I'm convinced that sometimes an elk will go into shock with the 1st shot. I've seen it several times. I once put 4 rounds into the chest of a bull. One broke the far shoulder. He just stood there the whole time then slowly laid down. The lungs were just a big pile of jello.
The main symptom of shock is low blood pressure. Other symptoms include rapid, shallow breathing; cold, clammy skin; rapid, weak pulse; dizziness, fainting, or weakness. The elk is rapidly dying but it doesn't show. It will seem to just stand there.