NSC Clinical Knowledge 5 — Questions and Answers
Question 1: A patient is found with altered mental status, cool clammy skin, rapid weak pulse, and low blood pressure. Which type of shock is most likely?
- Neurogenic shock
- Hypovolemic shock (Correct answer)
- Cardiogenic shock
- Obstructive shock
Correct answer: Hypovolemic shock
Cool clammy skin, tachycardia, and hypotension are hallmarks of hypovolemic shock caused by blood or fluid loss.
Question 2: What is the maximum time an AED should be used to analyze rhythm and deliver a shock before resuming CPR?
- No more than 10 seconds (Correct answer)
- No more than 30 seconds
- Up to 2 minutes
- Up to 5 minutes
Correct answer: No more than 10 seconds
Interruptions to chest compressions should be minimized and limited to no more than 10 seconds for AED analysis and shock delivery.
Question 3: When providing care to a victim with a suspected broken femur, what life-threatening complication should you monitor for?
- Air embolism
- Significant internal hemorrhage (Correct answer)
- Spinal cord compression
- Tension pneumothorax
Correct answer: Significant internal hemorrhage
A femur fracture can cause significant internal hemorrhage with up to 1-2 liters of blood loss into the thigh, leading to hypovolemic shock.
Question 4: Which assessment tool uses mnemonic AVPU to evaluate a patient's level of consciousness?
- Alert, Voice, Pain, Unresponsive (Correct answer)
- Airway, Ventilation, Pulse, Unconscious
- Awareness, Vision, Pupil, Unconscious
- Alert, Verbal, Posture, Unresponsive
Correct answer: Alert, Voice, Pain, Unresponsive
AVPU evaluates consciousness as Alert, responsive to Voice, responsive to Pain, or Unresponsive.
Question 5: A patient with suspected carbon monoxide poisoning presents with headache, dizziness, and confusion. What is the priority treatment?
- Administer aspirin and monitor for improvement
- Remove from the environment and give high-flow oxygen (Correct answer)
- Place in the recovery position and call 911
- Induce vomiting to remove ingested toxins
Correct answer: Remove from the environment and give high-flow oxygen
CO poisoning is treated by removing the patient from exposure and administering 100% high-flow oxygen to displace CO from hemoglobin.
Question 6: Which of the following is an early sign of increased intracranial pressure (ICP)?
- Bradycardia with widened pulse pressure (Cushing's triad)
- Altered level of consciousness and severe headache (Correct answer)
- Hypotension and tachycardia
- Bilateral fixed and dilated pupils
Correct answer: Altered level of consciousness and severe headache
Early signs of increased ICP include altered mental status and severe headache before progressing to Cushing's triad and herniation signs.
Question 7: A patient is having a severe asthma attack and is not responding to their rescue inhaler. Which finding indicates the patient's condition is critical?
- Respiratory rate of 24 breaths per minute
- Audible wheezing with each breath
- Silent chest with no breath sounds on auscultation (Correct answer)
- Use of neck muscles during inhalation
Correct answer: Silent chest with no breath sounds on auscultation
A 'silent chest' in a known asthmatic indicates near-complete airway obstruction with no air movement, signaling a life-threatening emergency.
NSC Clinical Knowledge 5
A patient is found with altered mental status, cool clammy skin, rapid weak pulse, and low blood pressure.
Which type of shock is most likely?