ENA Shock

A patient with an isolated blunt cardiac injury is most at risk for which type of shock? A. Cardiogenic B. Hypovolemic C. Obstructive D. Distributive

A

Distant heart tones may signal which type of shock? A. Obstructive B. Hypovolemic C. Distributive D. Cardiogenic

A

What is the most sensitive sign of early shock in a pediatric patient? A. Delayed capillary refill B. Bradycardia C. Hypotension D. Bradypnea

A

When shock causes cells to switch from aerobic to anaerobic metabolism, which event occurs? A. Digestive organelles leak destructive enzymes into cells, which begin to be autodigested. B. The sodium-potassium pump shifts sodium out of the cells. C. Mitochondrial swelling increases energy production. D. Glucose production decreases.

A

Which finding should you expect in a 70-kg patient with an estimated blood loss of 1,700 mL? A. Anxiety and confusion B. Increased pulse pressure C. Respiratory rate of 20 breaths per minute D. Urine output of 20 mL/hour

A

Which laboratory result is most associated with increased mortality in the patient with shock? A. Elevated serum lactate level B. Low base deficit C. Low pH D. Elevated blood glucose level

A

Which statement accurately characterizes the use of hemodynamic monitoring devices in the management of a patient with shock? A. Central venous pressure monitoring helps measure the effectiveness of shock management. B. Invasive blood pressure monitoring should be used early. C. Pulse oximetry monitoring is an accurate noninvasive measurement in shock. D. Use of arterial lines is discouraged in a patient with shock.

A

A multiple trauma patient with sustained blood loss is mildly anxious. He has a blood pressure of 120/90 mm Hg, a pulse of 110 beats per minute, and a respiratory rate of 22 breaths per minute. Based on these findings, what estimated percentage of blood loss has occurred? A. Up to 15% B. 15% to 30% C. 30% to 40% D. More than 40%

B

In which stage of shock is lactic acid initially produced? A. Uncompensated B. Compensated C. Progressive D. Irreversible

B

Which disorder is a cause of obstructive shock? A. Sepsis B. Pulmonary embolus C. Anaphylaxis D. Spinal cord injury

B

Which intervention is the priority for a patient with septic shock? A. Vasopressor administration B. Crystalloid infusion at 20 mL/kg C. Pericardiocentesis D. Positioning the patient flat with the legs elevated

B

Which statement accurately characterizes fluid resuscitation in a patient with hemorrhagic shock? A. Copious fluid resuscitation should occur early in a patient with penetrating trauma. B. Aggressive fluid resuscitation can cause blood clots to dislodge. C. Fluid and blood product resuscitation should continue until a specific blood pressure target is reached. D. Massive use of blood products decreases the risk of coagulopathies.

B

he increased glucose production triggered by the stress of shock also produces which reaction? A. Proinflammatory mediators are released. B. Insulin resistance occurs. C. Capillary permeability is increased. D. Systemic inflammatory response syndrome is activated.

B

During times of decreased tissue perfusion, the body shunts blood away from which organ? A. Heart B. Brain C. Kidneys D. Lungs

C

If a patient presents with profound hypersensitivity and a systemic antigen-antibody response, what other response should you expect? A. Smooth muscle dilation B. Peripheral vasoconstriction C. Increased capillary permeability D. Increased venous return

C

The increased glucose production triggered by the stress of shock also produces which reaction? A. Proinflammatory mediators are released. B. Insulin resistance occurs. C. Capillary permeability is increased. D. Systemic inflammatory response syndrome is activated.

C

What is the most sensitive sign of early shock in a pediatric patient? A. Delayed capillary refill B. Bradycardia C. Hypotension D. Bradypnea

C

What term is used to indicate the difference between the cellular demand for oxygen and the cellular consumption of available oxygen? A. Oxygen debt B. Oxygen consumption C. Oxygen delivery D. Anaerobic metabolism

C

Which effect occurs in a patient with hypovolemic shock? A. Increased cardiac output B. Increased preload C. Decreased venous return to the heart D. Fluid shifting to the intravascular space

C

Which hemodynamic finding supports the diagnosis of cardiogenic shock? A. Increased cardiac output B. Decreased systemic vascular resistance C. Increased right atrial pressure D. Decreased heart rate

C

Which intervention might you perform initially to manage a patient with obstructive shock? A. Vasopressor administration B. Aggressive fluid resuscitation C. Emergency needle thoracentesis D. Intra-aortic balloon pump placement

C

Which manifestation should you expect in a patient with shock? A. Deceased blood urea nitrogen level B. Urine output of 1 mL/kg/hour in an adult C. Increased blood glucose level D. Hyperactive bowel sounds

C

Why do geriatric patients respond differently to shock than younger patients? A. Geriatric patients have decreased physiologic reserves. B. Geriatric patients have an increased circulating blood volume. C. Geriatric patients have the ability to tolerate greater changes in end-organ perfusion. D. Cardiac output increases with age.

C

For a patient with shock who sustained a traumatic brain injury without systemic hemorrhage, which mean arterial pressure should you maintain? A. 40 mm Hg B. 50 mm Hg C. 65 mm Hg D. 90 mm Hg

D

When caring for a multiple trauma patient with a narrowed pulse pressure and anxiety, you should consider which intervention the priority? A. Insert an indwelling urinary catheter. B. Administer oxygen via a nasal cannula. C. Begin cardiac monitoring. D. Initiate large-caliber intravenous lines.

D

When managing a patient with shock, which intervention is appropriate? A. Delay sedation until the patient is hemodynamically stable. B. Administer O-positive packed red blood cells before the patient's blood is typed and screened. C. Administer vasopressors only through a peripheral line. D. Obtain a manual blood pressure before using a noninvasive blood pressure monitor.

D

Which finding is an early sign of decreased tissue perfusion? A. Unresponsiveness B. Confusion C. Obtundation D. Restlessness

D

Which finding is expected in a patient with shock caused by an isolated spinal cord injury? A. Jugular vein distention B. Tachycardia C. Cool, clammy skin D. Hypotension

D

Which manifestation is an early sign of hypovolemic shock in adults? A. Bradycardia B. Low diastolic blood pressure C. Tachypnea D. Decreased level of consciousness

D

Which structure is a collection of specialized neural tissues that respond to small changes in vascular tone or pressure? A. Renal tubule B. Hypothalamus C. Adrenal medulla D. Baroreceptors

D

Which type of shock results from the release of endotoxins? A. Cardiogenic B. Hypovolemic C. Obstructive D. Distributive

D

In which stage of shock does cellular derangement occur? A. Compensated B. Nonprogressive C. Uncompensated D. Irreversible

c