EMT Chapter 10: Shock Quiz

Questions and Answers

A 59-year-old male presents with severe vomiting and diarrhea of 3 days' duration. After applying 100% supplemental oxygen, you should:

Allow him to drink plain water.

Obtain a repeat blood pressure in 5 minutes.

Perform a head-to-toe exam.

Prepare for immediate transport. (correct)

Clinical signs of compensated shock include all of the following, EXCEPT:

Cool and clammy skin.

Restlessness or anxiety.

Absent peripheral pulses. (correct)

Rapid, shallow breathing.

Which of the following clinical signs is unique to anaphylactic shock?

Pallor.

Dizziness.

Hypotension.

Wheezing. (correct)

Activated charcoal is given to patients who have ingested certain substances because it:

Binds to the substance and prevents absorption. Signup and view all the answers

Following a stab wound to the left anterior chest, what additional assessment finding should increase your index of suspicion for a cardiac tamponade?

Engorged jugular veins. Signup and view all the answers

Which of the following MOST accurately describes septic shock?

Bacterial damage to the vessel wall, leaking blood vessels, and vasodilation. Signup and view all the answers

A 19-year-old male was stung multiple times by fire ants. After administering epinephrine, if his condition has not improved, you should:

Repeat the epinephrine injection after consulting with medical control. Signup and view all the answers

You are transporting a 33-year-old male who has stabilized after a crash. With an estimated time of arrival at the hospital of 20 minutes, you should:

Reassess his condition in 5 minutes. Signup and view all the answers

Shock is the result of:

Hypoperfusion to the cells of the body. Signup and view all the answers

Which of the following injuries would MOST likely cause obstructive shock?

Cardiac tamponade. Signup and view all the answers

Which of the following patients is in decompensated shock?

A 20-year-old female with absent radial pulses and dilated pupils. Signup and view all the answers

A 56-year-old male is found semiconscious with rapid breathing and low blood pressure. The MOST likely cause of this patient's condition is:

Cardiogenic hypoperfusion. Signup and view all the answers

A 25-year-old female struck the steering wheel during a vehicle crash. Which intervention will provide her with the greatest chance for survival?

Rapid transport to a trauma center. Signup and view all the answers

Most patients who die of anaphylaxis do so within the first ______ following exposure.

30 minutes Signup and view all the answers

Neurogenic shock occurs when:

Failure of the nervous system causes widespread vasodilation. Signup and view all the answers

Anaphylaxis is MOST accurately defined as a:

Extreme allergic reaction that may affect multiple body systems. Signup and view all the answers

Classic signs and symptoms of hypoglycemia include:

Cool, clammy skin; weakness; tachycardia; and rapid respirations. Signup and view all the answers

The principal clinical difference between a stroke and hypoglycemia is that patients with hypoglycemia:

Usually have an altered mental status or decreased level of consciousness. Signup and view all the answers

Temporary, widespread vasodilation and syncope caused by a sudden nervous system reaction MOST accurately describes:

Psychogenic shock. Signup and view all the answers

Hypovolemic shock occurs when:

The body cannot compensate for rapid blood loss. Signup and view all the answers

Pale skin in a child indicates that the:

Blood vessels near the skin are constricted. Signup and view all the answers

Hypothermia occurs when the core body temperature falls below:

95°F (35°C). Signup and view all the answers

Pulmonary edema and impaired ventilation occur during:

Cardiogenic shock. Signup and view all the answers

Which of the following would MOST likely result in hemorrhagic shock?

Liver laceration. Signup and view all the answers

Cardiogenic shock may result from all of the following, EXCEPT:

Increased preload. Signup and view all the answers

All of the following conditions would make you suspect shock, EXCEPT:

Tachycardia. Signup and view all the answers

A construction worker fell approximately 30 feet and is semiconscious. In addition to spinal immobilization and rapid transport, the MOST appropriate treatment for this patient includes:

Assisted ventilation, thermal management, and elevation of the lower extremities. Signup and view all the answers

Which of the following would MOST likely result in hemorrhagic shock?

Liver laceration. Signup and view all the answers

Clinical signs of compensated shock include all of the following, EXCEPT:

Absent peripheral pulses. Signup and view all the answers

Cardiogenic shock following AMI is caused by:

Decreased pumping force of the heart muscle. Signup and view all the answers

Pulmonary edema and impaired ventilation occur during:

Cardiogenic shock. Signup and view all the answers

Clinical signs of compensated shock include all of the following, EXCEPT:

Absent peripheral pulses Signup and view all the answers

Distributive shock occurs when:

Widespread dilation of the blood vessels causes blood to pool in the vascular beds Signup and view all the answers

Hypovolemic shock caused by severe burns is the result of a loss of:

Plasma Signup and view all the answers

Temporary, widespread vasodilation and syncope caused by a sudden nervous system reaction MOST accurately describes:

Psychogenic shock Signup and view all the answers

Cardiogenic shock may result from all of the following, EXCEPT:

Increased preload Signup and view all the answers

Which of the following clinical signs is unique to anaphylactic shock?

