding. The patient is conscious and breathing adequately; however, he is restless and his skin is diaphoretic. You should: a. Assess the rate and quality of his pulse. b. Apply direct pressure to the wound. c. Administer 100% supplemental oxygen d. Immediately evaluate his airway.
b. Apply direct pressure to the wound.
You and your partner are caring for a critically injured patient. Your partner is controlling severe bleeding from the patient's lower extremities as you attempt ventilations with a bag-mask device. After repositioning the mask several times, you are unable to effectively ventilate the patient. You should: a. Continue attempted ventilations and transport immediately. b. Begin ventilations using the mouth-to-mask technique. c. Hyperextend the patient's head and reattempt ventilations. d. Suction the patient's airway for 30 seconds and reattempt ventilations.
b. Begin ventilations using the mouth-to-mask technique.
A 56-year-old male is found semiconscious by his wife. Your assessment reveals that his respirations are rapid and shallow, his pulse is rapid and irregular, and his blood pressure is low. The patient's wife states that he complained of left arm pain and nausea the day before, but would not allow her to call 9-1-1. The MOST likely cause of this patient's present condition is: a. Severe septic hypoperfusion. b. Cardiogenic hypoperfusion. c. A ruptured aortic aneurysm. d. Acute myocardial infarction.
b. Cardiogenic hypoperfusion.
The hypoxic drive—the primary stimulus to breathe for patients with certain chronic respiratory diseases—is influenced by: a. Low blood carbon dioxide levels. b. Low blood oxygen levels. c. High blood carbon dioxide levels. d. High blood oxygen levels.
b. Low blood oxygen levels.
A 70-year-old female was recently discharged from the hospital following a total hip replacement. Today, she presents with restlessness, tachycardia, and a blood pressure of 100/64 mm Hg. Her skin is warm and moist. You should be MOST suspicious that she is experiencing: a. Decompensated shock. b. Septic shock. c. Pump failure. d. A local infection.
b. Septic shock.
A nasopharyngeal airway is inserted: a. Into the larger nostril with the tip pointing away from the septum. b. With the bevel facing the septum if inserted into the right nare. c. With the bevel pointing downward if inserted into the left nare. d. Into the smaller nostril with the tip following the roof of the nose.
b. With the bevel facing the septum if inserted into the right nare.
One of the primary waste products of normal cellular metabolism that must be removed from the body by the lungs is: a. Carbon monoxide. b. Pyruvic acid. c. Carbon dioxide. d. Lactic acid.
c. Carbon dioxide.
The jaw-thrust maneuver is used to open the airway of patients with suspected: a. Mandibular fractures. b. Upper airway swelling. c. Cervical spine injuries. d. Copious oral secretions.
c. Cervical spine injuries.
Cardiogenic shock may result from all of the following, EXCEPT: a. Heart attack b. Increased afterload c. Increased preload d. Poor contractility
c. Increased preload
Patients develop septic shock secondary to: a. Weak vessel tone due to nervous system damage. b. Failure of the blood vessels to adequately dilate. c. Poor vessel function and severe volume loss. d. An infection that weakens cardiac contractions.
c. Poor vessel function and severe volume loss.
Temporary, widespread vasodilation and syncope caused by a sudden nervous system reaction MOST accurately describes: a. Vasovagal shock b. Neurogenic shock c. Psychogenic shock d. Neurologic shock
c. Psychogenic shock
which of the following injury would most likely cause obstructive shock? A) liver laceration B)simple pneumothorax C)cardiac tamponade D)spinal cord injury
cardiac tamponade
a 56-year old male is found semiconscious by his wife. Your assessment reveals that his respirations are rapid and shallow, his pulse is rapid and irregular, and his blood pressure is low. The patients wife states the he complained of left arm pain and nausea the day before, but would not allow her to call 9-1-1. the most likely cause of this patients present condition is A)acute myocardial infraction B)cardiogenic hypoperfusion C)severe septic hypoperfusion D)a ruptured aorta aneurysm
cardiogenic hypoperfusion
Intrapulmonary shunting occurs when: a. Any impairment in circulatory function causes a reduced ability for oxygen and carbon dioxide to diffuse across the alveolar-capillary membrane. b. A decrease in respiratory rate and depth causes carbon dioxide accumulation in the alveoli and an overall decrease in blood oxygen levels. c. The presence of pulmonary surfactant causes a decrease in alveolar surface tension, thus impairing the exchange of gases in the lungs. d. Blood coming from the right side of the heart bypasses nonfunctional alveoli and returns to the left side of the heart in an unoxygenated state.
d. Blood coming from the right side of the heart bypasses nonfunctional alveoli and returns to the left side of the heart in an unoxygenated state.
