Deck 14: Overview of Shock and Sepsis

Question 1

A nurse working in the intensive care unit (ICU) is caring for a patient in the refractory stage of shock. The nurse correlates which clinical manifestations to this stage of shock?
1)A subtle change in heart rate
2)A change from aerobic to anaerobic metabolism
3)The development of hyperglycemia
4)The development of cardiac dysrhythmias

Answer 1

2

Question 2

The nurse is reviewing hemodynamic parameters and notes that the patient has an increased cardiac output. The nurse monitors for which shock disorder based on this finding?
1)Spinal cord injury
2)Pulmonary emboli
3)Severe bacterial infection
4)Severe valvular dysfunction

Answer 2

3

Question 3

The nurse provides care to a patient who is admitted for a myocardial infarction (MI). When planning care for this patient, the nurse includes interventions that address which type of shock?
1)Obstructive
2)Distributive
3)Cardiogenic
4)Hypovolemic

Answer 3

3

Question 4

The nurse is providing care to a patient who is admitted with neurogenic shock. The nurse administers the prescribed atropine with no results. The nurse prepares to initiate which prescription at this time?
1)Low-dose dopamine
2)Transcutaneous pacing
3)Cardiac defibrillation
4)Morphine

Question 5

Care of the patient with sepsis requires close monitoring of oxygenation status. The nurse correlates the SvO₂ value as measurement of which parameter?
1)Arterial oxygenation
2)Oxygen debt
3)Oxygen delivery
4)Venous oxygen consumption

Question 6

The nurse is providing care to a patient who is admitted to the emergency department with clinical manifestations of a myocardial infarction (MI). Which are the primary purposes for the administration of morphine to this patient?
1)Increasing blood pressure and heart rate
2)Preventing extension of damage and increasing venous return
3)Promoting vasodilation and pain relief
4)Reducing blood pressure and increasing urine output

Question 7

In monitoring a trauma patient for shock, the nurse differentiates neurogenic shock from hypovolemia shock by correlating which of the following data to spinal shock?
1)Tachycardia with increased systemic vascular resistance
2)Tachycardia with decreased systemic vascular resistance
3)Bradycardia with decreased systemic vascular resistance
4)Bradycardia with increased systemic vascular resistance

Question 8

The nurse is providing care for a patient receiving treatment for early hypovolemic shock. Which assessment finding indicates that compensatory mechanisms are developing in this patient?
1)Increased heart rate
2)Decreased blood glucose
3)Increased urine output
4)Decreased respiratory rate

Question 9

The nurse recognizes that which disorder increases a patient's risk for distributive shock?
1)Burns
2)Tension pneumothorax
3)Spinal cord injury
4)Valvular disease

Question 10

In providing care to a patient with a pulmonary artery catheter for hemodynamic monitoring, the nurse correlates measurement of central venous pressure to which port?
1)Proximal port
2)Thermistor port
3)Balloon inflation port
4)Distal port

Question 11

The nurse is providing care to a patient admitted to the emergency department (ED) with a gunshot wound and profound blood loss who is hypoxemic. The nurse correlates administration of which ordered fluid as the priority intervention?
1)Normal saline
2)Dextrose in water
3)Packed red blood cells
4)Fresh frozen plasma

Question 12

A patient in the early stages of hypovolemic shock is hyperventilating. The nurse monitors for which acid-base disorder based on this clinical presentation?
1)Respiratory acidosis
2)Respiratory alkalosis
3)Metabolic acidosis
4)Metabolic alkalosis

Question 13

A patient being treated for cardiogenic shock is prescribed a dopamine infusion at 2 mcg/kg per minute. Which outcome does the nurse anticipate?
1)Increased blood pressure
2)Increased heart rate
3)Increased urinary output to at least 30 mL/hour
4)Increased respiratory rate

Question 14

During the initial stage of shock, which clinical manifestation should the nurse monitor for when assessing the patient?
1)Lethargy
2)Hypotension
3)Respiratory alkalosis
4)Hypoxia