Wheezing Signup and view all the answers

Shock is the result of:

Hypoperfusion to the cells of the body Signup and view all the answers

When perfusion to the core of the body decreases:

Blood is shunted away from the skin Signup and view all the answers

Neurogenic shock occurs when:

Failure of the nervous system causes widespread vasodilation Signup and view all the answers

In an acute setting, neurogenic shock is commonly accompanied by:

Hypothermia Signup and view all the answers

Which intervention provides the greatest chance for survival for a patient with signs and symptoms of shock due to intrathoracic bleeding?

Rapid transport to a trauma center Signup and view all the answers

Which of the following statements regarding oxygenation and ventilation is correct?

In mines or confined places, where oxygen levels are low, ventilation may continue despite adequate oxygenation Signup and view all the answers

The partial pressure of oxygen in the alveoli is _ mm Hg, while the partial pressure of carbon dioxide in the alveoli is _ mm Hg.

104, 40 Signup and view all the answers

A 56-year-old male presents with rapid shallow respirations, rapid irregular pulse, and low blood pressure. What is the MOST likely cause of this patient's condition?

Cardiogenic hypoperfusion Signup and view all the answers

Which patient with signs of shock should be most suspicious for septic shock?

A 70-year-old female with warm moist skin and low blood pressure Signup and view all the answers

You are ventilating a patient with a stoma; however, air is escaping from the mouth and nose. To prevent this, you should:

Seal the mouth and nose Signup and view all the answers

A nasopharyngeal airway is inserted:

With the bevel facing the septum if inserted into the right nare Signup and view all the answers

Which of the following patients should you place in the recovery position?

A 31-year-old semi-conscious male with low blood sugar and adequate breathing Signup and view all the answers

The jaw-thrust maneuver is used to open the airway of patients with suspected:

Cervical spine injuries Signup and view all the answers

The hypoxic drive—the primary stimulus to breathe for patients with certain chronic respiratory diseases—is influenced by:

Low blood oxygen levels Signup and view all the answers

Pulmonary edema and impaired ventilation occur during:

Cardiogenic shock Signup and view all the answers

The nasopharyngeal airway is MOST beneficial because it:

Can maintain a patent airway in a semi-conscious patient with a gag reflex Signup and view all the answers

One of the primary waste products of normal cellular metabolism that must be removed from the body by the lungs is:

Carbon dioxide Signup and view all the answers

In infants and children, a capillary refill time (crt) that is greater than ___ second(s) is a sign of poor peripheral perfusion.

2 Signup and view all the answers

Which of the following most accurately describes septic shock?

Bacterial damage to the vessel wall, leaking blood vessels, and vasodilation Signup and view all the answers

Which of the following statements regarding anaphylactic shock is most correct?

Each subsequent exposure following sensitization often produces a more severe reaction Signup and view all the answers

Shock is the result of:

Hypoperfusion to the cells of the body Signup and view all the answers

Intrapulmonary shunting occurs when:

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 Signup and view all the answers

Which of the following would MOST likely result in hemorrhagic shock?

Liver laceration Signup and view all the answers

You and your partner are caring for a critically injured patient. After repositioning the bag-mask device multiple times, you are unable to effectively ventilate the patient. You should:

Begin ventilations using the mouth-to-mask technique Signup and view all the answers

Patients develop septic shock secondary to:

Poor vessel function and severe volume loss Signup and view all the answers

You are ventilating a patient with a stoma; however, air is escaping from the mouth and nose. To prevent this, you should:

Seal the mouth and nose Signup and view all the answers

Which of the following types of injury would most likely cause obstructive shock?

Cardiac tamponade Signup and view all the answers

Neurogenic shock occurs when:

Failure of the nervous system causes widespread vasodilation Signup and view all the answers

In a construction accident, a worker fell approximately 30 feet and is semiconscious with rapid, shallow respirations. His blood pressure is 70/50 mm Hg and he presents with warm, dry skin. What is the most appropriate treatment?

Assisted ventilation, thermal management, and elevation of the lower extremities Signup and view all the answers

Which of the following patients is in decompensated shock?

A female with absent radial pulses and dilated pupils Signup and view all the answers

You are dispatched to a residence for a 40-year-old female who fainted. What is your primary concern upon arrival?

Determine if she was injured when she fainted Signup and view all the answers

Study Notes

Signs of Shock

Compensated shock includes signs like restlessness, rapid shallow breathing, and cool clammy skin, but does not typically present with absent peripheral pulses.
Unique clinical signs for anaphylactic shock include wheezing.