In an acute injury setting, neurogenic shock is commonly accompanied by: a. Tachycardia. b. Hypovolemia. c. Diaphoresis. d. Hypothermia.
d. Hypothermia.
Which of the following statements regarding oxygenation and ventilation is correct? a. Oxygenation without adequate ventilation can occur in climbers who quickly ascend to an altitude of lower atmospheric pressure. b. Oxygenation is the movement of air into and out of the lungs, whereas ventilation is the exchange of gases. c. In carbon monoxide (CO) poisoning, ventilation is impaired because CO binds to oxygen very quickly. d. In mines or confined places, where oxygen levels are low, ventilation may continue despite adequate oxygenation.
d. In mines or confined places, where oxygen levels are low, ventilation may continue despite adequate oxygenation.
Which of the following would MOST likely result in hemorrhagic shock? a. Excessive sweating b. Repeated diarrhea c. Severe vomiting d. Liver laceration
d. Liver laceration
You are ventilating a patient with a stoma; however, air is escaping from the mouth and nose. To prevent this, you should: a. Thoroughly suction the stoma. b. Ventilate with less pressure. c. Thrust the jaw forward. d. Seal the mouth and nose.
d. Seal the mouth and nose.
Distributive shock occurs when: a. An injury causes restriction of the heart muscle and impairs its pumping function b. Severe bleeding causes tachycardia in order to distribute blood to the organs faster c. Temporary but severe vasodilation causes a decrease in blood supply to the brain d. Widespread dilation of the blood vessels causes blood to pool in the vascular beds
d. Widespread dilation of the blood vessels causes blood to pool in the vascular beds
3)which of the following statements regarding anaphylactic shock is most correct. A)anaphylactic shock occurs immediately after a person is sensitized to an allergen B)sensitized people will experience less severe reactions upon subsequent exposure. C)anaphylactic shock is the result of immune system failure due to a toxic exposure. D)each subsequent exposure following sensitization produces a more severe reaction.
each subsequent exposure following sensitization often produces a more severe reaction.
shock is the result of A)hypoperfusion to the cells of the body B)the bodes maintenance of homeostasis C)temporary dysfunction of a major organ D)widespread constriction of the blood vessels
hypoperfusion to the cells of the body
Which of the following clinical signs is unique to anaphylactic shock? Choose one answer. a. hypotension b. wheezing c. pallor d. dizziness
B
Clinical signs of compensated shock include all of the following, EXCEPT: Choose one answer. A. cool and clammy skin. B. rapid, shallow breathing. C. absent peripheral pulses. D. restlessness or anxiety.
C
The partial pressure of oxygen in the alveoli is _______ mm Hg, while the partial pressure of carbon dioxide in the alveoli is _______ mm Hg. a. 90, 50 b. 104, 40 c. 88, 30 d. 70, 28
b. 104, 40
Cardiogenic shock may result from all of the following, EXCEPT: Choose one answer. A. increased preload. B. increased afterload. C. heart attack. D. poor contractility.
...
Neurogenic shock occurs when: Choose one answer. A. failure of the nervous system causes widespread vasodilation. B. there is too much blood to fill a smaller vascular container. C. the spinal cord is severed and causes massive hemorrhaging. D. massive vasoconstriction occurs distal to a spinal cord injury.
...
Patients develop septic shock secondary to: Choose one answer. A. weak vessel tone due to nervous system damage. B. poor vessel function and severe volume loss. C. failure of the blood vessels to adequately dilate. D. an infection that weakens cardiac contractions.
...
When assessing a patient with signs and symptoms of shock, it is MOST important to remember that: Choose one answer. A. irreversible shock often responds well to a prompt blood transfusion. B. blood pressure may be the last measurable factor to change in shock. C. multiple fractures are the most common cause of hypovolemic shock. D. the patient's respirations are deep during the early stages of shock.
...
In infants and children, a capillary refill time (crt) that is greater than___ second(s) is a sign of poor peripheral perfusion a)1 b)2 c)3 d)4
2
A 25-year-old unrestrained female struck the steering wheel with her chest when her car hit a tree while traveling at a high rate of speed. She has signs and symptoms of shock, which you suspect are the result of intrathoracic bleeding. Which of the following interventions will provide this patient with the greatest chance for survival? Choose one answer. A. rapid transport to a trauma center B. full immobilization of her spine C. 100% oxygen administration D. application of the pneumatic antishock garment (PASG)
A
Anaphylaxis is MOST accurately defined as a: Choose one answer. a. extreme allergic reaction that may affect multiple body systems. b. allergic reaction that causes bronchodilation and vasoconstriction. c. severe allergic reaction that typically resolves without treatment. d. moderate allergic reaction that primarily affects the vasculature.
