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

Neurogenic shock from spinal cord injury causes loss of sympathetic tone, resulting in vasodilation (warm skin), hypotension, and paradoxical bradycardia.

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

Epinephrine IM is the first-line treatment for anaphylactic shock, reversing bronchospasm, vasodilation, and angioedema rapidly.

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

Normal SvO2 is 65–75%; a value of 55% reflects tissues extracting more oxygen due to inadequate delivery, signaling low cardiac output or severe hypoxia.

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

Obstructive shock from tension pneumothorax causes elevated venous backpressure leading to JVD and tracheal deviation, absent in pure hypovolemia.

Question 5

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

Accepted Answer

Anaerobic metabolism from inadequate tissue perfusion

Answer

Elevated lactate reflects anaerobic metabolism occurring when tissues are underperfused, making it a key marker of shock severity and resuscitation adequacy.

CFRN - Certified Flight Registered Nurse Practice Test

CFRN - Certified Flight Registered Nurse Practice Test

CFRN Shock and Hemodynamic Monitoring 2