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NCLEX RN Exam Bank: Shock, Sepsis, and Multi
Organ Dysfunction Syndrome (MODS)
Table of Contents
Subtopic 1: Early Identification and Classification of Shock States ................................... 2
Subtopic 2: Pathophysiology and Progression of Sepsis and Septic Shock....................... 10
Subtopic 3: Nursing Management of Shock—Monitoring and Interventions ..................... 18
Subtopic 4: Pharmacologic Therapy in Shock and Sepsis Management ........................... 27
Subtopic 5: Pediatric and Geriatric Considerations in Shock and Sepsis ......................... 36
Subtopic 6: Hemodynamic Monitoring and Shock Management Devices (Q101–Q120) .... 44
Subtopic 7: Nursing Monitoring Parameters & Lab Trends in Shock and MODS (Questions
121–140)..................................................................................................................... 53
Subtopic 8: Nursing Management of Septic Shock in Special Populations (Elderly,
Immunocompromised, Post-Surgical) .......................................................................... 62
Subtopic 9: Nutritional and Metabolic Support in Shock and MODS (Questions 161–180) . 69
Subtopic 10: Nutritional Support, Prognosis, and Recovery in Shock and MODS .............. 77
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Subtopic 1: Early Identification and Classification of Shock
States
Question 1
A patient presents with hypotension, cool clammy skin, and confusion after a motor
vehicle accident. Which type of shock is most likely?
A. Hypovolemic shock
B. Cardiogenic shock
C. Neurogenic shock
D. Septic shock
Correct Answer: A. Hypovolemic shock
Rationale: Hypovolemic shock results from blood or fluid loss. Cool skin, confusion, and
hypotension are classic early findings.
Question 2
Which assessment finding differentiates septic shock from other forms of distributive
shock?
A. Warm, flushed skin in early stages
B. Profound bradycardia
C. Increased stroke volume
D. Cool extremities initially
Correct Answer: A. Warm, flushed skin in early stages
Rationale: Septic shock uniquely presents with warm, flushed skin in early stages due to
peripheral vasodilation from inflammatory mediators.
Question 3
, 3
A nurse notes that a patient has a low systemic vascular resistance and high cardiac
output. These findings are consistent with which type of shock?
A. Septic shock
B. Cardiogenic shock
C. Hypovolemic shock
D. Obstructive shock
Correct Answer: A. Septic shock
Rationale: Septic shock is often characterized by vasodilation (low SVR) and initially
increased cardiac output due to compensatory mechanisms.
Question 4
Which patient is most at risk for neurogenic shock?
A. A patient with a high spinal cord injury
B. A patient with pericardial tamponade
C. A patient with a severe burn injury
D. A patient with myocardial infarction
Correct Answer: A. A patient with a high spinal cord injury
Rationale: Neurogenic shock often results from injury above T6 causing sympathetic
nervous system disruption.
Question 5
Which is a hallmark sign of cardiogenic shock?
A. Elevated pulmonary capillary wedge pressure (PCWP)
B. Warm extremities
C. Low central venous pressure
, 4
D. Increased urine output
Correct Answer: A. Elevated pulmonary capillary wedge pressure (PCWP)
Rationale: Cardiogenic shock causes fluid backup due to pump failure, increasing PCWP.
Question 6
What is the earliest indicator of shock in adults?
A. Change in mental status
B. Hypotension
C. Tachypnea
D. Cold extremities
Correct Answer: A. Change in mental status
Rationale: Decreased cerebral perfusion causes early altered LOC, often before vital signs
change significantly.
Question 7
Which of the following findings is not typically seen in hypovolemic shock?
A. Decreased preload
B. Tachycardia
C. Increased urine output
D. Cool, pale skin
Correct Answer: C. Increased urine output
Rationale: Hypovolemia leads to decreased renal perfusion and oliguria, not increased
urine output.
NCLEX RN Exam Bank: Shock, Sepsis, and Multi
Organ Dysfunction Syndrome (MODS)
Table of Contents
Subtopic 1: Early Identification and Classification of Shock States ................................... 2
Subtopic 2: Pathophysiology and Progression of Sepsis and Septic Shock....................... 10
Subtopic 3: Nursing Management of Shock—Monitoring and Interventions ..................... 18
Subtopic 4: Pharmacologic Therapy in Shock and Sepsis Management ........................... 27
Subtopic 5: Pediatric and Geriatric Considerations in Shock and Sepsis ......................... 36
Subtopic 6: Hemodynamic Monitoring and Shock Management Devices (Q101–Q120) .... 44
Subtopic 7: Nursing Monitoring Parameters & Lab Trends in Shock and MODS (Questions
121–140)..................................................................................................................... 53
Subtopic 8: Nursing Management of Septic Shock in Special Populations (Elderly,
Immunocompromised, Post-Surgical) .......................................................................... 62
Subtopic 9: Nutritional and Metabolic Support in Shock and MODS (Questions 161–180) . 69
Subtopic 10: Nutritional Support, Prognosis, and Recovery in Shock and MODS .............. 77
, 2
Subtopic 1: Early Identification and Classification of Shock
States
Question 1
A patient presents with hypotension, cool clammy skin, and confusion after a motor
vehicle accident. Which type of shock is most likely?
A. Hypovolemic shock
B. Cardiogenic shock
C. Neurogenic shock
D. Septic shock
Correct Answer: A. Hypovolemic shock
Rationale: Hypovolemic shock results from blood or fluid loss. Cool skin, confusion, and
hypotension are classic early findings.
Question 2
Which assessment finding differentiates septic shock from other forms of distributive
shock?
A. Warm, flushed skin in early stages
B. Profound bradycardia
C. Increased stroke volume
D. Cool extremities initially
Correct Answer: A. Warm, flushed skin in early stages
Rationale: Septic shock uniquely presents with warm, flushed skin in early stages due to
peripheral vasodilation from inflammatory mediators.
Question 3
, 3
A nurse notes that a patient has a low systemic vascular resistance and high cardiac
output. These findings are consistent with which type of shock?
A. Septic shock
B. Cardiogenic shock
C. Hypovolemic shock
D. Obstructive shock
Correct Answer: A. Septic shock
Rationale: Septic shock is often characterized by vasodilation (low SVR) and initially
increased cardiac output due to compensatory mechanisms.
Question 4
Which patient is most at risk for neurogenic shock?
A. A patient with a high spinal cord injury
B. A patient with pericardial tamponade
C. A patient with a severe burn injury
D. A patient with myocardial infarction
Correct Answer: A. A patient with a high spinal cord injury
Rationale: Neurogenic shock often results from injury above T6 causing sympathetic
nervous system disruption.
Question 5
Which is a hallmark sign of cardiogenic shock?
A. Elevated pulmonary capillary wedge pressure (PCWP)
B. Warm extremities
C. Low central venous pressure
, 4
D. Increased urine output
Correct Answer: A. Elevated pulmonary capillary wedge pressure (PCWP)
Rationale: Cardiogenic shock causes fluid backup due to pump failure, increasing PCWP.
Question 6
What is the earliest indicator of shock in adults?
A. Change in mental status
B. Hypotension
C. Tachypnea
D. Cold extremities
Correct Answer: A. Change in mental status
Rationale: Decreased cerebral perfusion causes early altered LOC, often before vital signs
change significantly.
Question 7
Which of the following findings is not typically seen in hypovolemic shock?
A. Decreased preload
B. Tachycardia
C. Increased urine output
D. Cool, pale skin
Correct Answer: C. Increased urine output
Rationale: Hypovolemia leads to decreased renal perfusion and oliguria, not increased
urine output.