A
Classic signs and symptoms of hypoglycemia include: Choose one answer. a. cool, clammy skin; weakness; tachycardia; and rapid respirations. b. cold, clammy skin; bradycardia; hunger; and deep, rapid respirations. c. warm, dry skin; irritability; bradycardia; and rapid respirations.
A
Hypothermia occurs when the core body temperature falls below: Choose one answer. a. 95°F (35°C). b. 90°F (32°C). c. 88°F (31°C). d. 98°F (37°C).
A
Most patients who die of anaphylaxis do so within the first __________ following exposure. Choose one answer. a. 30 minutes b. 60 minutes c. 90 minutes d. 5 minutes
A
Pale skin in a child indicates that the: Choose one answer. a. blood vessels near the skin are constricted. b. oxygen content in the blood is decreased. c. child is in severe decompensated shock. d. child's core body temperature is elevated.
A
The principal clinical difference between a stroke and hypoglycemia is that patients with hypoglycemia: Choose one answer. a. usually have an altered mental status or decreased level of consciousness. b. do not present with slurred speech or weakness to one side of the body. c. always take oral medications to maintain normal blood glucose levels. d. are typically alert and attempt to communicate with health care providers.
A
When assessing a patient with signs and symptoms of shock, it is MOST important to remember that: A. blood pressure may be the last measurable factor to change in shock. B. the patient's respirations are deep during the early stages of shock. C. irreversible shock often responds well to a prompt blood transfusion. D. multiple fractures are the most common cause of hypovolemic shock.
A
You are transporting a 33-year-old male who was involved in a motor vehicle crash. You have addressed all immediate and potentially life-threatening conditions and have stabilized his condition with the appropriate treatment. With an estimated time of arrival at the hospital of 20 minutes, you should: Choose one answer. A. reassess his condition in 5 minutes. B. take his vital signs in 15 minutes. C. repeat your secondary assessment. D. arrange for an ALS rendezvous.
A
You respond to a residence for a patient with a severe leg injury following an accident with a chainsaw. When you arrive, you find the patient, a 44-year-old male, lying supine in the backyard. He has a partial amputation of his right lower leg that is actively bleeding. The patient is conscious and breathing adequately; however, he is restless and his skin is diaphoretic. You should: Choose one answer. A. apply direct pressure to the wound. B. administer 100% supplemental oxygen. C. assess the rate and quality of his pulse. D. immediately evaluate his airway.
A
A 19-year-old male was stung multiple times by fire ants. He is experiencing obvious signs and symptoms of anaphylactic shock. You administer 100% oxygen and give him epinephrine via subcutaneous injection. Upon reassessment, you determine that his condition has not improved. You should: Choose one answer. A. transport him immediately and provide supportive care while en route. B. repeat the epinephrine injection after consulting with medical control. C. consider that he may actually be experiencing an acute asthma attack. D. request a paramedic unit that is stationed approximately 15 miles away.
B
A 70-year-old female was recently discharged from the hospital following a total hip replacement. Today, she presents with restlessness, tachycardia, and a blood pressure of 100/64 mm Hg. Her skin is warm and moist. You should be MOST suspicious that she is experiencing: A. a local infection. B. septic shock. C. decompensated shock. D. pump failure.
B
A construction worker fell approximately 30 feet. He is semiconscious with rapid, shallow respirations. Further assessment reveals deformity to the thoracic region of his spine. His blood pressure is 70/50 mm Hg, his pulse is 66 beats/min and weak, and his skin is warm and dry. In addition to spinal immobilization and rapid transport, the MOST appropriate treatment for this patient includes: Choose one answer. A) oxygen via nonrebreathing mask, blankets for warmth, and elevation of his head. B) assisted ventilation, thermal management, and elevation of the lower extremities. C) oxygen via nonrebreathing mask, thermal management, and elevation of his legs. D) assisted ventilation, preventing hyperthermia, and elevating his lower extremities.
B
Activated charcoal is given to patients who have ingested certain substances because it: Choose one answer. a. induces vomiting and empties the stomach. b. binds to the substance and prevents absorption. c. is a direct antidote for many toxic substances. d. decreases absorption of poisons into the lungs.
B
Cardiogenic shock may result from all of the following, EXCEPT: Choose one answer. A) increased afterload. B) increased preload. C) heart attack. D) poor contractility
B
Clinical signs of compensated shock include all of the following, EXCEPT: Choose one answer. A. restlessness or anxiety. B. absent peripheral pulses. C. rapid, shallow breathing. D. cool and clammy skin.
B
Pulmonary edema and impaired ventilation occur during: Choose one answer. A. neurogenic shock. B. cardiogenic shock. C. anaphylactic shock. D. septic shock.
B
Temporary, widespread vasodilation and syncope caused by a sudden nervous system reaction MOST accurately describes: Choose one answer. a. vasovagal shock. b. psychogenic shock. c. neurologic shock. d. neurogenic shock.
