Deck 20: Shock
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Deck 20: Shock
1
Hypotension associated with neurogenic and anaphylactic shock is because of
A) hypovolemia.
B) peripheral pooling of blood.
C) poor cardiac contractility.
D) high afterload.
A) hypovolemia.
B) peripheral pooling of blood.
C) poor cardiac contractility.
D) high afterload.
peripheral pooling of blood.
2
A patient presenting with fever,hypotension,and lactic acidosis is most likely to be experiencing what type of shock?
A) Cardiogenic
B) Septic
C) Anaphylactic
D) Neurogenic
A) Cardiogenic
B) Septic
C) Anaphylactic
D) Neurogenic
Septic
3
The progressive stage of hypovolemic shock is characterized by
A) tachycardia.
B) hypertension.
C) lactic acidosis.
D) cardiac failure.
A) tachycardia.
B) hypertension.
C) lactic acidosis.
D) cardiac failure.
tachycardia.
4
Administration of which therapy is most appropriate for hypovolemic shock?
A) Crystalloids
B) Vasoconstrictor agents
C) Inotropic agents
D) 5% dextrose in water
A) Crystalloids
B) Vasoconstrictor agents
C) Inotropic agents
D) 5% dextrose in water
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5
Which causes of shock are considered to be obstructive? (Select all that apply.)
A) Ventricular rupture
B) Pulmonary embolus
C) Cardiac tamponade
D) Tension pneumothorax
E) Acute hemorrhage
A) Ventricular rupture
B) Pulmonary embolus
C) Cardiac tamponade
D) Tension pneumothorax
E) Acute hemorrhage
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6
A patient with cold and edematous extremities,low cardiac output,and profound hypotension is likely to be experiencing a progressive stage of ________ shock.
A) cardiogenic
B) hypovolemic
C) obstructive
D) septic
A) cardiogenic
B) hypovolemic
C) obstructive
D) septic
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7
The majority of cases of anaphylactic shock occur when a sensitized individual comes in contact with
A) perfumes.
B) incompatible blood products.
C) animal proteins or dander.
D) antibiotics.
A) perfumes.
B) incompatible blood products.
C) animal proteins or dander.
D) antibiotics.
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8
Tumor necrosis factor a and interleukin-1 contribute to shock states because they induce production of
A) catecholamines.
B) clotting factors.
C) nitric oxide.
D) vasopressin.
A) catecholamines.
B) clotting factors.
C) nitric oxide.
D) vasopressin.
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9
A patient who was involved in a fall from a tree becomes short of breath.The lung sounds are absent on one side.This patient is experiencing ________ shock.
A) cardiogenic
B) obstructive
C) hypovolemic
D) distributive
A) cardiogenic
B) obstructive
C) hypovolemic
D) distributive
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10
Low cardiac output in association with high preload is characteristic of ________ shock.
A) hypovolemic
B) cardiogenic
C) anaphylactic
D) septic
A) hypovolemic
B) cardiogenic
C) anaphylactic
D) septic
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11
Administration of a vasodilator to a patient in shock would be expected to
A) decrease vascular resistance.
B) increase contractility.
C) decrease left ventricular afterload.
D) increase tissue perfusion.
A) decrease vascular resistance.
B) increase contractility.
C) decrease left ventricular afterload.
D) increase tissue perfusion.
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12
Sepsis has been recently redefined as
A) a systemic infection with viable organisms in the bloodstream.
B) a systemic inflammatory response to ischemia.
C) a systemic inflammatory response to infection.
D) severe hypotension in an infected patient.
A) a systemic infection with viable organisms in the bloodstream.
B) a systemic inflammatory response to ischemia.
C) a systemic inflammatory response to infection.
D) severe hypotension in an infected patient.
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13
In which stage of shock is a patient who has lost 1200 mL of blood,who has normal blood pressure when supine,but who experiences orthostatic hypotension upon standing?
A) Class I, Initial Stage
B) Class II, Compensated Stage
C) Class III, Progressive Stage
D) Class IV, Refractory Stage
A) Class I, Initial Stage
B) Class II, Compensated Stage
C) Class III, Progressive Stage
D) Class IV, Refractory Stage
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14
Improvement in a patient with septic shock is indicated by an increase in
A) cardiac output.
