TCRN TCRN Shock and Resuscitation 4

Question 1

Which class of hemorrhagic shock is characterized by 30-40% blood volume loss, confusion, and systolic BP of 90 mmHg?

Accepted Answer

Class III

Answer

Class III hemorrhage involves 30-40% blood volume loss (1,500-2,000 mL) with confusion, tachycardia, and systolic BP around 90 mmHg.

Question 2

A patient in septic shock requires norepinephrine. Which additional agent is recommended as a second-line vasopressor to reduce norepinephrine dosing?

Accepted Answer

Vasopressin

Answer

Vasopressin (0.03-0.04 units/min) is added as a second-line vasopressor to septic shock management, allowing reduction of norepinephrine dose.

Question 3

During resuscitation of a trauma patient with hemorrhagic shock, which finding indicates successful resuscitation?

Accepted Answer

Lactate clearance of >10% per hour

Answer

Lactate clearance of greater than 10% per hour indicates improved tissue perfusion and is a reliable marker of successful resuscitation.

Question 4

A trauma patient receives 10 units of PRBCs during massive transfusion. Which complication is specifically associated with this volume of transfusion?

Accepted Answer

Transfusion-associated circulatory overload (TACO)

Answer

Massive transfusion increases risk of TACO, characterized by pulmonary edema, hypertension, and respiratory distress from volume overload.

Question 5

Which mechanism causes the 'paradoxical bradycardia' sometimes seen in severe hemorrhagic shock (Bezold-Jarisch reflex)?

Accepted Answer

Vagal stimulation from an empty ventricle causing paradoxical slowing

Answer

The Bezold-Jarisch reflex occurs when a near-empty left ventricle triggers vagal stimulation, paradoxically causing bradycardia in severe hemorrhage.

TCRN Exam Practice Test

TCRN Exam Practice Test

TCRN TCRN Shock and Resuscitation 4