PALS Chapter 9: Shock Practice Test 2025

Last Updated on June 28, 2025

Pediatric Advanced Life Support PALS Chapter 9: Shock Practice Test Questions, Answers, Quiz. Shock is defined as a condition in which peripheral tissues and end organs do not receive adequate oxygen and nutrients.

While it is sometimes used interchangeably with severe hypotension, shock does not only occur in the setting of severely low blood pressure. Notably, the body attempts to compensate for shock through various mechanisms, most commonly by increasing heart rate.

HYPOVOLEMIC: Low blood volume, often due to hemorrhage or fluid shifting out of the vasculature
DISTRIBUTIVE: Blood vessel dilation (e.g. septic shock)
CARDIOGENIC: Heart is not pumping adequately
OBSTRUCTIVE: Physical block of the blood flow

PALS Chapter 9: Shock Practice Test

PALS Practice Test
Chapter 9: Shock
Total Items: 20 MCQs
Time Limit: N/A

1 / 20

1) Which clinical sign would you expect in cardiogenic shock but not hypovolemic shock?

A) Crackles in the lungs

B) Cool extremities

C) Hypotension

D) Delayed cap refill

2 / 20

2) What is the primary problem in hypovolemic shock?

A) Widespread vasodilation

B) Heart muscle failure

C) Cardiac tamponade

D) Blood volume loss

3 / 20

3) A child presents with low blood pressure and decreased urine output. Which finding supports the diagnosis of shock?

A) Warm skin

B) Strong distal pulses

C) Alert mental status

D) Delayed capillary refill

4 / 20

4) Which type of shock may result from a severe allergic reaction?

A) Cardiogenic

B) Obstructive

C) Distributive (anaphylactic)

D) Hypovolemic

5 / 20

5) What type of shock typically presents with bounding pulses and wide pulse pressure?

A) Septic shock

B) Hypovolemic shock

C) Cardiogenic shock

D) Obstructive shock

6 / 20

6) What is the main issue in distributive shock?

A) Decreased blood volume

B) Pump failure

C) Abnormal distribution of blood flow due to vasodilation

D) Obstruction to circulation

7 / 20

7) What is the standard fluid bolus amount for treating pediatric shock?

A) 5 mL/kg

B) 20 mL/kg

C) 50 mL/kg

D) 10 mL/kg

8 / 20

8) Which shock type is often associated with elevated central venous pressure and poor heart function?

A) Hypovolemic

B) Neurogenic

C) Distributive

D) Cardiogenic

9 / 20

9) Which of the following is a classic sign of cardiogenic shock in children?

A) Narrow pulse pressure with normal blood pressure

B) Crackles in the lungs and hepatomegaly

C) Bradycardia with bounding pulses

D) Warm extremities

10 / 20

10) Which fluid is recommended for initial shock management in children?

A) Isotonic crystalloid (e.g., normal saline)

B) Dextrose 5%

C) Hypertonic saline

D) Colloid solutions only

11 / 20

11) What distinguishes septic (distributive) shock from hypovolemic shock?

A) Always bradycardia

B) Loss of fluid volume

C) Vasodilation and abnormal distribution of blood flow

D) Low cardiac output

12 / 20

12) Which of the following is a common cause of obstructive shock?

A) Myocarditis

B) Pulmonary embolism

C) Diarrhea

D) Sepsis

13 / 20

13) What type of shock is most commonly caused by severe dehydration or hemorrhage?

A) Obstructive

B) Distributive

C) Hypovolemic

D) Cardiogenic

14 / 20

14) What sign is most specific to hypovolemic shock?

A) Rales on lung exam

B) Wide pulse pressure

C) Bradycardia with strong pulses

D) Rapid improvement with fluid bolus

15 / 20

15) What is a late and ominous sign of pediatric shock?

A) Delayed capillary refill

B) Cool extremities

C) Tachycardia

D) Hypotension

16 / 20

16) What is an early compensatory response to pediatric shock?

A) Hypertension

B) Tachycardia

C) Decreased heart rate

D) Bradycardia

17 / 20

17) A 7-year-old struck by a car presents with hypotension and cool extremities. What is the most likely cause of shock?

A) Obstructive shock

B) Hypovolemic shock

C) Cardiogenic shock

D) Anaphylactic shock

18 / 20

18) What laboratory value might be elevated in prolonged shock?

A) Serum sodium

B) Lactic acid

C) Blood glucose

D) Hemoglobin

19 / 20

19) A child with suspected obstructive shock may have which clinical sign?

A) Low urine output and clear lungs

B) Bounding pulses

C) Widened pulse pressure

D) Muffled heart sounds and distended neck veins

20 / 20

20) What medication might be considered early in cardiogenic shock?

A) Furosemide

B) High-dose fluid bolus

C) Acetaminophen

D) Epinephrine infusion

Your score is

See also:

Free PALS Practice Test 2025 Official Study Guide [PDF]

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