B) SvO2.
C) systemic vascular resistance.
D) serum lactate level.
A) cardiac output.
B) SvO2.
C) systemic vascular resistance.
D) serum lactate level.
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15
Overproduction of nitric oxide is an important aspect of the pathophysiologic process of what type of shock?
A) Cardiogenic
B) Hypovolemic
C) Anaphylactic
D) Septic
A) Cardiogenic
B) Hypovolemic
C) Anaphylactic
D) Septic
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16
Massive release of histamine with consequent vasodilation and hypotension occurs with what type of shock?
A) Cardiogenic
B) Hypovolemic
C) Anaphylactic
D) Neurogenic
A) Cardiogenic
B) Hypovolemic
C) Anaphylactic
D) Neurogenic
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17
Cardiogenic shock is characterized by
A) hypovolemia.
B) reduced systemic vascular resistance.
C) reduced cardiac output.
D) elevated SvO₂.
A) hypovolemia.
B) reduced systemic vascular resistance.
C) reduced cardiac output.
D) elevated SvO₂.
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18
Tachycardia is an early sign of low cardiac output that occurs because of
A) tissue hypoxia.
B) anxiety.
C) baroreceptor activity.
D) acidosis.
A) tissue hypoxia.
B) anxiety.
C) baroreceptor activity.
D) acidosis.
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19
In contrast to all other types of shock,the hyperdynamic phase of septic shock is associated with
A) high afterload.
B) low cardiac output.
C) high cardiac output.
D) reduced contractility.
A) high afterload.
B) low cardiac output.
C) high cardiac output.
D) reduced contractility.
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20
The effect of nitric oxide on systemic arterioles is
A) vasodilation.
B) vasoconstriction.
C) not significant.
D) opposed by nitrate drugs.
A) vasodilation.
B) vasoconstriction.
C) not significant.
D) opposed by nitrate drugs.
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21
Positive inotropic drugs work by increasing (Select all that apply.)
A) contractility.
B) cardiac output.
C) tissue perfusion.
D) myocardial oxygen demand.
E) vascular resistance.
A) contractility.
B) cardiac output.
C) tissue perfusion.
D) myocardial oxygen demand.
E) vascular resistance.
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22
Lactated Ringer solution and normal saline are commonly used crystalloid solutions that contain electrolytes.
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23
Disseminated intravascular coagulation is a serious complication of septic shock characterized by abnormal clot formation in the microvasculature throughout the body.
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24
A patient experiencing shock may exhibit which signs and symptoms? (Select all that apply.)
A) Warm, flushed skin
B) Pinpoint pupils
C) Pulse of more than 100 beats/minute
D) Increased urinary output
E) Fast and deep respirations
A) Warm, flushed skin
B) Pinpoint pupils
C) Pulse of more than 100 beats/minute
D) Increased urinary output
E) Fast and deep respirations
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25
The urinary signs and symptoms of acute renal failure associated with the progressive stage of shock are (Select all that apply.)
A) polyuria.
B) oliguria.
C) decreased blood urea nitrogen.
D) increased serum creatinine.
E) tachycardia.
A) polyuria.
B) oliguria.
C) decreased blood urea nitrogen.
D) increased serum creatinine.
E) tachycardia.
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26
A patient is diagnosed with cardiogenic shock.The patient is hyperventilating and is therefore at risk for the respiratory complication of respiratory acidosis.
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27
A type of shock that includes brain trauma that results in depression of the vasomotor center is cardiogenic.
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28
Septic shock is commonly associated with Gram-negative infections and Gram-positive organisms that enter the body through the (Select all that apply.)
A) eyes.
B) genitourinary tract.
C) gastrointestinal tract.
D) respiratory tract.
E) skin.
A) eyes.
B) genitourinary tract.
C) gastrointestinal tract.
D) respiratory tract.
E) skin.
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29
A patient experiences anaphylactic shock.The nurse expects to observe which signs and symptoms in the patient? (Select all that apply.)
A) Stupor
B) Hypotension
C) Urticaria
D) Angioedema
E) Wheezing
A) Stupor
B) Hypotension
C) Urticaria
D) Angioedema
E) Wheezing
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