Shock and Resuscitation

Sample questions.

8 free shock and resuscitation questions with answers and explanations. MedRelay's full question bank covers every NREMT domain, plus live scenarios that grade the decision, not just the answer.

1. Question 1

   At a farm driveway, a 71-year-old male trauma patient has weak radial pulses and restlessness after blunt abdominal injury. What should you suspect?

   • A.Minor pain only
   • B.Internal bleedingCorrect
   • C.Simple dehydration
   • D.Anxiety only

   Why:Correct. Restlessness and weak pulses after abdominal trauma suggest shock from internal bleeding.

2. Question 2

   You respond to a 44-year-old male who was in a industrial accident and had a large metal press trap his abdomen and chest for approximately 25 minutes before rescue. He is now free and conscious but his abdomen is massively distended. HR 138, BP 88/56, SpO2 91%. He has no external abdominal wounds. What specific injury pattern occurs when the chest and abdomen are compressed simultaneously under high force?

   • A.Standard blunt trauma — treat with oxygen and transport
   • B.Traumatic diaphragmatic rupture and intra-abdominal organ herniationCorrect
   • C.Aortic injury only — monitor BP and transport
   • D.Bowel injury only

   Why:Correct. Traumatic diaphragmatic rupture from compressive force allows abdominal organs to herniate into the thoracic cavity. This can present with absent or bowel sounds heard in the left chest, respiratory distress, and hemodynamic compromise. High-flow oxygen, Priority 1 surgical transport. Auscultate both chest fields carefully.

3. Question 3

   You respond to a 44-year-old male who was a restrained driver in a frontal collision at moderate speed. He is conscious with GCS 14. HR 118, BP 96/72. He has diffuse left upper quadrant tenderness. No external signs of hemorrhage. His seatbelt sign is visible — a linear bruise across his left upper abdomen from the lap belt. What specific abdominal injury pattern is associated with a seatbelt sign across the upper abdomen?

   • A.Seatbelt signs are cosmetic only
   • B.Seatbelt signs always indicate a broken rib — nothing else
   • C.Seatbelt signs only occur with aortic injuries
   • D.Seatbelt sign across the upper abdomen correlates withCorrect

   Why:Correct. Seatbelt sign abdominal pattern: the compressive force of the lap belt over the abdomen during deceleration causes predictable injuries — splenic/hepatic laceration, mesenteric tear, bowel injury, and the Chance fracture (flexion-distraction lumbar spine fracture from the fulcrum effect). Left UQ seatbelt sign with hemodynamic instability = splenic injury until proven otherwise. Priority 1 trauma center.

4. Question 4

   You respond to a 29-year-old female who is 20 weeks pregnant and is in cardiac arrest. Two bystanders have been performing CPR. You arrive and take over. You note the patient is supine on the floor. Your partner is preparing the AED. What specific CPR modification is required for a pregnant patient at 20 weeks gestation?

   • A.Manual left uterine displacementCorrect
   • B.No modifications are needed — standard CPR is identical
   • C.Use 2-finger compressions to avoid harming the fetus
   • D.Compressions should be performed at a slower

   Why:Correct. Pregnant CPR modification: at 20 weeks gestation manual left uterine displacement (LUD) or 15-30 degree right hip tilt is required to relieve aortocaval compression from the gravid uterus. Aortocaval compression reduces venous return and CPR effectiveness. LUD is performed continuously during compressions by a dedicated rescuer. Standard compression rate, depth, and technique otherwise.

5. Question 5

   You respond to a 19-year-old female who was stung by multiple bees. She has diffuse urticaria, tongue angioedema, and audible stridor. SpO2 is 88%, HR is 158, BP is 68/44. You administer 0.3 mg epinephrine IM. Two minutes later SpO2 has improved to 93%, BP is 88/64, and the stridor has lessened but not resolved. She asks if you should wait to see if the first dose continues to work. What is the correct response?

   • A.Wait 15 minutes — the epinephrine is still working
   • B.The first dose worked well enough
   • C.Wait 10 minutes — it is too soon to judge the first dose
   • D.The first dose produced a partial responseCorrect

   Why:Correct. Second epinephrine dose for incomplete response: ongoing stridor with BP 88/64 and SpO2 93% indicates inadequate response to the first dose. A second 0.3 mg IM dose is indicated at 5-15 minutes for partial or inadequate response. Persistent stridor = ongoing airway risk. Do not wait. ALS urgently for IV epinephrine and fluid support for refractory anaphylaxis.

6. Question 6

   A 19-year-old MVC patient has HR 126, BP 88/60 with no visible injuries and a rigid tender abdomen. Reassessed 8 minutes later: HR 136, BP 80/52. What does this vital sign trend indicate?

   • A.The patient is stabilizing
   • B.Normal variation during transport
   • C.Ongoing hemorrhagic shock decompensationCorrect
   • D.Anxiety is causing the vital sign changes

   Why:Correct. Progressive tachycardia plus declining BP indicates ongoing hemorrhage exceeding compensatory capacity. The rate of deterioration (HR up 10, BP down 8 in 8 minutes) predicts continued deterioration. Pre-notify the trauma center immediately with the vital sign trend and ETA. The OR is the only treatment.

7. Question 7

   A pulseless adult has CPR in progress. The AED says shock advised. What should you do?

   • A.Analyze the rhythm manually
   • B.Check a pulse for one minute
   • C.Clear everyone and shockCorrect
   • D.Remove the pads

   Why:Correct. The AED interprets the rhythm. Clear the patient, deliver the shock, and resume CPR as directed.

8. Question 8

   A stabbing patient has uncontrolled bleeding from the upper arm. Direct pressure is ineffective. What should you do?

   • A.Delay for BP
   • B.Give glucose
   • C.Ask OPQRST
   • D.Apply tourniquetCorrect

   Why:Correct. Life-threatening extremity bleeding that is not controlled by direct pressure requires tourniquet placement.