Adult Critical Care Specialty (ACCS) Practice Exam

When evaluating a patient with a history of alcoholism, which vital sign change most strongly suggests shock?

1. Bradycardia

2. Hypertension

3. Tachycardia

4. Normal BP

The correct answer is: Tachycardia

Tachycardia is a vital sign that strongly suggests shock, especially in a patient with a history of alcoholism. In such cases, the body may respond to hypotension and decreased perfusion by increasing the heart rate as a compensatory mechanism. This tachycardic response is aimed at maintaining adequate cardiac output and ensuring that vital organs remain perfused despite falling blood pressure. In patients with a history of alcoholism, who may have associated health issues such as liver disease or electrolyte imbalances, the presentation of tachycardia can be particularly significant in the context of shock. Shock often leads to reduced blood volume or impaired heart function, triggering the heart to pump faster to maintain circulation. Therefore, the presence of tachycardia indicates that the body is attempting to compensate for a critical condition, thereby making it a key indicator of shock in this clinical scenario. Other vital sign changes, such as bradycardia or hypertension, do not reliably correlate with shock in this context. Bradycardia may indicate other issues, such as increased vagal tone or certain medications, while hypertension is typically not observed in shock states, where blood pressure is often low. A normal blood pressure in the setting of shock can be misleading, as it may occur in