Deck 19: Shock

Question 1

One of the most important assessments that the nurse makes is to check urine output.The value that objectively validates minimal acceptable renal perfusion for the average-size person is:

A) 0.5 ml/kg/hr
B) 0.5 ml/lb/hr
C) 1 ml/lb/hr
D) 0.2 ml/kg/hr

Answer 1

0.5 ml/kg/hr

Question 2

A nurse explains to a family member the pathophysiologic characteristic of vasogenic shock,which is:

A) The intravascular compartment fills beyond capacity, allowing fluid to leak out, compressing vital organs.
B) The circulating volume causes excessive constriction of the vessels, causing blood pooling.
C) Widely fluctuating blood pressures stimulate vascular collapse, causing severe alterations in peripheral perfusion.
D) Although the circulating volume is intact, excessive vascular dilation causes drastic drops in the blood pressure.

Answer 2

Although the circulating volume is intact, excessive vascular dilation causes drastic drops in the blood pressure.

Question 3

The licensed practical/vocational nurse (LPN/LVN),assisting in developing a nursing care plan for a patient in shock,would include the nursing diagnosis of:

A) Increased cardiac output, related to hypertension
B) Increased cardiac output, related to hypotension
C) Decreased cardiac output, related to hypovolemia
D) Decreased cardiac output, related to hypertension

Answer 3

Decreased cardiac output, related to hypovolemia

Question 4

Although several life-supporting systems of the body are involved in the pathophysiologic characteristics of shock,shock itself results from failure of which system?

A) Circulatory
B) Endocrine
C) Neurologic
D) Respiratory

Question 5

The nurse assessing a patient who is in shock is aware that one common sign that the nurse will find,regardless of the cause of the shock,is:

A) Skin is cool and dry with cyanotic nail beds.
B) Skin is cool and moist with cyanotic nail beds.
C) Nail beds are reddened, and the skin is moist and warm.
D) Nail beds are reddened, and the skin is dry and warm.

Question 6

The nurse is administering dopamine to the patient to treat the shock syndrome.The expected action of this drug is as a(n):

A) Alpha-adrenergic agonist
B) Beta-adrenergic agonist
C) Alpha- and beta-adrenergic agonist
D) Inotropic agent

Question 7

The nurse explains that the intraaortic balloon pump (IABP)assists the patient who is in cardiogenic shock to increase cardiac output by:

A) Providing generalized vasoconstriction.
B) Inflating during the diastole phase.
C) Constricting the vena cava.
D) Adding hypertonic fluid to the circulating volume.

Question 8

Because of the falling blood pressure and impaired blood circulation during the refractory stage of shock,the nurse expects that the respirations will be:

A) Rapid and deep
B) Rapid and shallow
C) Slow and deep
D) Slow and shallow

Question 9

The nurse reviews the four types of shock,which are:

A) Multiple organ, cardiogenic, renal, and anaphylactic
B) Cardiogenic, renal, hypovolemic, and septic
C) Renal, hypervolemic, obstructive shock, and neurogenic
D) Hypovolemic, cardiogenic, obstructive shock, and vasogenic

Question 10

The nurse explains that the use of medical antishock trousers (MAST)garment compress the legs and abdomen to:

A) Help restore cellular perfusion.
B) Decrease internal hemorrhage.
C) Cool the patient to create less metabolic demand.
D) Apply pressure during the systole phase and relax pressure during the diastole phase.

Question 11

The nurse caring for a patient who has a cervical spine injury immediately documents and reports the assessment of progressive hypotension as a sign of probable:

A) Anaphylaxis
B) Respiratory alkalosis
C) Multiple organ dysfunction syndrome (MODS)
D) Neurogenic shock

Question 12

While shopping in the mall,the nurse sees a lady suddenly fall to the floor.On immediate assessment,the nurse realizes she is not in cardiac arrest and has no need for cardiopulmonary resuscitation (CPR).The immediate actions by the nurse are to:

A) Check the pulse and respirations, and call for a blood pressure cuff.
B) Check the pulse, respirations, skin color, and temperature.
C) Call for help and check the pulse, respiration, and mental status.
D) Ask someone to help place large blankets or coats under her legs and trunk.

