Chap 13

A 25-year-old unrestrained female struck the steering wheel with her chest when her car hit a tree while traveling at a high rate of speed. She has signs and symptoms of shock, which you suspect are the result of intrathoracic bleeding. Which of the following interventions will provide this patient with the greatest chance for survival? Select one: A. Rapid transport to a trauma center B. Full immobilization of her spine C. Intravenous fluid administration D. High-flow oxygen administration

A. Rapid transport to a trauma center

Which of the following clinical signs is unique to anaphylactic shock? A. Wheezing B. Dizziness C. Hypotension D. Pallor

A. Wheezing

Clinical signs of compensated shock include all of the following, EXCEPT: A. absent peripheral pulses. B. cool and clammy skin. C. rapid, shallow breathing. D. restlessness or anxiety.

A. absent peripheral pulses.

A 56-year-old male is found semiconscious by his wife. Your assessment reveals that his respirations are rapid and shallow, his pulse is rapid and irregular, and his blood pressure is low. The patient's wife states that he complained of left arm pain and nausea the day before, but would not allow her to call 9-1-1. The MOST likely cause of this patient's present condition is: Select one: A. acute myocardial infarction. B. dehydration from GI virus. C. a ruptured aortic aneurysm. D. severe septic hypoperfusion.

A. acute myocardial infarction.

A 33-year-old woman presents with a generalized rash, facial swelling, and hypotension approximately 10 minutes after being stung by a hornet. Her BP is 70/50 mm Hg and her heart rate is 120 beats/min. In addition to high-flow oxygen, this patient is in MOST immediate need of: A. epinephrine. B. rapid transport. C. an antihistamine. D. IV fluids.

A. epinephrine.

All of the following are potential causes of impaired tissue perfusion, EXCEPT: A. increased number of red blood cells. B. pump failure. C. low fluid volume. D. poor vessel function.

A. increased number of red blood cells.

Cardiogenic shock may result from all of the following, EXCEPT: Select one: A. increased preload. B. increased afterload. C. heart attack. D. poor contractility.

A. increased preload.

Anaphylactic shock is typically associated with: A. urticaria. B. bradycardia. C. localized welts. D. a severe headache

A. urticaria.

Which of the following statements regarding anaphylactic shock is correct? A. Anaphylactic shock occurs immediately after a person is sensitized to an allergen. B. Subsequent exposure after sensitization often produces a more severe reaction. C. Anaphylactic shock is caused by immune system failure due to a toxic exposure. D. Sensitized people will experience less severe reactions upon subsequent exposure.

B. Subsequent exposure after sensitization often produces a more severe reaction.

When assessing a patient with signs and symptoms of shock, it is important to remember that: Select one: A. the patient's respirations are deep during the early stages of shock. B. blood pressure may be the last measurable factor to change in shock. C. multiple fractures are the most common cause of hypovolemic shock. D. irreversible shock often responds well to a prompt blood transfusion.

B. blood pressure may be the last measurable factor to change in shock.

One of the primary waste products of normal cellular metabolism that must be removed from the body by the lungs is: A. carbon monoxide. B. carbon dioxide. C. pyruvic acid. D. lactic acid.

B. carbon dioxide.

Neurogenic shock occurs when: A. the spinal cord is severed and causes massive hemorrhaging. B. failure of the nervous system causes widespread vasodilation. C. there is too much blood to fill a smaller vascular container. D. massive vasoconstriction occurs distal to a spinal cord injury.

B. failure of the nervous system causes widespread vasodilation.

A 27-year-old male was stabbed in the chest during a disagreement at a poker game. As you approach him, you see that a knife is impaled in his chest. Before you make physical contact with the patient, it is MOST important to: Select one: A. form a general impression. B. follow standard precautions. C. call for an ALS ambulance. D. ask bystanders what happened.

B. follow standard precautions.

A 59-year-old male presents with severe vomiting and diarrhea of 3 days' duration. He is confused and diaphoretic, and his radial pulses are absent. His blood pressure is 78/50 mm Hg. After applying supplemental oxygen, you should: Select one: A. perform a head-to-toe exam. B. prepare for immediate transport. C. obtain a repeat blood pressure in 5 minutes. D. allow him to drink plain water.

B. prepare for immediate transport.

Temporary, widespread vasodilation and syncope caused by a sudden nervous system reaction MOST accurately describes: Select one: A. vasovagal shock. B. psychogenic shock. C. neurologic shock. D. neurogenic shock.

B. psychogenic shock.

You are transporting a 33-year-old male who was involved in a major motor vehicle crash. You have addressed all immediate and potentially life-threatening conditions and have stabilized his condition with the appropriate treatment. With an estimated time of arrival at the hospital of 20 minutes, you should: Select one: A. take his vital signs in 15 minutes. B. reassess his condition in 5 minutes. C. arrange for an ALS rendezvous. D. repeat your secondary assessment.

B. reassess his condition in 5 minutes.

Which of the following would MOST likely result in hemorrhagic shock? A. Severe vomiting B. Excessive sweating C. Liver laceration D. Repeated diarrhea

C. Liver laceration

A 20-year-old male has a large laceration to his wrist. He is holding a blood-soaked towel over the wound, but it continues to bleed rapidly. You should: Select one: A. administer high-flow supplemental oxygen. B. apply pressure to the brachial artery. C. apply a tourniquet proximal to the wrist. D. wrap the towel with pressure bandages.