B
Which of the following MOST accurately describes septic shock? Choose one answer. A. viral infection of the blood vessels, vascular damage, and vasoconstriction B. bacterial damage to the vessel wall, leaking blood vessels, and vasodilation C. widespread vasoconstriction and plasma loss due to a severe viral infection D. bacterial infection of the nervous system with widespread vasodilation
B
Which of the following would MOST likely result in hemorrhagic shock? Choose one answer. a. severe vomiting b. liver laceration c. excessive sweating d. repeated diarrhea
B
which of the following Most accurately describes septic shock? A) bacterial infection of the nervous system with widespread vasodilation B)widespread vasoconstriction and plasma loss due to a severe viral infection. C)bacterial damage to the vessel wall, leaking blood vessels, and vasodilation D) viral infection of the blood vessels, vascular damage, and vasoconstriction
Bacterial damage to the vessel wall, leaking blood vessels, and vasodilation
A 59-year-old male presents with severe vomiting and diarrhea of 3 days' duration. He is confused and diaphoretic, and his radial pulses are absent. His blood pressure is 78/50 mm Hg. After applying 100% supplemental oxygen, you should: Choose one answer. A. allow him to drink plain water. B. obtain a repeat blood pressure in 5 minutes. C. prepare for immediate transport. D. perform a head-to-toe exam.
C
Which of the following injuries would MOST likely cause obstructive shock? Choose one answer. A. liver laceration B. simple pneumothorax C. cardiac tamponade D. spinal cord injury
C
Which of the following patients is in decompensated shock? Choose one answer. A. a 32-year-old male with anxiety and a systolic blood pressure of 110 mm Hg B. a 28-year-old female with pale skin and rapid, shallow respirations C. a 20-year-old female with absent radial pulses and dilated pupils D. a 23-year-old restless male with cool, clammy skin and tachycardia
C
Which of the following would MOST likely result in hemorrhagic shock? Choose one answer. A. repeated diarrhea B. excessive sweating C. liver laceration D. severe vomiting
C
A 56-year-old male is found semiconscious by his wife. Your assessment reveals that his respirations are rapid and shallow, his pulse is rapid and irregular, and his blood pressure is low. The patient's wife states that he complained of left arm pain and nausea the day before, but would not allow her to call 9-1-1. The MOST likely cause of this patient's present condition is: Choose one answer. A. a ruptured aortic aneurysm. B. severe septic hypoperfusion. C. acute myocardial infarction. D. cardiogenic hypoperfusion.
D
All of the following conditions would make you suspect shock, EXCEPT: A. severe infection. B. heart attack. C. anaphylaxis. D. tachycardia.
D
Cardiogenic shock following AMI is caused by: Choose one answer. A. hypovolemia secondary to severe vomiting. B. widespread dilation of the systemic vasculature. C. a profound increase in the patient's heart rate. D. decreased pumping force of the heart muscle.
D
Distributive shock occurs when: A. an injury causes restriction of the heart muscle and impairs its pumping function. B. temporary but severe vasodilation causes a decrease in blood supply to the brain. C. severe bleeding causes tachycardia in order to distribute blood to the organs faster. D. widespread dilation of the blood vessels causes blood to pool in the vascular beds.
D
Following a stab wound to the left anterior chest, a 25-year-old male presents with a decreased level of consciousness and signs of shock. Which of the following additional assessment findings should increase your index of suspicion for a cardiac tamponade? Choose one answer. a. widening pulse pressure b. diminished breath sounds c. a rapid, irregular pulse d. engorged jugular veins
D
Hypovolemic shock occurs when: Choose one answer. a. at least 10% of the patient's blood volume is lost. b. the clotting ability of the blood is enhanced. c. the patient's systolic blood pressure is less than 100 mm Hg. d. the body cannot compensate for rapid blood loss.
D
Neurogenic shock occurs when: Choose one answer. a. massive vasoconstriction occurs distal to a spinal cord injury. b. there is too much blood to fill a smaller vascular container. c. the spinal cord is severed and causes massive hemorrhaging. d. failure of the nervous system causes widespread vasodilation.
D
Shock is the result of: Choose one answer. A. widespread constriction of the blood vessels. B. temporary dysfunction of a major organ. C. the body's maintenance of homeostasis. D. hypoperfusion to the cells of the body.
D
You are dispatched to a residence for a 40-year-old female who fainted. Upon your arrival, the patient is conscious and alert, and states that she is fine. Her husband tells you that she fainted after receiving news that her sister was killed in a car crash. You offer oxygen to the patient, but she refuses to accept it. At this point, your primary concern should be to: A. advise her that she needs to go to the hospital. B. provide emotional support regarding her sister. C. obtain baseline vital signs and a medical history. D. determine if she was injured when she fainted.
D