Question 13

The position that would enhance cerebral blood flow to counteract the symptoms of compensatory shock is:

A) Fowler
B) Trendelenburg
C) Gravity neutral
D) Sidelying

Question 14

The stages of shock proceed in a definite sequence.What is the correct order?

A) Progressive, compensatory, refractory
B) Refractory, progressive, compensatory
C) Compensatory, progressive, refractory
D) Distributive, compensatory, refractory

Question 15

When speaking to the family of a 65-year-old Hispanic woman,the nurse will address most conversation to the:

A) 66-year-old husband
B) Entire family, in general
C) 42-year-old daughter (oldest child)
D) 40-year-old son (only son)

Question 16

Nursing interventions to help the patient cope with decreased cardiac output include which one of the following?

A) Dovetailing nursing care tasks allows rest periods for the patient.
B) Maintaining enough cover prevents the patient from shivering.
C) Turning, coughing, deep-breathing, and ambulating the patient every 2 hours reduce the risk of embolism.
D) Administering analgesics cautiously.

Question 17

The nurse is administering heparin,subcutaneous twice daily,for a patient in cardiogenic shock.The expected action of this drug is as a(n):

A) Inotropic to improve cardiac contractibility
B) Anticoagulant to prevent blood clots
C) Antidysrhythmic to restore normal cardiac contractibility
D) Vasopressor to increase blood pressure

Question 18

In treating a person outside of a medical facility,the nurse knows that immediate circulatory support for the vital organs must begin as quickly as possible because,without oxygen,the brain cells will begin to die in how many minutes?

A) 4
B) 6
C) 14
D) 24

Question 19

The nurse assessing a patient in the progressive stage of shock would expect to find:

A) Bounding pulse, decreased respirations, and decreased blood pressure
B) Bounding pulse, shallow respirations, and significantly increased blood pressure
C) Thready pulse and deep respirations with decreased blood pressure
D) Thready pulse and irregular respirations with increased blood pressure

Question 20

The cool,damp skin of patients in compensatory shock is caused by:

A) Constriction of peripheral blood vessels because of the shunting of blood to the vital organs.
B) Action of the antidiuretic hormone released in shock by the adrenal glands.
C) Decreasing levels of arterial carbon dioxide, which are pooling in the arms and legs.
D) Activation of the baroreceptors in the renal arteries.

Question 21

When a family member asks why her father,who is being treated for cardiogenic shock,needs parenteral feeding since he is capable of eating small amounts,the nurse replies that the parenteral feedings:

A) Reduce the risk of constipation.
B) Meet the patient's hypermetabolic needs.
C) Are more convenient and less time consuming .
D) Decrease the hazard of infection.

Question 22

The nurse explains that pericardial tamponade and pulmonary embolus can place the patient at risk for ______________ shock.

Question 23

The nurse explains to a concerned family member about the purpose of some of the interventions for systemic inflammatory response syndrome (SIRS),which is:

A) Applying a MAST garment to promote and conserve body heat.
B) Inserting an IABP to decrease fluid leaking into the extravascular space.
C) Maintaining strict isolation to prevent an overlying bacterial infection.
D) Aggressively treating to support the multiple failing organs.

Question 24

The nurse explains that the minimal acceptable hourly urine output for the patient in shock who weighs 220 pounds is ____________________.

Question 25

The nurse explains that when shock forces the body into anaerobic metabolism,organ damage is caused by a product of that metabolism,which is ____________________.

Question 26

An older Japanese patient in progressive shock lingers on the verge of death.In general,the patient's cultural background dictates that the medical team should:

A) Allow any and all cultural rituals at the bedside.
B) Encourage the family to talk to the patient who can be comforted by their familiar voices.
C) Restrict the ministrations of the folk healer.
D) Suggest that small children not see the patient.

Question 27

In the treatment of the progressive stage of shock,the nurse would anticipate the use of drugs to bring about a(n):

A) Increase in cardiac output
B) Decrease in blood pressure
C) Decrease in urine output
D) Lower temperature

Question 28

In the compensatory stage of shock,the nurse would need to implement actions to care for the patient who is:

A) Irritable and restless
B) Listless and confused
C) Unconscious
D) Anxious and fearful

Question 29

The nurse is aware that immobility and insertion of urinary catheters,although therapeutic,also places the patient at risk for _________________________.