CFRN Shock and Hemodynamic Monitoring 3

Question 1

Which hemodynamic profile is expected in distributive (septic) shock?

Accepted Answer

High CO, low SVR, normal or low PCWP

Answer

Low CO, high SVR, high PCWP

Answer

Low CO, low SVR, low PCWP

Answer

High CO, high SVR, high PCWP

Question 2

A flight nurse monitoring a patient on a ventilator notices end-tidal CO2 (EtCO2) has dropped from 38 to 20 mmHg without changes in ventilator settings. The most likely explanation is:

Accepted Answer

Significant decrease in cardiac output from worsening shock

Answer

Improving pulmonary compliance reducing dead space ventilation

Answer

Endotracheal tube migration into the right mainstem bronchus

Answer

Metabolic alkalosis from bicarbonate administration

Question 3

Pulse pressure variation (PPV) greater than 13% in a mechanically ventilated patient in shock suggests:

Accepted Answer

Fluid responsiveness indicating preload dependence

Answer

Fluid overload requiring diuresis

Answer

Fixed cardiac output unresponsive to volume

Answer

Ventricular arrhythmia requiring antiarrhythmic therapy

Question 4

In right ventricular (RV) failure causing obstructive shock, which intervention should the flight nurse avoid?

Accepted Answer

Rapidly infusing large volumes of IV crystalloid to improve RV preload

Answer

Administering inhaled nitric oxide to reduce pulmonary vascular resistance

Answer

Using norepinephrine to maintain coronary perfusion pressure

Answer

Optimizing oxygenation and ventilation to reduce hypoxic vasoconstriction

Question 5

A trauma patient in Class IV hemorrhagic shock (>40% blood volume loss) will most likely present with:

Accepted Answer

Heart rate >140 bpm, negligible urine output, and loss of consciousness

Answer

Mildly elevated heart rate with normal blood pressure and anxiety

Answer

Tachycardia with systolic BP 90–100 mmHg and mild confusion

Answer

Normal heart rate with profound hypotension and diaphoresis

Question 6

When titrating vasopressor therapy in a septic shock patient during air transport, the target MAP should be maintained at a minimum of:

Accepted Answer

65 mmHg

Answer

50 mmHg

Answer

55 mmHg

Answer

75 mmHg

Question 7

Lactate clearance of greater than 10% over 2 hours during resuscitation of a shock patient is significant because it indicates:

Accepted Answer

Adequate tissue reperfusion and response to resuscitative efforts

Answer

Worsening anaerobic metabolism requiring escalation of vasopressors

Answer

Development of hepatic failure impairing lactate metabolism

Answer

Iatrogenic alkalosis from excessive bicarbonate administration