Types of Shock

Distributive Shock: Caused by widespread dilation of blood vessels leading to blood pooling in vascular beds.
Hypovolemic Shock: Resulting from plasma loss due to severe burns.
Psychogenic Shock: Characterized by temporary widespread vasodilation and syncope from a nervous system reaction.
Cardiogenic Shock: Often occurs due to heart attacks, increased afterload, or poor contractility, not increased preload.
Neurogenic Shock: Occurs due to failure of the nervous system, leading to vasodilation and is often accompanied by hypothermia.

Patient Assessment and Management

Key intervention for a patient in shock due to intrathoracic bleeding is rapid transport to a trauma center.
Direct pressure should be applied to actively bleeding wounds to manage severe trauma.
In cases of stoma ventilation, sealing the mouth and nose during ventilation can enhance efficacy.
Patients exhibiting signs of shock require careful assessment; hypotension may be the last measurable factor to change.

Oxygenation and Ventilation Concepts

Oxygenation refers to the transport of oxygen within the bloodstream, while ventilation is the gas exchange process in the lungs.
Intrapulmonary shunting refers to unoxygenated blood bypassing nonfunctional alveoli.

Conditions Inducing Shock

Septic shock arises from poor vessel function and severe volume loss due to infections.
Hemorrhagic shock can result from severe liver lacerations.
Obstructive shock can stem from conditions like cardiac tamponade.

Special Considerations

The hypoxic drive impacts breathing in patients with chronic respiratory issues, primarily influenced by low blood oxygen levels.
When assessing pediatric patients, a capillary refill time greater than 2 seconds indicates poor peripheral perfusion.

Important Indicators

In patients with shock, absent radial pulses and dilated pupils indicate decompensated shock.
A patient’s condition may be critical if they are semiconscious, exhibiting signs of severe dehydration or infection post-surgery.

Treatment Protocols

For a severely injured patient, oxygen should be administered promptly while considering additional treatments based on assessments.
The jaw-thrust maneuver is critical for maintaining airway in patients suspected of having cervical spine injuries.

Risk Management

Patients with a history of multiple allergic reactions are at increased risk for more severe reactions upon re-exposure to allergens.
Continuous monitoring and supportive care are vital in managing patients with signs of shock, including preparing for rapid transport if necessary.### Bacterial Infection of the Nervous System
Widespread vasodilation is often associated with bacterial infections affecting the nervous system, leading to septic shock.

Anaphylactic Shock

Anaphylactic shock occurs within the first 30 minutes after exposure to allergens.
Classic treatment includes administering epinephrine and providing supportive care during transport.

Shock

Shock results from hypoperfusion to body cells, indicating a systemic failure to maintain blood flow.
Types of shock include obstructive (caused by cardiac tamponade) and neurogenic (caused by nervous system failure leading to vasodilation).

Patient Assessment in Trauma

Reassessing patients every five minutes is critical post-stabilization during transport.
Indicators of shock include cool, clammy skin and altered mental status.

Hypovolemic Shock

Hypovolemic shock occurs when at least 10% of blood volume is lost, leading to critical levels of low blood pressure and insufficient organ perfusion.

Indicators of Shock

Pale skin in children indicates vasoconstriction near the skin due to shock.
Classic signs of hypoglycemia can include cool, clammy skin, weakness, and tachycardia.

Cardiogenic Shock

Cardiogenic shock is significantly influenced by the heart's ability to contract, commonly following an acute myocardial infarction.
Conditions such as increased preload do not directly result in cardiogenic shock.

Neurogenic Shock

Neurogenic shock is characterized by massive vasodilation due to failure of the nervous system.
Patients may present with warm, dry skin and low blood pressure.

Pulmonary Edema

Pulmonary edema and impaired ventilation are notable in cardiogenic shock, affecting respiratory function.

Management of Injuries

Rapid transport to a trauma center is crucial for patients with signs of intrathoracic bleeding.
Thermal management and oxygen delivery are essential during treatment for patients exhibiting signs of shock.

Clinical Signs

Compensated shock can present with signs such as cool, clammy skin and rapid, shallow breathing.
Awareness of irreversible shock is vital; blood pressure may not be the first indicator of deterioration.

Infection and Shock Relations

Septic shock often results from widespread infection leading to systemic vascular changes, negatively impacting blood vessel tone and functionality.

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Test your knowledge on shock and its clinical signs with this flashcard quiz from EMT Chapter 10. Each question focuses on identifying types of shock and their symptoms. Perfect for EMT students preparing for exams!

EMT Chapter 10: Shock Quiz

Questions and Answers

A 59-year-old male presents with severe vomiting and diarrhea of 3 days' duration. After applying 100% supplemental oxygen, you should:

Clinical signs of compensated shock include all of the following, EXCEPT:

Which of the following clinical signs is unique to anaphylactic shock?

