Shock (chapter 20) Part I

In what 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. Class II, Compensated Stage

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. Neurologic

b. Septic

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

c. Anaphylactic

Tachycardia is an early sign of low cardiac output that occurs because of a. Tissue hypoxia b. Anxiety c. Baroreceptor activity d. Acidosis

c. Baroreceptor activity

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

c. Nitric oxide

Cardiogenic shock characterized by a. Hypovolemia b. Reduced systemic vascular resistance c. Reduced cardiac output d. Elevated SvO2

c. Reduced cardiac output

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. Systemic inflammatory response to infection

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. Systemic vascular reistance

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. Antibiotics

Low cardiac output in association with high preload is characteristic of ________ shock. a. Hypovolemic b. Cardiogenic c. Anaphylactic d. Septic

b. Anaphylactic

A patient in septic shock is getting IV fluids but remains hypotensive and the nurse notes third spacing of fluids. What is mechanism behind these observation? a. Capillary leaking of fluids b. Inadequate fluid administration c. Ongoing vasoconstriction d. Destruction of CAM molecules

a. Capillary leaking of fluids

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

Class II hypovolemic shock is characterized by a. Tachycardia b. Hypertension c. Lactic acidosis d. Narrowed pulse pressure

a. Tachycardia

The effect of nitric oxide on systemic arterioles is a. Vasodilation b. Vasocontraction c. Not significant d. Opposed by nitrate drugs

a. Vasodilation

A patient with cold and clammy 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. Septic

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. Septic

The nurse is caring for a patient being treated with an Impella device. What statement by the nurse shows good understanding of tis treatment? a. -It is like an external heart-lung bypass machine b. -It is a tiny device that assists the left ventricle c. -It is a flow-directed catheter to measure pressures d. -It is a new type of Intra-Aortic Balloon Pump

b. It is a tiny device that assists the left ventricle

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. Obstructive

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. Peripheral pooling of blood

Administration of a vasodilator to a patient in shock would be expected to a. Increase vascular resistance b. Increase contractility c. Decrease left ventricular afterload d. Increase tissue perfusion

c. Decrease left ventricular afterload

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. High cardiac output

The nurse is caring for who has acute hemorrhagic shock. The patient's shock index today is 1.08. What does the nurse understand about this value? a. The patient is in critical condition b. The patient has fully recovered c. This value is concerning d. This value doesn't correlate with the patient's condition

c. This value is concerning