Chapter 13 Shock

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

A. A 20-year-old female with absent radial pulses and dilated pupils Chapter 13, Page 540

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

A. poor vessel function and severe volume loss. Chapter 13, Page 537

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: A.septic shock. B.pump failure. C.a local infection. D.decompensated shock.

A. septic shock. Chapter 13, Page 537

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 skin. B.the heart. C.the brain. D.the lungs.

A. the skin. Chapter 13, Page 532

In infants and children, a capillary refill time that is greater than ______ second(s) is a sign of poor peripheral perfusion. A.1 B.2 C.3 D.4

B. 2 Chapter 13, Page 540

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

B. Liver laceration Chapter 13, Page 539

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

B. absent peripheral pulses. Chapter 13, Page 540

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.apply pressure to the brachial artery. B.apply a tourniquet proximal to the wrist. C.administer high-flow supplemental oxygen. D.wrap the towel with pressure bandages.

B. apply a tourniquet proximal to the wrist. Chapter 13, Page 543

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: A.immediately evaluate his airway. B.apply direct pressure to the wound. C.assess the rate and quality of his pulse. D.administer 100% supplemental oxygen.

B. apply direct pressure to the wound. Chapter 13, Page 543

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: A.oxygen via nonrebreathing mask, blankets for warmth, and elevation of his head. B.assisted ventilation, thermal management, and elevation of the lower extremities. C.oxygen via nonrebreathing mask, thermal management, and elevation of his legs. D.assisted ventilation, preventing hyperthermia, and elevating his lower extremities.

B. assisted ventilation, thermal management, and elevation of the lower extremities. Chapter 13, Page 548

When assessing a patient with signs and symptoms of shock, it is important to remember that: 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. Chapter 13, Page 540

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

C. Wheezing Chapter 13, Page 538

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

C. increased preload. Chapter 13, Page 534

Hypotension in a child with blunt or penetrating trauma is particularly significant because: A.it typically develops earlier in children than it does in adults. B.the most likely cause of the hypotension is respiratory failure. C.it often indicates the loss of half of his or her blood volume. D.most children with hypotension die in the prehospital setting.

C. it often indicates the loss of half of his or her blood volume. Chapter 13, Page 540

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

C. psychogenic shock. Chapter 13, Page 539

A 19-year-old male was stung multiple times by fire ants. He is experiencing obvious signs and symptoms of anaphylactic shock. You administer high-flow oxygen and give him epinephrine via intramuscular injection. Upon reassessment, you determine that his condition has not improved. You should: A.transport him immediately and provide supportive care while en route. B.consider that he may actually be experiencing an acute asthma attack. C.repeat the epinephrine injection after consulting with medical control. D.request a paramedic unit that is stationed approximately 15 miles away.

C. repeat the epinephrine injection after consulting with medical control. Chapter 13, Page 546

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? A.High-flow oxygen administration B.Full immobilization of her spine C.Intravenous fluid administration D.Rapid transport to a trauma center

D. Rapid transport to a trauma center Chapter 13, Page 546

When treating an 80-year-old patient who is in shock, it is important to remember that: A.compensation from the respiratory system usually manifests with increased tidal volume. B.the older patient's central nervous system usually reacts more briskly to compensate for shock. C.medications older patients take for hypertension often cause an unusually fast heart rate. D.changes in gastric motility may delay gastric emptying, which increases the risk for vomiting.

D. changes in gastric motility may delay gastric emptying, which increases the risk for vomiting. Chapter 13, Page 548

Capillary sphincters are: 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. Chapter 13, Page 533

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: A.perform a head-to-toe exam. B.allow him to drink plain water. C.obtain a repeat blood pressure in 5 minutes. D.prepare for immediate transport.

D. prepare for immediate transport. Chapter 13, Page 546