NCLEX-RN practice › Physiological Adaptation
NCLEX question: cardiogenic shock hemodynamics (SATA)
Physiological Adaptation · Select all that apply · Clinical judgment step: Analyze cues
Client record
Hemodynamics
| Parameter | Value | Reference |
|---|---|---|
| Cardiac index (L/min/m²) | 1.7 | 2.5–4.0 |
| PAWP (mm Hg) | 24 | 6–12 |
| SVR (dynes·s/cm⁵) | 1850 | 800–1200 |
| CVP (mm Hg) | 12 | 2–6 |
| MAP (mm Hg) | 58 | 70–105 |
Assessment
- Skin
- cool, mottled knees
- Lungs
- crackles to mid-scapulae
- Urine output
- 15 mL/hr for 3 hours
- Lactate
- 4.6 mmol/L
A client with an anterior myocardial infarction has a pulmonary artery catheter. The nurse reviews the client record. Which findings are consistent with cardiogenic shock? Select all that apply.
- A. Low PAWP with low CVP
- B. High pulmonary artery wedge pressure
- C. High systemic vascular resistance
- D. Urine output of 15 mL/hr
- E. Low cardiac index
- F. Lactate of 4.6 mmol/L
- G. Warm, flushed skin
Show the answer and rationales
Answer: B, C, D, E, F
Cardiogenic shock shows low cardiac output with high filling pressures and high SVR, plus signs of hypoperfusion: oliguria, raised lactate, cool mottled skin and pulmonary congestion.
- A. Incorrect. Low filling pressures indicate hypovolemic shock, not pump failure.
- B. Correct. Elevated PAWP shows left ventricular filling pressure is high because the ventricle cannot empty.
- C. Correct. Vasoconstriction is the body's compensation for low output.
- D. Correct. Oliguria reflects poor renal perfusion.
- E. Correct. A cardiac index below 2.2 shows pump failure, the defining feature of cardiogenic shock.
- F. Correct. Raised lactate signals tissue hypoperfusion and anaerobic metabolism.
- G. Incorrect. Warm skin is seen in early distributive (septic) shock, not cardiogenic shock; this client's skin is cool and mottled.
Scoring: select all that apply items on the Next Generation NCLEX use plus/minus scoring. You gain a point for each correct option you choose and lose a point for each incorrect one, with a minimum of zero. This item is worth 5 points.
Practise more NCLEX questions like this, free →
10 free questions a day, with rationales. Unlimited with a weekly or monthly pass.
More NCLEX practice questions
- NCLEX question: when to start basal insulin as DKA resolves
- NCLEX question: signs of rising intracranial pressure (SATA)
- NCLEX question: rising PaCO2 in an asthma attack
- NCLEX postpartum question: bleeding with a firm uterus
- NCLEX mental health question: suicide safety plan (SATA)
- NCLEX question: postoperative delirium in an older adult
All Physiological Adaptation questions → · NCLEX-RN practice hub →
NCLEX® and NCLEX-RN® are registered trademarks of the National Council of State Boards of Nursing, Inc. (NCSBN). RecallMed is independent and is not affiliated with, or endorsed by, NCSBN or any board of nursing. All questions are original, written and reviewed for exam practice, and do not come from any NCLEX exam. They are not a substitute for your nursing education or clinical guidelines.