Decompensated shock is indicated by which finding?

• A. BP drops below 90 systolic
• B. Pulse rate increases
• C. Skin warm and flushed
• D. Respirations slow

Answer: (A)

In shock, the body's ability to maintain adequate perfusion eventually fails. When compensatory mechanisms collapse, blood pressure falls—that's decompensation. A systolic blood pressure dropping below 90 mmHg is the clearest sign that perfusion has deteriorated to the point of decompensation.

While a faster pulse can occur as the body tries to compensate, it isn’t specific to decompensation and can be seen in earlier stages. Skin that is warm and flushed isn’t typical of decompensated shock (the common pattern is cool, clammy skin from peripheral vasoconstriction). Respirations are usually faster rather than slower as metabolic acidosis and hypoxia drive increased breathing rather than a slowdown.