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Tissue Perfusion: Shock Syndromes

Total questions: 20

Worksheet time: 10mins

Name
Class
Date
1.

Which type of shock leads to SIRS (Systemic inflammatory response syndrome)?

a)

Cardiogenic Shock

b)

Anaphylactic Shock

c)

Septic Shock

d)

All of the above

2.

If adequate treatment is not provided during the SIRS stage, what will the shock progress to?

a)

Fluid volume overload

b)

Airway closure

c)

Multi-Organ Dysfunction Syndrome (MODS)

d)

Decreased cardiac output

3.

What are some things that could lead to hypovolemic shock? Select all that apply.

a)

Allergic reaction to medication.

b)

Pericarditis

c)

Hemorrhage

d)

Burns

e)

Extreme malnourishment

4.

Which type of shock involves histamines causing vasodilation?

a)

Hypovolemic

b)

Neurogenic

c)

Anaphylactic

d)

Septic

5.

A patient with severe burns is experiencing tachycardia, tachypnea, edema, weak peripheral pulses, hypotension and decreased urinary output. Which type of shock does the nurse suspect?

a)

Absolute hypovolemic shock

b)

Septic shock

c)

Cardiogenic shock

d)

Relative hypovolemic shock

6.

What is the second stage of hypovolemic shock?

a)

Progressive stage

b)

Initial stage

c)

Non-progressive stage

d)

Refractory stage

7.

What are some of the compensatory mechanisms the body uses to battle shock? Select all that apply.

a)

Increased cardiac contractility to increase BP

b)

ADH and Aldosterone are released to cause selective vasoconstriction and increase preload.

c)

Body temperature drops to slow metabolism

d)

Auto-transfusion: fluid is shifted from interstitial spaces to intravascular spaces.

e)

HR and RR both slow as the body focuses all energy on self preservation.

8.

Retention of lactic acid,a byproduct of anaerobic respiration, generally leads to what?

a)

Respiratory alkalosis

b)

Respiratory acidosis

c)

Metabolic alkalosis

d)

Metabolic acidosis or Respiratory acidosis

9.

Which of the following volume expanders are considered crystalloids?

a)

PRBCs

b)

Normal saline

c)

Platelets

d)

Plasma

e)

Lacatated Ringers

10.

If a patient's MAP remains low after fluid volume replacement, what is the next step of treatment?

a)

Blood transfusion

b)

A different type of fluid

c)

Vasopressors

d)

Steroids

11.

A low CVP indicates...

a)

Hypervolemia

b)

Hypovolemia

c)

Hyperkalemia

d)

Hypokalemia

12.

Early manifestations of anaphylactic shock include: (select all that apply)

a)

Cyanosis

b)

Erythema

c)

Stridor

d)

Pruritus

e)

Angioedema

13.

Which lab findings support a diagnosis of sepsis? Select all that apply.

a)

CRP: 18 mg/L

b)

Creatinine: 0.1 mg/dL

c)

Lactate: 6 mmol/L

d)

INR: 4.2

e)

Uric acid: 1.2 mg/dL

14.

Why are steroids used to treat shock? Select all that apply.

a)

Reduction of inflammation due to infection.

b)

Reduction of glucose levels

c)

Assist with BP control by causing fluid retention.

d)

Draws fluid to the peripheral parts of the body.

e)

Analgesia

15.

According to the sepsis bundle, which actions must be completed within three hours of admission?

a)

Administer vasopressors

b)

Measure lactate levels twice, two hours apart.

c)

Obtain blood cultures prior to administering antibiotics.

d)

Administer blood products

e)

Administer crystalloids in the amount of 30 ml/kg

16.

Disseminated Intravascular Coagulation (DIC) is characterized by: (Select all that apply)

a)

Excessive urination

b)

Bruising of skin and mucous membranes

c)

Petechiae, purpuric papules, and blood filled blisters

d)

Sudden drop in body temperature

e)

Overall ruddy appearance that may resemble a sunburn

17.

Which of the following should be administered via a central line rather than peripheral?

a)

Three prophylactic doses of Cefepime for a patient following abdominal surgery.

b)

TPN for a patient on extended bowel rest.

c)

Dobutamine for a patient with septic shock.

d)

Pantoprazole for a patient with an NG tube.

e)

Furosemide for a patient with CHF.

18.

A MAP of 58 mmHg is a medical emergency. Why?

a)

The patient could have a stroke.

b)

The patient's vital organs (heart, brain, kidneys) are not receiving adequate perfusion to avoid ischemia.

c)

The patient is experiencing heart failure.

d)

The patient is at risk for coronary artery rupture.

19.

During Multiple Organ Dysfunction Syndrome (MODS), which body system typically fails first?

a)

Renal system

b)

Gastrointestinal system

c)

Respiratory system

d)

Nervous system

20.

Cytokines cause vasodilation during what type of shock?

a)

Anaphylactic shock

b)

Neurogenic shock

c)

Septic shock

d)

Hypovolemic shock