Chapter 20: Shock

Administration of which therapy is most appropriate for hypovolemic shock? A. Crystalloids B. Vasoconstrictor agents C. Inotropic agents D. 5% dextrose in water

A

The effect of nitric oxide on systemic arterioles is a. vasodilation. b. vasoconstriction. c. not significant. d. opposed by nitrate drugs.

A

The progressive stage of hypovolemic shock is characterized by a. tachycardia. b. hypertension. c. lactic acidosis. d. cardiac failure.

A

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 B C D

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

B

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

B

Hypotension associated with neurogenic and anaphylactic shock is because of a. hypovolemia. b. peripheral pooling of blood. c. poor cardiac contractility. d. high afterload.

B

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

B

Low cardiac output in association with high preload is characteristic of ________ shock. a. hypovolemic b. cardiogenic c. anaphylactic d. septic

B

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

B C D

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

B C D E

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.

B C D E

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.

B D

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.

C

Cardiogenic shock is characterized by a. hypovolemia. b. reduced systemic vascular resistance. c. reduced cardiac output. d. elevated SvO2.

C

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.

C

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.

C

Massive release of histamine with consequent vasodilation and hypotension occurs with what type of shock? a. Cardiogenic b. Hypovolemic c. Anaphylactic d. Neurogenic

C

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.

C

Tachycardia is an early sign of low cardiac output that occurs because of a. tissue hypoxia. b. anxiety. c. baroreceptor activity. d. acidosis.

C

Tumor necrosis factor and interleukin-1 contribute to shock states because they induce production of a. catecholamines. b. clotting factors. c. nitric oxide. d. vasopressin.

C

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 d. Fast and deep respirations

C E

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

D

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

D

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.

D

Disseminated intravascular coagulation is a serious complication of septic shock characterized by abnormal clot formation in the microvasculature throughout the body. T/F?

T

Lactated Ringer solution and normal saline are commonly used crystalloid solutions that contain electrolytes. T/F?

T

A patient is diagnosed with cardiogenic shock. The patient is hyperventilating and is therefore at risk for the respiratory complication of respiratory acidosis. T/F?

F

A type of shock that includes brain trauma that results in depression of the vasomotor center is cardiogenic. T/F?

F