Free BCEN Certified Emergency Nurse (CEN) Practice Question

The correct answer is anaphylaxis. This patient's presentation is consistent with distributive shock, characterized by vasodilation and increased vascular permeability. The warm, flushed skin is a key indicator of vasodilation. While septic shock can present similarly, the rapid onset and combination of hypotension with elevated liver enzymes and thrombocytopenia are more indicative of anaphylaxis, particularly if there's a history of allergen exposure.

Neurogenic shock typically presents with bradycardia due to loss of sympathetic tone, not tachycardia. Cardiogenic shock usually presents with cool, clammy skin due to poor perfusion, unlike the warm skin in this case. Hypovolemic shock from internal bleeding might cause elevated liver enzymes if there's hepatic congestion, but wouldn't typically cause thrombocytopenia this quickly.

It's important to note that shock states can have overlapping features, and a thorough history and physical examination are crucial for accurate diagnosis. In this case, the combination of distributive shock features with specific lab abnormalities points most strongly to anaphylaxis.