Activated charcoal is given to patients who have ingested certain substances because it:

Following a stab wound to the left anterior chest, what additional assessment finding should increase your index of suspicion for a cardiac tamponade?

Which of the following MOST accurately describes septic shock?

A 19-year-old male was stung multiple times by fire ants. After administering epinephrine, if his condition has not improved, you should:

You are transporting a 33-year-old male who has stabilized after a crash. With an estimated time of arrival at the hospital of 20 minutes, you should:

Shock is the result of:

Which of the following injuries would MOST likely cause obstructive shock?

Which of the following patients is in decompensated shock?

A 56-year-old male is found semiconscious with rapid breathing and low blood pressure. The MOST likely cause of this patient's condition is:

A 25-year-old female struck the steering wheel during a vehicle crash. Which intervention will provide her with the greatest chance for survival?

Most patients who die of anaphylaxis do so within the first ______ following exposure.

Neurogenic shock occurs when:

Anaphylaxis is MOST accurately defined as a:

Classic signs and symptoms of hypoglycemia include:

The principal clinical difference between a stroke and hypoglycemia is that patients with hypoglycemia:

Temporary, widespread vasodilation and syncope caused by a sudden nervous system reaction MOST accurately describes:

Hypovolemic shock occurs when:

Pale skin in a child indicates that the:

Hypothermia occurs when the core body temperature falls below:

Pulmonary edema and impaired ventilation occur during:

Which of the following would MOST likely result in hemorrhagic shock?

Cardiogenic shock may result from all of the following, EXCEPT:

All of the following conditions would make you suspect shock, EXCEPT:

A construction worker fell approximately 30 feet and is semiconscious. In addition to spinal immobilization and rapid transport, the MOST appropriate treatment for this patient includes:

Which of the following would MOST likely result in hemorrhagic shock?

Clinical signs of compensated shock include all of the following, EXCEPT:

Cardiogenic shock following AMI is caused by:

Pulmonary edema and impaired ventilation occur during:

Clinical signs of compensated shock include all of the following, EXCEPT:

Distributive shock occurs when:

Hypovolemic shock caused by severe burns is the result of a loss of:

Temporary, widespread vasodilation and syncope caused by a sudden nervous system reaction MOST accurately describes:

Cardiogenic shock may result from all of the following, EXCEPT:

Which of the following clinical signs is unique to anaphylactic shock?

Shock is the result of:

When perfusion to the core of the body decreases:

Neurogenic shock occurs when:

In an acute setting, neurogenic shock is commonly accompanied by:

Which intervention provides the greatest chance for survival for a patient with signs and symptoms of shock due to intrathoracic bleeding?

Which of the following statements regarding oxygenation and ventilation is correct?

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 56-year-old male presents with rapid shallow respirations, rapid irregular pulse, and low blood pressure. What is the MOST likely cause of this patient's condition?

Which patient with signs of shock should be most suspicious for septic shock?

You are ventilating a patient with a stoma; however, air is escaping from the mouth and nose. To prevent this, you should:

A nasopharyngeal airway is inserted:

Which of the following patients should you place in the recovery position?

The jaw-thrust maneuver is used to open the airway of patients with suspected:

The hypoxic drive—the primary stimulus to breathe for patients with certain chronic respiratory diseases—is influenced by:

Pulmonary edema and impaired ventilation occur during:

The nasopharyngeal airway is MOST beneficial because it:

One of the primary waste products of normal cellular metabolism that must be removed from the body by the lungs is:

In infants and children, a capillary refill time (crt) that is greater than ___ second(s) is a sign of poor peripheral perfusion.

Which of the following most accurately describes septic shock?

Which of the following statements regarding anaphylactic shock is most correct?

Shock is the result of:

Intrapulmonary shunting occurs when:

Which of the following would MOST likely result in hemorrhagic shock?

You and your partner are caring for a critically injured patient. After repositioning the bag-mask device multiple times, you are unable to effectively ventilate the patient. You should:

Patients develop septic shock secondary to:

You are ventilating a patient with a stoma; however, air is escaping from the mouth and nose. To prevent this, you should:

Which of the following types of injury would most likely cause obstructive shock?

Neurogenic shock occurs when:

In a construction accident, a worker fell approximately 30 feet and is semiconscious with rapid, shallow respirations. His blood pressure is 70/50 mm Hg and he presents with warm, dry skin. What is the most appropriate treatment?

Which of the following patients is in decompensated shock?

You are dispatched to a residence for a 40-year-old female who fainted. What is your primary concern upon arrival?

Study Notes

Signs of Shock

Types of Shock

Patient Assessment and Management

Oxygenation and Ventilation Concepts

Conditions Inducing Shock

Special Considerations

Important Indicators

Treatment Protocols

Risk Management

The partial pressure of oxygen in the alveoli is _ mm Hg, while the partial pressure of carbon dioxide in the alveoli is _ mm Hg.