TNCC Shock and Fluid Resuscitation 2

Question 1

Which type of shock is characterized by decreased cardiac output due to impaired myocardial contractility following blunt chest trauma?

Accepted Answer

Cardiogenic shock

Answer

Hypovolemic shock

Answer

Distributive shock

Answer

Obstructive shock

Question 2

During massive transfusion protocol, which electrolyte abnormality is most likely to cause cardiac arrest?

Accepted Answer

Hyperkalemia

Answer

Hyponatremia

Answer

Hypocalcemia

Answer

Hypomagnesemia

Question 3

A trauma patient receiving crystalloid resuscitation develops worsening metabolic acidosis. Which crystalloid is LEAST likely to cause hyperchloremic acidosis?

Accepted Answer

Lactated Ringer's solution

Answer

Normal saline (0.9% NaCl)

Answer

Hypertonic saline (3%)

Answer

Half-normal saline (0.45% NaCl)

Question 4

Tranexamic acid (TXA) administration in trauma hemorrhage is most effective when given within what time frame from injury?

Accepted Answer

3 hours

Answer

6 hours

Answer

12 hours

Answer

24 hours

Question 5

Which assessment finding differentiates obstructive shock from hypovolemic shock?

Accepted Answer

Distended neck veins are present in obstructive shock but flat in hypovolemic shock

Answer

Tachycardia is present in obstructive but not hypovolemic shock

Answer

Both present identically and cannot be differentiated clinically

Answer

Hypovolemic shock causes bradycardia while obstructive shock causes tachycardia

Question 6

A trauma patient in hemorrhagic shock has received 4 units of PRBCs and remains hypotensive with a heart rate of 140. The next priority in the massive transfusion protocol is:

Accepted Answer

Continue balanced transfusion with plasma and platelets in a 1:1:1 ratio with PRBCs

Answer

Switch to crystalloid-only resuscitation

Answer

Administer vasopressors as the primary intervention

Answer

Stop all transfusion and obtain a CT scan