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

Septic/distributive shock causes massive vasodilation (low SVR) and a hyperdynamic state (high CO) due to inflammatory mediators overriding normal vascular tone.

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

A sudden drop in EtCO2 without ventilator changes indicates decreased pulmonary perfusion from reduced cardiac output, making it an early warning of hemodynamic deterioration.

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

PPV >13% in ventilated patients predicts fluid responsiveness, indicating the patient is preload-dependent and likely to improve cardiac output with fluid bolus.

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

Aggressive fluid loading in RV failure can overdistend the already stressed right ventricle, worsening septal shift, impairing LV filling, and precipitating cardiovascular collapse.

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

Class IV hemorrhage is immediately life-threatening, presenting with profound tachycardia, negligible urine output, and altered or lost consciousness from critical hypoperfusion.

CFRN - Certified Flight Registered Nurse Practice Test

CFRN - Certified Flight Registered Nurse Practice Test

CFRN Shock and Hemodynamic Monitoring 3