Chapter 13: Shock Quiz Questions

Which of the following patients is in decompensated shock? Select one: A. A 20-year-old female with absent radial pulses and dilated pupils B. A 23-year-old restless male with cool, clammy skin and tachycardia C. A 28-year-old female with pale skin and rapid, shallow respirations D. A 32-year-old male with anxiety and a systolic blood pressure of 110 mm Hg

A. A 20-year-old female with absent radial pulses and dilated pupils

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: Select one: A. acute myocardial infarction. B. dehydration from GI virus. C. severe septic hypoperfusion. D. a ruptured aortic aneurysm.

A. acute myocardial infarction.

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: Select one: A. determine if she was injured when she fainted. B. provide emotional support regarding her sister. C. advise her that she needs to go to the hospital. D. obtain baseline vital signs and a medical history.

A. determine if she was injured when she fainted.

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 90/64 mm Hg. Her skin is hot and moist. You should be MOST suspicious that she is experiencing: Select one: A. septic shock. B. pump failure. C. a local infection. D. decompensated shock.

A. septic shock.

To protect vital organs, the body compensates by directing blood flow away from organs that are more tolerant of low flow, such as: Select one: A. the skin. B. the heart. C. the brain. D. the lungs.

A. the skin.

In infants and children, a capillary refill time that is greater than ______ second(s) is a sign of poor peripheral perfusion. Select one: A. 1 B. 2 C. 3 D. 4

B. 2

Which of the following injuries would MOST likely cause obstructive shock? Select one: A. Liver laceration B. Cardiac tamponade C. Simple pneumothorax D. Spinal cord injury

B. Cardiac tamponade

A 20-year-old male has a large laceration to his wrist. He is holding a blood-soaked towel over the wound, but it continues to bleed rapidly. You should: Select one: A. apply pressure to the brachial artery. B. apply a tourniquet proximal to the wrist. C. administer high-flow supplemental oxygen. D. wrap the towel with pressure bandages.

B. apply a tourniquet proximal to the wrist.

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: Select one: A. immediately evaluate is airway. B. apply direct pressure to the wound. C. assess the rate and quality of his pulse. D. administer 100% supplemental oxygen.

B. 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 70/50 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: Select one: 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. assisted ventilation, thermal management, and elevation of the lower extremities.

When assessing a patient with signs and symptoms of shock, it is important to remember that: Select one: A. the patient's respirations are deep during the early stages of shock. 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. irreversible shock often responds well to a prompt blood transfusion.

B. blood pressure may be the last measurable factor to change in shock.

One of the primary waste products of normal cellular metabolism that must be removed from the body by the lungs is: Select one: A. lactic acid. B. carbon dioxide. C. pyruvic acid. D. carbon monoxide.

B. carbon dioxide.

Your assessment of an unresponsive patient reveals that her breathing is inadequate.Your MOST immediate action should be to: Select one: A. administer high-flow oxygen. B. check her airway for obstructions. C. move her to the ambulance stretcher. D. ventilate her with a bag-mask device.

B. check her airway for obstructions.

Which of the following MOST accurately describes septic shock? Select one: 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

C. Bacterial damage to the vessel wall, leaking blood vessels, and vasodilation

Which of the following is the ONLY action that can prevent death from a tension pneumothorax? Select one: A. Early administration of high-flow oxygen B. Rapid administration of intravenous fluids C. Decompression of the injured side of the chest D. Positive-pressure ventilation with a bag-valve mask

C. Decompression of the injured side of the chest

Which of the following clinical signs is unique to anaphylactic shock? Select one: A. Pallor B. Dizziness C. Wheezing D. Hypotension

C. Wheezing

Pulmonary edema and impaired ventilation occur during: Select one: A. septic shock. B. neurogenic shock. C. cardiogenic shock. D. anaphylactic shock.

C. cardiogenic shock.

A 27-year-old male was stabbed in the chest during a disagreement at a poker game.As you approach him, you see that a knife is impaled in his chest. Before you make physical contact with the patient, it is MOST important to: Select one: A. form a general impression. B. call for an ALS ambulance. C. follow standard precautions. D. ask bystanders what happened.

C. follow standard precautions.

Cardiogenic shock may result from all of the following, EXCEPT: Select one: A. heart attack. B. increased afterload. C. increased preload. D. poor contractility.

C. increased preload.

Hypotension in a child with blunt or penetrating trauma is particularly significant because: Select one: A. it typically develops earlier in children than it does in adults. B. the most likely cause of the hypotension is respiratory failure. C. it often indicates the loss of half of his or her blood volume. D. most children with hypotension die in the prehospital setting.

C. it often indicates the loss of half of his or her blood volume.

Temporary, widespread vasodilation and syncope caused by a sudden nervous system reaction MOST accurately describes: Select one: A. vasovagal shock. B. neurogenic shock. C. psychogenic shock. D. neurologic shock.

C. psychogenic shock.

You are transporting a 33-year-old male who was involved in a major 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: Select one: A. take his vital signs in 15 minutes. B. arrange for an ALS rendezvous. C. reassess his condition in 5 minutes. D. repeat your secondary assessment.

C. reassess his condition in 5 minutes.

A 19-year-old male was stung multiple times by fire ants. He is experiencing obvious signs and symptoms of anaphylactic shock. You administer high-flow oxygen and give him epinephrine via intramuscular injection. Upon reassessment, you determine that his condition has not improved. You should: Select one: A. transport him immediately and provide supportive care while en route. B. consider that he may actually be experiencing an acute asthma attack. C. repeat the epinephrine injection after consulting with medical control. D. request a paramedic unit that is stationed approximately 15 miles away.

C. repeat the epinephrine injection after consulting with medical control.

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? Select one: A. High-flow oxygen administration B. Full immobilization of her spine C. Intravenous fluid administration D. Rapid transport to a trauma center

D. Rapid transport to a trauma center

Which of the following statements regarding anaphylactic shock is correct? Select one: 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 caused by immune system failure due to a toxic exposure. D. Subsequent exposure after sensitization often produces a more severe reaction.

D. Subsequent exposure after sensitization often produces a more severe reaction.

When treating an 80-year-old patient who is in shock, it is important to remember that: Select one: A. compensation from the respiratory system usually manifests with increased tidal volume. B. the older patient's central nervous system usually reacts more briskly to compensate for shock. C. medications older patients take for hypertension often cause an unusually fast heart rate. D. changes in gastric motility may delay gastric emptying, which increases the risk for vomiting.

D. changes in gastric motility may delay gastric emptying, which increases the risk for vomiting.

Capillary sphincters are: Select one: A. under complete control of the voluntary portion of the nervous system. B. capable of dilating in order to increase perfusion to crucial body organs. C. responsible for constricting to compensate for decreased cell perfusion. D. circular muscular walls that regulate blood flow through the capillaries.

D. circular muscular walls that regulate blood flow through the capillaries.

In an acute injury setting, neurogenic shock is commonly accompanied by: Select one: A. hypovolemia. B. tachycardia. C. diaphoresis. D. hypothermia.

D. hypothermia.

All of the following conditions should make you suspect shock, EXCEPT: Select one: A. anaphylaxis. B. spinal injury. C. severe infection. D. ischemic stroke.

D. ischemic stroke.

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 supplemental oxygen, you should: Select one: A. perform a head-to-toe exam. B. allow him to drink plain water. C. obtain a repeat blood pressure in 5 minutes. D. prepare for immediate transport.

D. prepare for immediate transport.