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Worksheets476 Week 3: NCLEX-Style Cardiogenic Shock Quiz
Total questions: 24
Worksheet time: 12mins
Which of the following clinical criteria is essential for diagnosing cardiogenic shock?
Systolic blood pressure > 120 mm Hg
Urine output of 50 mL/hr
Cool extremities
Pulmonary-capillary wedge pressure > 15 mm Hg
The most common cause of cardiogenic shock is:
Septic shock
Acute myocardial infarction
Pulmonary embolism
Cardiotoxic drug overdose
Which of the following mechanical defects can lead to cardiogenic shock?
Mitral stenosis (MS)
Ventricular wall rupture
Hypertrophic obstructive cardiomyopathy (HOCM)
All of the above
A risk factor for developing cardiogenic shock after a ST-elevation myocardial infarction (STEMI) is:
Age less than 60 years
Systolic blood pressure greater than 140 mmHg
Sinus tachycardia
Short duration of symptoms before treatment
Which of the following correctly describes a pathologic counteraction that occurs in cardiogenic shock?
Activation of the sympathetic system leading to peripheral vasoconstriction.
Release of interleukin-1, tumor necrosis factor-a, and interleukin-6 causing pathologic vasodilation.
Increased cardiac output improving coronary perfusion.
Decreased myocardial oxygen demand.
A nurse assessing a patient with suspected cardiogenic shock might expect to find:
Warm, dry skin
Bounding peripheral pulses
Oliguria
Normal mental status
During a physical examination of a patient with cardiogenic shock, which finding is most indicative of the condition?
Warm extremities
Jugular venous distension
Strong, regular peripheral pulses
Clear lung sounds
What is a crucial diagnostic test for a patient with cardiogenic shock that helps guide fluid management?
Thyroid-stimulating hormone
Comprehensive metabolic panel
Ultrasonography
Coagulation profile
In the immediate management of cardiogenic shock due to myocardial infarction, what is considered the most important intervention?
Administration of fibrinolytic therapy
Early restoration of coronary blood flow
Aggressive fluid resuscitation
Initiation of beta-blockers
For patients with severe hypotension (SBP < 70 mm Hg) or hypotension unresponsive to other medications in cardiogenic shock, which vasoactive agent is preferred over dopamine?
Dobutamine
Milrinone
Norepinephrine
Epinephrine
Dobutamine primarily exerts its inotropic effects by binding and activating which receptors?
Alpha-1 receptors
Beta-2 receptors
Beta-1 receptors selectively
Dopaminergic receptors
Due to its mechanism of action, dobutamine typically causes:
A significant increase in arterial blood pressure.
A significant decrease in arterial blood pressure.
Little to no change in arterial blood pressure.
Only systolic blood pressure elevation without affecting diastolic.
Dobutamine is FDA approved for short-term use in patients with decreased contractility due to:
Septic shock
Uncontrolled hypertension
Heart failure or cardiac surgical procedures
Peripheral vascular thrombosis
A nurse should monitor for which common adverse effect in a patient receiving dobutamine?
Significant hypokalemia
Heart rate increase of 5 to 10 beats per minute
Profound hypotension
Decreased myocardial oxygen demand
Which condition is a contraindication for the use of dobutamine?
History of allergic reactions to sulfites
Chronic stable angina
Well-controlled atrial fibrillation
Hypertension managed by medication
At doses higher than 3 mcg/min, norepinephrine's primary effect is due to significant activation of which receptors?
Beta-1 receptors, increasing cardiac output.
Beta-2 receptors, causing vasodilation.
Alpha-1 receptors, increasing systemic vascular resistance.
Dopaminergic receptors, enhancing renal perfusion.
Norepinephrine is a first-line agent for treating hypotension in which specific acute state?
Hypovolemic shock unresponsive to fluid resuscitation
Sepsis that does not respond to fluid resuscitation
Cardiogenic shock with SBP > 90 mmHg
Anaphylactic shock
A potential adverse effect of norepinephrine, particularly if hypovolemia is not adequately treated, is:
Decreased systemic vascular resistance
Increased end-organ perfusion
Excessive vasoconstriction leading to decreased end-organ perfusion
Decreased myocardial oxygen demand
When preparing norepinephrine for intravenous infusion, it should be diluted in:
Saline solution only
Dextrose-containing solutions
Lactated Ringer's solution
Sterile water
Norepinephrine should generally be avoided or used with extreme caution in patients with:
Hypotension due to cardiogenic mechanisms
Mesenteric or peripheral vascular thrombosis
Profound hypoxia or hypercarbia
All of the above
Which mechanical circulatory support device is described as the 'most commonly used and least expensive,' working by displacing blood into the proximal aorta during diastole and creating a vacuum effect during systole?
Extracorporeal membrane oxygenation (ECMO)
Percutaneous Left Ventricular Assist Device (LVAD)
Left-Atrium-to-Aorta Assist Device
Intra-aortic balloon pump (IABP)
What is a known limitation of the Intra-aortic balloon pump (IABP)?
It consistently provides superior hemodynamic support compared to other MCS devices.
It provides significant mortality benefit in all cardiogenic shock patients.
It offers modest hemodynamic support and has no proven mortality benefit.
It is only indicated for long-term support.
In the interprofessional management of a patient in cardiogenic shock, the pharmacist's role includes:
Administering IV medications and monitoring for extravasation.
Performing primary percutaneous coronary intervention (PCI).
Ensuring the patient is not on medications that depress heart function, like beta-blockers.
Managing mechanical ventilation settings.
Despite advances in treatment, what is the general prognosis for cardiogenic shock, especially as the leading cause of death in patients with acute MI?
Mortality rates are less than 10%.
Close to 80% of patients die despite optimal treatment.
Long-term survival is guaranteed with revascularization.
It is largely preventable through vaccination.
