Deck 28: Shock and Multiple Organ Dysfunction Syndrome

Question 1

The emergency department nurse is assessing a client in shock. The nurse understands that shock can be caused by which conditions? Select all that apply.

A) Psychological distress
B) Obstruction of blood flow
C) Failure of the heart to pump
D) Inflammatory vascular disease
E) Low blood volume

Answer 1

Obstruction of blood flow
Failure of the heart to pump
Inflammatory vascular disease
Low blood volume

Question 2

The critical care nurse is assessing a client for clinical signs of shock. Which assessment finding does the nurse understand to be a clinical sign of shock?

A) Polydipsia
B) Headache
C) Nausea
D) Cold, clammy skin

Answer 2

Cold, clammy skin

Question 3

The nurse is providing discharge instructions to a client hospitalized with a bacterial infection. Which statement will the nurse include in the education?

A) "An unresolved infection may result in septic shock."
B) "Infections can cause a failure of the heart to pump, resulting in obstructive shock."
C) "Bacterial buildup may cause abnormal redistribution of blood, resulting in hypovolemic shock."
D) "The inflammatory vascular response in infections can lead to cardiogenic shock."

Answer 3

"An unresolved infection may result in septic shock."

Question 4

The nurse is providing care to a client with multiple organ dysfunction syndrome (MODS). What does the nurse understand is occurring in the body's cells as a result?

A) A shift to aerobic metabolism
B) Disruption of the cell cycle, leading to apoptosis
C) Serum level of potassium increases
D) Lactic acid production increases

Question 5

The nurse is caring for a client with early shock. The nurse understands that which mechanism in the body is maintaining the client's blood flow?

A) The kidneys respond to poor perfusion by activating the renin-angiotensin-aldosterone system.
B) Baroreceptors respond to the increase in heart rate by increasing sympathetic outflow to the heart and blood vessels.
C) The body's blood vessels are constricted as a result of parasympathetic stimulation.
D) The cardiovascular center in the brain responds by slowing the pulse and increasing cardiac contractility.

Question 6

The nurse is caring for a client presenting with confusion, angina, and muscular pain. The nurse understands that these findings are consistent with which stage of shock?

A) Refractory shock
B) Progressive shock
C) Reversible shock
D) Compensated shock

Question 7

The emergency department nurse receives a call about an incoming client with hypovolemic shock. The nurse understands that which conditions can result in hypovolemic shock? Select all that apply.

A) Diuresis
B) Severe burns
C) Congestive heart failure
D) Blood loss
E) Constipation

Question 8

The critical care nurse is preparing to admit a client with suspected hypovolemic shock to the intensive care unit. Which laboratory tests does the nurse anticipate to be included in the client's plan of care? Select all that apply.

A) Urinalysis
B) Blood glucose level
C) Thyroid stimulating hormone (TSH)
D) Complete blood count (CBC)
E) Serum lactate concentration

Question 9

The nurse is reviewing the plan of care for a client with hypovolemic shock. Which objectives does the nurse recognize are relevant for this client? Select all that apply.

A) Reducing body temperature
B) Reducing blood pressure
C) Prevent further fluid loss
D) Replace lost fluids
E) Maximize oxygen delivery

Question 10

The nurse is caring for a client with an acute myocardial infarction. The nurse understands that this condition results in cardiogenic shock by which mechanism?

A) Increased coronary perfusion pressure
B) Increased left ventricular pressure
C) Increased myocardial contractility
D) Increased cardiac output

Question 11

The nurse is providing education to a client's family about cardiogenic shock. Which statement should be included in the education?

A) "The heart's imbalanced pH, causes further tissue damage."
B) "Compensatory mechanisms work to preserve the function of the heart."
C) "This condition results in decreased fluid retention in the body."
D) "The body works to shunt blood to major organs."

Question 12

The nurse is preparing to administer a client's medications. Which medications does the nurse recognize are used to treat the client's diagnosis of cardiogenic shock? Select all that apply.

A) Antibiotic therapy
B) Proton pump inhibitor therapy
C) Nitroglycerine therapy
D) Diuretic therapy
E) Thrombolytic therapy

Question 13

The nurse is preparing to admit a client diagnosed with anaphylactic shock. The nurse understands that anaphylactic shock can have which triggers?

A) Drugs
B) Foods
C) Hyperthermia
D) Proteins
E) Inactivity

Question 14

While assessing a client, the nurse notes stridor, tachycardia, edema, and hives. The nurse understands that these findings are consistent with which type of shock?

A) Anaphylactic
B) Hypovolemic
C) Cardiogenic
D) Obstructive

Question 15

The nurse is reviewing medications for a client with anaphylactic shock. Which medication would the nurse anticipate to be included in the client's plan of care? Select all that apply.

A) Beta agonist treatment
B) Diphenhydramine infusion treatment
C) Epinephrine treatment
D) Lorazepam treatment
E) Heparin treatment

Question 16

The nurse is providing education about anaphylaxis to a parent at a well-child visit. Which agents does the nurse include when reviewing common causes of anaphylaxis in children? Select all that apply.

A) Lead-based paint
B) Low grade plastics
C) Nuts
D) Bee stings
E) Pool chemicals

Question 17

The nurse is assisting with a client undergoing a sequential organ failure assessment (SOFA). Which systems will the nurse anticipate being included in the assessment? Select all that apply.

A) Respiratory
B) Gastrointestinal
C) Integumentary
D) Neurological
E) Cardiovascular

Question 18

The nurse is reviewing orders for a client with a diagnosis of septic shock. Which order will the nurse verify with the health care provider before proceeding?

A) 2 Liters per minute of oxygen by nasal cannula
B) Sliding scale subcutaneous insulin
C) Intravenous furosemide
D) Intravenous amoxicillin

Question 19

The nurse is providing education to a client about how the body responds to pulmonary emboli. Which statement will the nurse include in the teaching?

A) "Initially, the body will be able to compensate for this condition."
B) "Hypovolemic shock can occur as a result of this condition."
C) "This condition raises the risk for obstructive shock."
D) "This may result in a form of shock related to brain injury."

Question 20

The nurse is caring for a client with multiple organ dysfunction syndrome (MODS). Which statement about this condition does the nurse know to be true?

A) Three or more organ systems are affected
B) Renal and hepatic function are monitored by urine and stool output
C) Variable clinical presentations occur
D) It is characterized by specific manifestations