Shock NCLEX Questions

Shock NCLEX Questions ScienceMedicineEmergency Medicine UnitedLife Save Shock NCLEX Review Questions 12 terms Dominique_Comeaux Preview NCLEX questions on Shock 25 terms LauraRNtobePreview Nclex Questions for Shock - Critical ...32 terms karmageniePreview Shock Teacher Titi A patient is admitted to the emergency department after sustaining abdominal injuries and a broken femur from a motor vehicle accident. The patient is pale, diaphoretic, and is not talking coherently. Vital signs upon admission are temperature 98 F (36 C), heart rate 130 beats/minute, respiratory rate 34 breaths/minute, blood pressure 50/40 mmHg. The healthcare provider suspects which type of shock?a.) Hypovolemic b.) Cardiogenic c.) Neurogenic d.) Distributive a.) Hypovolemic A patient who has pericarditis related to radiation therapy, becomes dyspneic, and has a rapid, weak pulse. Heart sounds are muffled, and a 12 mmHg drop in blood pressure is noted on inspiration. The healthcare provider's interventions are aimed at preventing which type of shock?a.) Distributive b.) Neurogenic c.) Obstructive d.) Cardiogenic c.) Obstructive

Rationale:

Obstructive shock can be caused by anything that impedes the heart's ability to contract and pump blood around the body, as with cardiac tamponade.

The healthcare provider is caring for a patient who has septic shock. Which of these should the healthcare provider administer to the patient first?a.) Antibiotics to treat the underlying infection.b.) Corticosteroids to reduce inflammation.c.) IV fluids to increase intravascular volume.d.) Vasopressors to increase blood pressure.c.) IV fluids to increase intravascular volume.

Rationale:

Circulation and perfusion are addressed first so IV fluids will be started immediately. After blood cultures are obtained, broad-spectrum antibiotics should be administered without delay. Vasopressors are administered if the patient is not responding to the fluid challenge.Corticosteroids may be considered to address the inflammatory-induced vasodilation and capillary leakage.A 4.5 kg infant is admitted to the pediatric intensive care unit after 33 days of watery diarrhea. The infant is diagnosed with severe dehydration.The infant's skin is mottled and turgor is poor. Capillary refill is delayed, and there is an absence of tears with crying. Which intervention should be the priority action by the healthcare provider?a.) Calculate the mean arterial pressure b.) Draw blood for a complete blood count c.) Establish vascular access d.) Take a complete set of vital signs c.) Establish vascular access

Rationale:

Vascular access should be established quickly in order to replace lost volume before shock progresses.Which of the following assessment findings is an early indication of hypovolemic shock?a.) Diminished bowel sounds b.) Increased urinary output c.) Tachycardia d.) Hypertension c.) Tachycardia

Rationale:

Tachycardia is an early symptom as the body compensates for a declining blood pressure the heart rate increases to circulate the blood faster to prevent tissue hypoxia.When compensatory mechanisms for hypovolemic shock are activated, the nurse would expect which two patient findings to normalize?a.) Intensity of peripheral pulses and body temperature.b.) Peripheral pulses and heart rate (HR).c.) Metabolic alkalosis and oxygen saturation.d.) Cardiac output (CO) and blood pressure (BP).d.) Cardiac output (CO) and blood pressure (BP).

Which type of fluid is most appropriate for volume replacement for a patient with non-hemorrhagic hypovolemic shock?a.) Lactated Ringers (LR) b.) 10% Dextrose in Water (D 10 W) c.) One-half Normal Saline (1/2% NS) d.) Packed Red Blood Cells (PRBC) a.) Lactated Ringers (LR) A client has been diagnosed with sepsis. The nurse will most likely find which of the following when assessing this client:

Select all that apply:

a.) Rapid shallow respirations.b.) Severe hypotension.c.) Mental status changes.d.) Elevated temperature.e.) Lactic acidosis.f.) Oliguria.a.) Rapid shallow respirations.d.) Elevated temperature.A client in shock is prescribed an inotropic drug to act on alpha and beta receptors. The nurse will most likely be administering: a.) Dopamine.b.) Dobutamine.c.) Pavulon.d.) Milrinone.a.) Dopamine.The client experiences shock following a spinal cord injury. This type of shock is classified as: a.) Hypovolemic.b.) Neurogenic.c.) Cardiogenic.d.) Anaphylactic.a.) Neurogenic.The client in shock is prescribed an infusion of lactated Ringer's solution. The nurse recognizes that the function of this fluid in the treatment of

shock is to:

a.) Replace fluid, and promote urine output.b.) Draw water into cells.c.) Draw water from cells to blood vessels.d.) Maintain vascular volume.a.) Replace fluid, and promote urine output.

Dobutamine (Dobutrex) is used to treat a client experiencing cardiogenic shock. Nursing intervention includes: a.) Monitoring for fluid overload.b.) Monitoring for cardiac dysrhythmias.c.) Monitoring respiratory status.d.) Monitoring for hypotension.b.) Monitoring for cardiac dysrhythmias.

Rationale:

Dobutamine is beneficial in cases where shock is caused by heart failure. The drug increases contractility, and has the potential to cause dysrhythmias.An intensive care nurse, is assessing a patient with suspected sepsis. Which predisposing factors would expect to be found in the patient with septic shock?a.) A 45 year old client with a history of renal insufficiency.b.) A client age 65, with a history of cancer who is recovering from an abdominal peritoneal resection.c.) A 27 year old with pyelonephritis responding to treatment with an antibiotic.d.) A 50 year old with community acquired tuberculosis.b.) A client age 65, with a history of cancer who is recovering from an abdominal peritoneal resection.Multiple organ dysfunction syndrome (MODS) develops in severe sepsis as a result of systemic inflammatory response syndrome (SIRS), disseminated intravascular coagulation and damage to the endothelium. Which of the following statements best describes the management of MODS?a.) The use of proton pump inhibitors and H2 agents to increase the pH of the stomach inhibit the development of stress ulcers, an ileus and malabsorption issues.b.) Maintaining ventilator settings that ensure a tidal volume of at least 6 mL/kg of body weight will keep the lungs from being injured by endothelial damage.c.) There is no specific therapies for MODS other than supportive care and the early recognition of dysfunctional organ(s).d.) Much of the organ damage that occurs with MODS in the setting of severe sepsis is associated with pre-existing conditions.c.) There is no specific therapies for MODS other than supportive care and the early recognition of dysfunctional organ(s).