Shock Quiz: Ace Your Exams

Get ready to dominate your medical and nursing exams by using our dynamic quizzes to elevate your knowledge and increase your confidence. Whether you're gearing up for the USMLE®, COMLEX®, or your next in-class assessment, Osmosis quizzes tackle key topics in pathology, diagnostics, and treatment approaches. By honing in on clinical readiness and decision-making, we make sure the knowledge you gain empowers you both in the classroom and in real-world practice. Jump in and supercharge your exam prep!

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An 87-year-old male is brought to the emergency department with worsening shortness of breath. Per paramedics, the patient was found down at his assisted living facility with increased work of breathing. Yesterday, the patient was in no acute distress but was noted by nursing staff to be acting “more confused” than usual. The patient’s past medical history is notable for coronary artery disease, hypertension, and type II diabetes mellitus. Temperature is 38.9°C (102°F), pulse is 140/min, respirations are 32/min, blood pressure is 79/50 mmHg, and O2 saturation is 89% on room air. On physical exam, the patient is obtunded, ill appearing, and has both suprasternal and intercostal retractions. Laboratory findings are demonstrated below:
A table shows laboratory values for blood gas and lactic acid. pH is 6.99, pCO2 is 20 mmg Hg, pO2 is 60 mm Hg, and lactic acid is 7 mg/dL (normal <2 mg/dL).

This patient is likely to have which of the following additional clinical findings?

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