Question 15

In providing care to a patient with a pulmonary artery catheter for hemodynamic monitoring, the nurse correlates the pulmonary artery occlusive pressure (PAOP) to which hemodynamic parameter?
1)Right heart preload
2)Pulmonary vascular resistance
3)Left heart preload
4)Systemic vascular resistance

Question 16

The nurse recognizes that which disorder increases the patient's risk for obstructive shock?
1)Dissecting aneurysm
2)Cardiac tamponade
3)Gastrointestinal bleeding
4)Severe heart failure

Question 17

The nurse correlates which arterial blood gas values to the patient in refractory shock?
1)pH 7.55
2)pH 7.48
3)pH 7.35
4)pH 7.30

Question 18

The nurse correlates which hemodynamic parameter to the patient with hypovolemic shock?
1)Increased right atrial pressure
2)Increased central venous pressure
3)Increased systemic vascular resistance
4)Increased missed venous oxygen saturation

Question 19

The nurse monitors for which clinical manifestations in a patient in the progressive stage of shock?
1)Polyuria
2)Absent bowel sounds
3)Severe metabolic alkalosis
4)Full, bounding pulses

Question 20

Which of the following medications is administered to increase cardiac contractility in the patient with cardiogenic shock?
1)Low-dose dopamine
2)Dobutamine
3)Nitroglycerine
4)Atropine

Question 21

The nurse provides care to a patient admitted for the treatment of sepsis whose lactate level is 4.3 mg/dL. The healthcare provider's prescription indicates fluid administration at 30 mL/kg. The patient's current weight is 110 lbs (50 kg). The nurse administers ____________________ mL.

Question 22

Which assessment findings indicate to the nurse that a patient is exhibiting early clinical manifestations of the compensatory stage of shock? Select all that apply.
1)Cool, moist skin
2)Increased bowel sounds
3)Restlessness
4)Decreased blood glucose
5)Increased respiratory rate

Question 23

The nurse recognizes that which medications are indicated in the treatment of a patient with cardiogenic shock? Select all that apply.
1)Vasopressors
2)Morphine sulfate
3)Inotropic medications
4)Diuretics
5)Antibiotics

Question 24

The nurse monitors for which finding in the patient admitted in neurogenic shock?
1)Bradycardia
2)Increased central venous pressure
3)Increased cardiac output
4)Hyperventilation

Question 25

In the patient diagnosed with multiple organ dysfunction syndrome (MODS), the nurse identifies the nursing diagnosis of Ineffective Peripheral Tissue Perfusion as being most relevant. Which assessment provides the most specific data to support this nursing diagnosis?
1)Monitor urine output
2)Assess character of stool
3)Assess temperature
4)Monitor pupil reactions

Question 26

According to the Surviving Sepsis campaign Bundles of Care, which action by the nurse must be implemented within 3 hours for a patient who is admitted for the treatment of sepsis?
1)Monitoring serum lactate levels
2)Reassessing tissue perfusion for persistent hypotension
3)Administering prescribed vasopressors if unresponsive to fluids
4)Administering prescribed antibiotics before obtaining blood cultures

Question 27

The nurse is preparing an educational session on sepsis. Which does the nurse include as a major risk factor for the development of this health problem?
1)Immunosuppression
2)Decreased antibiotic use
3)Fungal infections
4)Leukocytosis on the complete blood count

Question 28

A nurse working in the intensive care unit (ICU) is receiving a patient diagnosed with late septic shock from the emergency department (ED). The nurse correlates which clinical manifestations to this stage of septic shock? Select all that apply.
1)Tachycardia
2)Lethargic mental status
3)Decreased urine output
4)Normal blood pressure
5)Warm and flushed skin

Question 29

A nurse working in the intensive care unit (ICU) is receiving a patient diagnosed with early septic shock from the emergency department (ED). The nurse correlated which clinical manifestations to this stage of septic shock? Select all that apply.
1)Full, bounding pulses
2)Afebrile
3)Warm and flushed skin
4)Confusion
5)Decreased urine output

Question 30

Which hemodynamic parameter indicates that fluid resuscitation in the patient with septic shock is improving?
1)Cardiac output of 3.5 L/min
2)Low central venous pressure
3)Mean arterial pressure of 65 mm Hg
4)Low right atrial pressure