Which of the following is not a sign and symptom of shock?

KPSC Staff Nurse - 2017

Medical & Surgical Nursing

Easy

Appeared in: KPSC Staff Nurse - 2017

Explanation

The correct option identifies a pulse that becomes 'slower and stronger,' which is not a characteristic sign of most forms of shock.
In shock, the body attempts to compensate for decreased blood volume or cardiac output by increasing the heart rate (tachycardia).
The pulse is typically rapid and weak (thready) due to low stroke volume and peripheral vasoconstriction, which is the opposite of a slow, strong pulse.

Option A: Thirst is a common symptom of shock, particularly hypovolemic shock, as the body signals the need to replenish lost fluid volume.
Option B: Blurring of vision, fainting, and giddiness are all neurological signs caused by decreased cerebral perfusion (insufficient blood flow to the brain), a central feature of shock.
Option C: A pale face and lips (pallor) result from the body shunting blood away from the periphery to vital organs. Restlessness and eventual unconsciousness are due to cerebral hypoxia (lack of oxygen to the brain). These are classic signs of progressing shock.

Clinical Relevance

Nursing practice connection: Prioritize focused assessment, early escalation, and real-time monitoring when managing Identification of the signs and symptoms of shock in acute care settings.
Early recognition of shock is a critical nursing responsibility. Monitoring vital signs, level of consciousness, and skin perfusion can alert the nurse to a patient's deteriorating condition, allowing for prompt intervention.
A key nursing action for a patient in shock is to establish intravenous access for fluid resuscitation and medication administration, maintain airway, and apply oxygen.
What if the patient had a spinal cord injury? In neurogenic shock, a specific type of distributive shock, the patient might present with bradycardia (a slow pulse) and hypotension due to the loss of sympathetic nervous system tone. This is an exception to the typical tachycardia seen in other shock types.

How to Approach the Question

First, carefully read the question and identify the negative keyword 'not'. This tells you that three of the options are correct signs of shock, and one is incorrect.
Recall the basic pathophysiology of shock: it is a state of inadequate tissue perfusion.
Think about the body's compensatory mechanisms. To improve perfusion, the heart rate increases, and blood is shunted from non-vital to vital organs.
Evaluate each option based on this understanding. Does it fit the picture of a body trying to compensate for low perfusion?
Option A (thirst), B (dizziness), and C (pallor, restlessness) are all consistent with shock.
Option D (slower, stronger pulse) contradicts the expected compensatory tachycardia and weak pulse. Therefore, this is the correct answer.

Concept Tested & Keywords

Concept Tested: Identification of the signs and symptoms of shock.
Stem keywords: shock, sign, symptom
Lead-in keywords: not
Negative lead-in flag: This is a negative-lead question, asking you to identify the option that is NOT a sign of shock.

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