CFRN Shock and Hemodynamic Monitoring 2

Question 1

A patient involved in a high-speed MVC presents with hypotension, bradycardia, and warm flushed skin below the level of injury. Which type of shock should the flight nurse suspect?

Accepted Answer

Neurogenic shock

Answer

Hypovolemic shock

Answer

Septic shock

Answer

Anaphylactic shock

Question 2

A patient receiving a blood transfusion develops sudden hypotension, urticaria, bronchospasm, and angioedema. The flight nurse's priority intervention is:

Accepted Answer

Administer epinephrine 0.3 mg IM to the lateral thigh

Answer

Administer diphenhydramine 50 mg IV

Answer

Increase the IV fluid rate and notify the receiving facility

Answer

Stop the transfusion and administer methylprednisolone

Question 3

Mixed venous oxygen saturation (SvO2) of 55% in a critically ill patient most likely indicates:

Accepted Answer

Inadequate oxygen delivery with increased tissue extraction

Answer

Adequate oxygen delivery with normal tissue extraction

Answer

Increased oxygen delivery exceeding tissue demand

Answer

Left-to-right shunting increasing venous oxygenation

Question 4

A patient with tension pneumothorax is in obstructive shock. Which hemodynamic finding distinguishes obstructive from hypovolemic shock?

Accepted Answer

Elevated jugular venous distension (JVD) and tracheal deviation

Answer

Tachycardia and hypotension

Answer

Cool clammy extremities

Answer

Decreased urine output

Question 5

Serum lactate levels are used in shock assessment primarily because elevated lactate indicates:

Accepted Answer

Anaerobic metabolism from inadequate tissue perfusion

Answer

Hyperglycemia from stress response

Answer

Renal failure with decreased excretion

Answer

Hepatic overproduction during inflammation

Question 6

During flight transport of a hemorrhagic shock patient, which resuscitation strategy is recommended over large-volume crystalloid administration?

Accepted Answer

Permissive hypotension with balanced blood product resuscitation (1:1:1 ratio)

Answer

Hypertonic saline 3% at 250 mL boluses

Answer

Normal saline at 30 mL/kg over 30 minutes

Answer

Colloid-only resuscitation with 5% albumin

Question 7

The base deficit on an arterial blood gas in a trauma patient is -10 mEq/L. This finding correlates with:

Accepted Answer

Severe metabolic acidosis indicating significant tissue hypoperfusion

Answer

Mild metabolic alkalosis from hyperventilation

Answer

Respiratory acidosis from hypoventilation

Answer

Compensated respiratory alkalosis