A 68-year-old female is found sitting in a recliner, complaining of "crushing" chest pain and extreme weakness. She appears pale, cool, and clammy. You note distended neck veins (JVD) and hear crackles (rales) in the lower lobes of both lungs upon auscultation. Vital Signs: • Heart Rate: 118 bpm, weak and thready • Blood Pressure: 78/52 mmHg • Respirations: 26 breaths/min and labored • SpO_2: 89% on room air Based on this clinical presentation, what is the most likely underlying cause of her hypotension? A) Massive Pulmonary Embolism (Obstructive Shock) B) Left Ventricular Failure (Cardiogenic Shock) C) Systemic Vasodilation (Anaphylactic Shock) D) Internal Hemorrhage (Hypovolemic Shock)

You respond to a 24-year-old male who was stabbed in the left chest. Assessment findings: - Conscious but restless - Respiratory rate: 28/min, labored - SpO₂: 90% on room air - HR: 132 - BP: 86/60 - Jugular veins distended - Trachea slightly deviated to the right - Absent breath sounds on the left What is the MOST likely cause of this patient’s shock? A. Massive hemothorax B. Cardiac tamponade C. Tension pneumothorax D. Neurogenic shock

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