Font size
WorksheetsChapter 19
Total questions: 28
Worksheet time: 16mins
What are the four types of shock?
Multiple organ, cardiogenic, renal, and anaphylactic
Cardiogenic, renal, hypovolemic, and septic
Renal, hypervolemic, obstructive shock, and neurogenic
Hypovolemic, cardiogenic, obstructive shock, and vasogenic
Although several life-supporting systems of the body are involved in the pathophysiologic characteristics of shock, shock itself results from failure of which system?
Circulatory
Endocrine
Neurologic
Respiratory
A nurse is assessing a patient who is in shock. What should the nurse be aware that one common sign will be, regardless of the cause of the shock?
The skin is cool and dry with cyanotic nail beds.
The skin is cool and moist with cyanotic nail beds.
The nail beds are reddened, and the skin is moist and warm.
The nail beds are reddened, and the skin is dry and warm.
What should a nurse assessing a patient in the progressive stage of shock expect to find?
Bounding pulse, decreased respirations, and decreased blood pressure
Bounding pulse, shallow respirations, and significantly increased blood pressure
Thready pulse and deep respirations with decreased blood pressure
Thready pulse and irregular respirations with increased blood pressure
What should a nurse expect of a patient’s respirations caused by the falling blood pressure and impaired blood circulation during the refractory stage of shock?
Rapid and deep
Rapid and shallow
Slow and deep
Slow and shallow
A licensed practical/vocational nurse (LPN/LVN) is assisting in developing a nursing care plan for a patient in shock. Which nursing diagnosis should be included?
Increased cardiac output, related to hypertension
Increased cardiac output, related to hypotension
Decreased cardiac output, related to hypovolemia
Decreased cardiac output, related to hypertension
How does the intraaortic balloon pump (IABP) assist a patient who is in cardiogenic shock to increase cardiac output?
Provides generalized vasoconstriction
Inflates during the diastole phase
Constricts the vena cava
Adds hypertonic fluid to the circulating volume
A nurse is explaining to a family member the pathophysiologic characteristic of vasogenic shock. What information should the nurse include?
The intravascular compartment fills beyond capacity, allowing fluid to leak out, compressing vital organs.
The circulating volume causes excessive constriction of the vessels, causing blood pooling.
Widely fluctuating blood pressures stimulate vascular collapse, causing severe alterations in peripheral perfusion.
Although the circulating volume is intact, excessive vascular dilation causes drastic drops in the blood pressure.
A nurse is caring for a patient who has a cervical spine injury and assesses progressive hypotension. What does this signify?
Anaphylaxis
Respiratory alkalosis
Multiple organ dysfunction syndrome (MODS)
Neurogenic shock
While shopping in the mall, a nurse sees a lady suddenly fall to the floor. On immediate assessment, the nurse realizes she is not in cardiac arrest and has no need for cardiopulmonary resuscitation (CPR). What should be the immediate actions by the nurse?
Check the pulse and respirations and call for a blood pressure cuff.
Check the pulse, respirations, skin color, and temperature.
Call for help and check the pulse, respiration, and mental status.
Ask someone to help place large blankets or coats under her legs and trunk
A nurse is explaining the rationale behind the use of Hypothermic devices to a patient’s family. When relaying information what explanation should the nurse provide when asked why this garment provides compression to the legs and abdomen?
To help restore cellular perfusion
Decreases internal hemorrhage
Cools the patient to create less metabolic demand
Applies pressure during the systole phase and relax pressure during the diastole phase
A nurse is speaking to the family of a 65-year-old Latino woman. To whom should the nurse address most of the conversation to keeping in mind cultural considerations?
66-year-old husband
Entire family, in general
42-year-old daughter (oldest child)
40-year-old son (only son)
In treating a person outside of a medical facility, a nurse knows that immediate circulatory support for the vital organs must begin as quickly as possible because, without oxygen, the brain cells will begin to die in how many minutes?
4
6
14
24
The stages of shock proceed in a definite sequence. What is the correct order?
Progressive, compensatory, refractory
Refractory, progressive, compensatory
Compensatory, progressive, refractory
Distributive, compensatory, refractory
What causes the cool, damp skin of patients in compensatory shock?
Constriction of peripheral blood vessels because of the shunting of blood to the vital organs
Action of the antidiuretic hormone released in shock by the adrenal glands
Decreasing levels of arterial carbon dioxide, which are pooling in the arms and legs
Activation of the baroreceptors in the renal arteries
Which position enhances cerebral blood flow to counteract the symptoms of compensatory shock?
Fowler
Trendelenburg
Gravity neutral
Side lying
A nurse is administering heparin, subcutaneous twice daily, to a patient in cardiogenic shock. What is the expected action of this drug?
Inotropic to improve cardiac contractibility
Anticoagulant to prevent blood clots
Antidysrhythmic to restore normal cardiac contractibility
Vasopressor to increase blood pressure
Which nursing interventions will best assist a patient cope with decreased cardiac output?
Dovetailing nursing care tasks allows rest periods for the patient.
Maintaining enough cover prevents the patient from shivering
Turning, coughing, deep breathing, and ambulating the patient every 2 hours reduce the risk of embolism.
Analgesics should be administered cautiously.
One of the most important assessments that a nurse makes is to check urine output. Which value objectively validates minimal acceptable renal perfusion for the average-size person?
0.5 mL/kg/hr
0.5 mL/lb/hr
1 mL/lb/hr
0.2 mL/kg/hr
A patient is in the compensatory stage of shock. What symptoms displayed by the patient would indicate the need to implement immediate nursing action?
Irritable and restless
Listless and confused
Unconscious
Anxious and fearful
A patient in the progressive stage of shock is receiving medication to manage the symptoms. What is the desired effect of the medication?
Increase in cardiac output
Decrease in blood pressure
Decrease in urine output
Lower temperature
A family member asks why her father, who is being treated for cardiogenic shock, needs parenteral feeding because he is capable of eating small amounts. What is the best response by the nurse?
“Parenteral feedings reduce the risk of constipation.”
“Parenteral feedings meet the patient’s hypermetabolic needs.”
“Parenteral feedings are more convenient and less time consuming.”
“Parenteral feedings decrease the hazard of infection.”
A patient’s family voices concern regarding the purpose of some of the interventions for systemic inflammatory response syndrome (SIRS). What explanation by the nurse is most appropriate when explaining the rationale of treatment?
“Applying a MAST garment is mandatory to promote and conserve body heat.”
“Inserting an IABP is required to decrease fluid leaking into the extravascular space.”
“Maintaining strict isolation is vital to prevent an overlying bacterial infection.”
“Aggressive treatment is necessary to support the multiple failing organs.”
An older Japanese patient in progressive shock lingers on the verge of death. What intervention does the patient’s cultural background dictate?
Allow any and all cultural rituals at the bedside.
Encourage the family to talk to the patient who can be comforted by their familiar voices.
Restrict the ministrations of the folk healer.
Suggest that small children not see the patient.
A nurse explains that pericardial tamponade and pulmonary embolus can place the patient at risk for (a) shock.
A nurse explains that when shock forces the body into anaerobic metabolism, organ damage is caused by a product of that metabolism, which is (a) .
A nurse explains that the minimal acceptable hourly urine output for a patient in shock who weighs 220 lb is (a) .
A nurse is aware that immobility and insertion of urinary catheters, although therapeutic, also places the patient at risk for (a) .
