Which of the following is a sign of hemorrhagic shock?

• A. Altered mental status in the absence of brain injury
• B. Cyanosis
• C. Excess thirst
• D. Nausea or vomiting

Answer: (A)

When blood loss drops circulating volume, the body's ability to perfuse organs becomes compromised. The brain is highly sensitive to reduced blood flow, so early cerebral hypoperfusion often manifests as altered mental status—confusion, agitation, or drowsiness—even before other signs become obvious. This makes altered mental status a reliable early indicator of hemorrhagic shock.

Cyanosis isn’t an early or reliable sign of hemorrhagic shock; it reflects severe hypoxemia and tends to appear later when oxygen delivery is critically impaired. Excess thirst points more to dehydration or other conditions and isn’t specific to shock. Nausea or vomiting can occur for many reasons and does not uniquely signal hemorrhagic shock.