CCRN Multisystem Trauma and Shock 5

Question 1

Which finding suggests that a trauma patient is progressing from compensated to decompensated shock?

Accepted Answer

Narrowing pulse pressure with falling blood pressure

Answer

A narrowing pulse pressure followed by falling blood pressure signals failing compensation and decompensated shock.

Question 2

A patient with a high thoracic spinal cord injury is at risk for autonomic dysreflexia. Which trigger is most common?

Accepted Answer

Bladder distention

Answer

Bladder distention is the most common noxious stimulus triggering autonomic dysreflexia in high spinal cord injury.

Question 3

Which vasopressor is typically first-line for distributive (septic) shock unresponsive to fluids?

Accepted Answer

Norepinephrine

Answer

Norepinephrine is the first-line vasopressor for septic shock due to its potent vasoconstriction with modest inotropy.

Question 4

A trauma patient develops bilateral diffuse infiltrates, refractory hypoxemia, and a PaO2/FiO2 ratio of 150. Which condition is most likely?

Accepted Answer

Acute respiratory distress syndrome

Answer

ARDS is defined by acute bilateral infiltrates and a PaO2/FiO2 ratio below 300 without cardiac cause.

Question 5

What is the recommended ventilation strategy for a trauma patient with ARDS?

Accepted Answer

Low tidal volume 6 mL/kg of predicted body weight

Answer

Low tidal volume (6 mL/kg PBW) lung-protective ventilation reduces ventilator-induced injury in ARDS.

CCRN Review Practice Test