C. apply a tourniquet proximal to the wrist.

Pulmonary edema and impaired ventilation occur during: A. septic shock. B. anaphylactic shock. C. cardiogenic shock. D. neurogenic shock.

C. cardiogenic shock.

Shock is the result of: A. widespread constriction of the blood vessels. B. the body's maintenance of homeostasis. C. hypoperfusion to the cells of the body. D. temporary dysfunction of a major organ

C. hypoperfusion to the cells of the body.

In an acute injury setting, neurogenic shock is commonly accompanied by: A. hypovolemia. B. tachycardia. C. hypothermia. D. diaphoresis.

C. hypothermia.

Hypovolemic shock caused by severe burns is the result of a loss of: A. platelets. B. whole blood. C. plasma. D. red blood cells.

C. plasma

Patients develop septic shock secondary to: Select one: A. an infection that weakens cardiac contractions. B. weak vessel tone caused by nervous system damage. C. poor vessel function and severe volume loss. D. failure of the blood vessels to adequately dilate.

C. poor vessel function and severe volume loss.

A 70-year-old female was recently discharged from the hospital following a total hip replacement. Today, she presents with restlessness, tachycardia, and a blood pressure of 90/64 mm Hg. Her skin is hot and moist. You should be MOST suspicious that she is experiencing: Select one: A. decompensated shock. B. a local infection. C. septic shock. D. pump failure.

C. septic shock.

Potential causes of cardiogenic shock include all of the following, EXCEPT: A. inadequate heart function. B. disease of muscle tissue. C. severe bacterial infection. D. impaired electrical system.

C. severe bacterial infection.

When treating a trauma patient who is in shock, LOWEST priority should be given to: A. spinal protection. B. thermal management. C. splinting fractures. D. notifying the hospital.

C. splinting fractures.

A patient with neurogenic shock would be LEAST likely to present with: A. tachypnea. B. hypotension. C. tachycardia. D. altered mentation.

C. tachycardia.

Distributive shock occurs when: A. temporary but severe vasodilation causes a decrease in blood supply to the brain. B. severe bleeding causes tachycardia in order to distribute blood to the organs faster. C. widespread dilation of the blood vessels causes blood to pool in the vascular beds. D. an injury causes restriction of the heart muscle and impairs its pumping function.

C. widespread dilation of the blood vessels causes blood to pool in the vascular beds.

Which of the following patients is in decompensated shock? A. A 23-year-old restless male with cool, clammy skin and tachycardia B. A 28-year-old female with pale skin and rapid, shallow respirations C. A 32-year-old male with anxiety and a systolic blood pressure of 110 mm Hg D. A 20-year-old female with absent radial pulses and dilated pupils

D. A 20-year-old female with absent radial pulses and dilated pupils

Which of the following injuries would MOST likely cause obstructive shock? A. Liver laceration B. Simple pneumothorax C. Spinal cord injury D. Cardiac tamponade

D. Cardiac tamponade

Which of the following is the ONLY action that can prevent death from a tension pneumothorax? A. Rapid administration of intravenous fluids B. Positive-pressure ventilation with a bag-valve mask C. Early administration of high-flow oxygen D. Decompression of the injured side of the chest

D. Decompression of the injured side of the chest

You respond to a residence for a patient with a severe leg injury following an accident with a chainsaw. When you arrive, you find the patient, a 44-year-old male, lying supine in the backyard. He has a partial amputation of his right lower leg that is actively bleeding. The patient is conscious and breathing adequately; however, he is restless and his skin is diaphoretic. You should: Select one: A. administer 100% supplemental oxygen. B. immediately evaluate his airway. C. assess the rate and quality of his pulse. D. apply direct pressure to the wound.

D. apply direct pressure to the wound.

A construction worker fell approximately 30 feet. He is semiconscious with rapid, shallow respirations. Further assessment reveals deformity to the thoracic region of his spine. His blood pressure is 70/50 mm Hg, his pulse is 66 beats/min and weak, and his skin is warm and dry. In addition to spinal immobilization and rapid transport, the MOST appropriate treatment for this patient includes: Select one: A. oxygen via nonrebreathing mask, blankets for warmth, and elevation of his head. B. oxygen via nonrebreathing mask, thermal management, and elevation of his legs. C. assisted ventilation, preventing hyperthermia, and elevating his lower extremities. D. assisted ventilation, thermal management, and elevation of the lower extremities.

D. assisted ventilation, thermal management, and elevation of the lower extremities.

Capillary sphincters are: Select one: A. under complete control of the voluntary portion of the nervous system. B. capable of dilating in order to increase perfusion to crucial body organs. C. responsible for constricting to compensate for decreased cell perfusion. D. circular muscular walls that regulate blood flow through the capillaries.

D. circular muscular walls that regulate blood flow through the capillaries.

A 20-year-old man was kicked numerous times in the abdomen during an assault. His abdomen is rigid and tender, his heart rate is 120 beats/min, and his respirations are 30 breaths/min. You should treat this patient for: A. a lacerated liver. B. a ruptured spleen. C. respiratory failure. D. hypovolemic shock.

D. hypovolemic shock.

All of the following conditions should make you suspect shock, EXCEPT: Select one: A. severe infection. B. spinal injury. C. anaphylaxis. D. ischemic stroke.

D. ischemic stroke.

To protect vital organs, the body compensates by directing blood flow away from organs that are more tolerant of low flow, such as: A. the brain. B. the lungs. C. the heart. D. the skin.

D. the skin.