Chapter 20 - Pathophysiology
Administration of which of the following therapies would be most appropriate for hypovolemic shock? a. Normal saline b. Vasoconstrictor agents c. Inotropic agents d. 5% dextrose in water
A
The early stage of hypovolemic shock is characterized by a. tachycardia. b. hypotension. c. lactic acidosis. d. cardiac failure.
A
The effect of nitric oxide on systemic arterioles is a. vasodilation. b. vasoconstriction. c. not significant. d. opposed by nitrate drugs.
A
Which of the following causes of shock is not considered to be obstructive? a. Ventricular rupture b. Pulmonary embolus c. Cardiac tamponade d. Tension pneumothorax
A
All forms of shock are associated with inadequate tissue perfusion. True/False
T
Cardiogenic and hypovolemic shock can be differentiated based on differences in cardiac preload. True/False
T
Excessive production of nitric oxide is a contributor to abnormal vasodilation seen in septic shock. True/False
T
In septic shock, a decrease in venous oxygen saturation (SvO2) may indicate an improvement in distribution of blood flow. True/False
T
In the early stages of circulatory shock, the blood pressure may not accurately reflect the impairment in cardiac output. True/False
T
Severe hypovolemic shock occurs when more than 40% of the total blood volume is lost. True/False
T
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
After surgery for a cardiac valve replacement, a patient becomes hypotensive and tachycardic. The heart sounds are muffled, and the central venous pressure and left atrial pressure are elevated and equal. This patient is experiencing _____ shock. a. cardiogenic b. obstructive c. hypovolemic d. distributive
B
Hypotension associated with neurogenic and anaphylactic shock is due to 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, has normal blood pressure when supine, but experiences orthostatic hypotension upon standing? a. Compensated b. Mild c. Moderate d. Severe
B
Low cardiac output in association with high preload is characteristic of _____ shock. a. hypovolemic b. cardiogenic c. anaphylactic d. septic
B
Administration of a pure 〈1-adrenergic agonist medication to a patient in shock would be expected to increase a. cardiac output. b. heart rate. c. blood pressure. d. stroke volume.
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. Septic
C
Sepsis is defined 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 with cold extremities and low cardiac output is not likely to be experiencing _____ 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
Cardiogenic shock is characterized by low cardiac output, low blood pressure, and low cardiac preload. True/False
F
In cardiogenic shock, an increase in oxygen extraction (lower SvO2) indicates an increase in cardiac output. True/False
F
Pulmonary edema is likely to occur when the left atrial or pulmonary capillary occlusion pressure reaches 12 mm Hg. True/False
F
Vasopressor drugs to restore blood pressure are the primary therapy for hypovolemic shock. True/False
F