6 free EMT practice questions: Shock (All Types) & Hemorrhage Control

The patient is recovering; the drop in systolic pressure means the heart rate is normalizing: The heart rate does slow down as a patient truly recovers from shock. Nothing in this question shows the heart rate slowing. The lower blood pressure and the new confusion mean perfusion is getting worse, not better.

The patient is developing hypertension and will improve shortly: Hypertension means a high blood pressure. This patient's blood pressure is 88/50, which is low.

The patient's condition is stable and no change in care is needed: A stable patient has the same vital signs and mental status on each check. This patient's systolic pressure fell from normal to 88, and the patient became confused. Both changes call for more care right away, not routine transport.

The patient's condition is stable because the blood pressure has not significantly changed: A blood pressure that barely changed can look like stability. In shock, the skin goes pale, cool, and clammy before the blood pressure ever moves. This patient's new pallor, cool and clammy skin, and rising heart rate are the early warning signs.

The vital signs show only minor changes and do not warrant urgent intervention: Small changes in the vital signs can be minor when nothing else moves. The blood pressure only went from 134/82 to 128/80, and that change is small. The skin went from warm and dry to cool and clammy, and the heart rate climbed from 98 to 118. That trend is the pattern you see before a patient decompensates, and it needs action now.

The patient's heart rate increase is a normal response to chest pain anxiety and does not indicate shock: Anxiety from chest pain can raise the heart rate. Anxiety alone does not explain skin that turned pale, cool, and clammy over the same 5 minutes. The skin change and the rising heart rate together point to worsening perfusion.

Cardiogenic shock: gives a low pressure and a fast pulse from a failing pump after a heart attack or from heart failure. The skin turns cool, pale, and clammy. This patient has warm, flushed skin and a fever of 102.8°F. Warm skin with a fever points to dilated vessels from an infection, not a failing pump.

Neurogenic shock: follows a spinal cord injury. The nerves that hold vessel tone stop working below the injury. Neurogenic shock gives you a low pressure with warm, dry, pink skin and a normal or slow pulse. This patient's pulse is 118, and nothing points to a spinal cord injury.

Hypoglycemia: causes an altered mental status with pale, cool, sweaty skin. No blood sugar is given in this question. The fever of 102.8°F and the warm, flushed skin point to an infection, not low blood sugar.

The reaction is strongest on the first exposure to the allergen: This has the pattern backward. A first exposure to an allergen typically produces little or no reaction; the severe reactions build with repeated exposure, not on exposure one.

The severity of the reaction depends only on the dose: Dose matters, but it doesn't explain why the same or a smaller dose can produce a mild reaction one time and a severe one the next; the difference is sensitization, not amount.

It is a failure of the immune system: Anaphylaxis happens because the immune system is overreacting to a substance it now treats as a threat, not because it has failed or shut down.

Withhold further treatment until the blood pressure improves: His absent radial pulse and pressure of 78/50 already tell you he is in decompensated shock. Withholding treatment until the pressure improves only lets a treatable emergency get worse.

Give the patient sips of water: Sips of water would replace fluid by mouth. This patient is confused, so he cannot reliably protect his own airway. Giving him water by mouth puts him at risk for aspiration. A patient in shock gets nothing by mouth.

Apply ice packs to the skin: Ice packs on the skin are for a patient who is overheated, like a patient in heat stroke. This patient's problem is lost fluid, not heat. Cooling the skin does nothing for the fluid he has lost. A patient in shock needs to stay at a normal body temperature, not get cooled.

Hypovolemic shock: comes from losing blood or fluid, and nothing in this call points to either one. His left arm pain and nausea yesterday point to his heart.

Septic shock: comes with a fever and a source of infection. His history has neither one.

Obstructive shock: comes from a tension pneumothorax, cardiac tamponade, or a large clot in the lungs. He has no injury or history that points to any of those.