Adult Critical Care Specialty (ACCS) Practice Exam

When assessing for shock in a patient, which physiological finding is crucial?

1. Increased urinary output

2. Elevated blood glucose

3. Decreased peripheral pulses

4. Increased body temperature

The correct answer is: Decreased peripheral pulses

In the context of assessing a patient for shock, the crucial physiological finding is decreased peripheral pulses. This is indicative of inadequate perfusion and can be an early sign of shock, as the body prioritizes blood flow to vital organs in response to decreased cardiac output or hypovolemia. As shock progresses, peripheral circulation becomes increasingly compromised, leading to weak or thready pulses in the extremities. The presence of decreased peripheral pulses serves as a key indicator of the severity of shock and guides further assessment and intervention. Recognition of this finding allows for timely intervention, which is critical in preventing multi-organ failure and improving patient outcomes. While the other options may reflect changes that occur in a patient’s physiology, they are not as directly linked to the immediate assessment for shock. For instance, increased urinary output typically indicates good renal perfusion, which is contrary to what would be expected in shock. Elevated blood glucose levels can arise in various stress responses but are not specific to shock assessment. Increased body temperature may indicate infection or inflammation rather than providing a clear assessment of perfusion and circulatory status, which are central to diagnosing shock. Thus, monitoring peripheral pulses is paramount in the evaluation of a patient presenting with signs and symptoms suggestive of shock.