Which of the following lists represents signs of shock?

• A. Hypertension, calm mental status, warm flushed skin.
• B. Hypertension and tachycardia.
• C. Normal perfusion with rapid breathing.
• D. Hypotension, altered mental status, mottled skin, delayed capillary refill, decreased skin turgor, tachypnea, and tachycardia.

Answer: (D)

Shock is a state of inadequate tissue perfusion, so the signs you look for reflect poor blood flow to organs and the body’s compensatory attempts to restore it. The combination of hypotension, altered mental status, mottled skin, delayed capillary refill, decreased skin turgor, tachypnea, and tachycardia fits this pattern. When perfusion drops, the brain can become confused or sleepy; the skin often becomes cool, pale, or mottled as blood is shunted to vital organs; capillary refill slows as peripheral perfusion worsens; skin loses turgor with dehydration; and the body speeds up breathing and heart rate to improve oxygen delivery and circulation. The other options show signs that are not characteristic of shock—for example, high blood pressure with warm flushed skin, or normal perfusion with rapid breathing—so they do not represent shock.