Question: A critical care nurse is caring for a patient who suffered massive blood loss after trauma. How does the nurse correlate the blood loss with the patient’s mean arterial pressure (MAP)?

Answer Options:
There is no direct correlation to MAP
It causes vasoconstriction and increased MAP
Lower blood volume lowers MAP
It raises cardiac output and MAP

Answer: Lower blood volume lowers MAP

 

Question: The ICU nurse provides care to a patient admitted with a spinal cord injury. When planning care for this patient, the nurse includes interventions that address their risk of which type of shock?

Answer Options:
Hypovolemic
Obstructive
Distributive
Cardiogenic

Answer: Distributive

 

Question: Which statement about the systemic effects of shock is correct?

Answer Options:
The brain can tolerate hypoxia for two hours without damage
The effect of a mean decrease in MAP on the kidneys is evidenced by oliguria
The parasympathetic nervous system stimulates the cardiovascular system in order to increase MAP as shock progresses
The liver increases insulin levels to lower blood glucose levels

Answer: The effect of a mean decrease in MAP on the kidneys is evidenced by oliguria

 

Question: A patient is receiving norepinephrine for shock. What assessment finding best indicates a therapeutic outcome?

Answer Options:
Patient denial of chest pain or pressure
Urine output of 30 ml for 2 hours
Extremities are pale and cool
Alert and oriented, answering questions

Answer: Alert and oriented, answering questions

 

Question: Care of the patient with sepsis requires close monitoring of oxygenation status. The nurse correlates the SvO2 value as measurement of which parameter?

Answer Options:
Partial pressure of oxygen
Oxygen saturation
Arterial oxygenation
Venous oxygen consumption

Answer: Venous oxygen consumption

 

Question: The nurse monitors for which clinical manifestation for a patient in the progressive stage of shock?

Answer Options:
Hypokalemia
Sense of impending doom
Bounding pulses
Elevated blood pH

Answer: Sense of impending doom

 

Question: During what stage of shock is the body unable to compensate for altered tissue perfusion and cells start to experience hypoxic injury that results in increased capillary permeability?

Answer Options:
Compensatory
Progressive
Refractory
Both progressive and refractory

Answer: Progressive

 

Question: A patient in shock is apprehensive and slightly confused. What action by the nurse is best?

Answer Options:
Raise all four side rails on the patient’s bed
Tell the patient that everything will be fine
Remain with the patient for support
Prepare to administer antianxiety medication

Answer: Remain with the patient for support

 

Question: Joann White is admitted for sepsis secondary to bacterial pneumonia. Her MAP has decreased by more than 10mmHg from her baseline. Which hormones are released in response to her decreased MAP?

Answer Options:
Antidiuretic hormone (ADH)
Aldosterone
Renin
Serotonin
Insulin
Epinephrine

Answer: ADH, Aldosterone, Renin, Epinephrine

 

Question: The nurse understands that the common manifestations of shock are directly related to which problems?

Answer Options:
Anaerobic metabolism
Inadequate perfusion
Aerobic metabolism
Hyperglycemia

Answer: Anaerobic metabolism and Inadequate perfusion

 

Question: The nurse gets hand-off report on four patients. Which patient has the highest risk of developing sepsis?

Answer Options:
70 year old admitted with community acquired pneumonia
50 year old patient admitted with pyelonephritis
30 year old type I diabetic admitted with DKA
65 year old with severe rheumatoid arthritis admitted with covid-19 pneumonia

Answer: 65 year old with severe rheumatoid arthritis admitted with covid-19 pneumonia

 

Question: The ICU nurse observes petechiae, ecchymosis, and blood oozing from gums and other mucous membranes of a patient with septic shock. How does the nurse interpret this finding?

Answer Options:
Pulmonary emboli
Multiple organ dysfunction syndrome
Disseminated intravascular coagulation
Acute respiratory distress syndrome

Answer: Disseminated intravascular coagulation

 

Question: The student nurse recognizes that which disorder increases the patient’s risk for obstructive shock?

Answer Options:
Liver impairment
Gastrointestinal bleeding
Cardiac tamponade
Cardiomyopathy

Answer: Cardiac tamponade

 

Question: A patient experiencing hypovolemic shock has decreased cardiac output, which contributes to ineffective tissue perfusion. The nurse attributes the decrease in cardiac output to which of the following?

Answer Options:
Decreased cardiac preload
Decreased cardiac afterload
Increased MAP
Increased cardiac preload

Answer: Decreased cardiac preload

 

Question: Which statement about assessment of skin during shock is most accurate?

Answer Options:
For a patient with dark skin tone, color will be bluish-gray
For all patients in shock, the skin is expected to feel warm and dry to the touch
For a patient with dark skin tone, pallor or cyanosis is best assessed via mucous membranes
For a patient with light skin tone, color will be bluish-green

Answer: For a patient with dark skin tone, pallor or cyanosis is best assessed via mucous membranes

 

Question: The nurse is providing care for a patient receiving treatment for early hypovolemic shock. Which assessment finding indicates that compensatory mechanisms are developing in this patient?

Answer Options:
Increased urine output
Decreased respiratory rate
Increased heart rate
Decreased blood glucose

Answer: Increased heart rate

 

Question: The nurse caring frequently for older adults in the hospital is aware of risk factors that place them at a higher risk of shock. For which factors would the nurse assess?

Answer Options:
Overhydration
Malnutrition
Decreased thirst response
Altered mobility
Diminished immune response

Answer: Malnutrition, Decreased thirst response, Altered mobility, Diminished immune response

 

Question: The nurse is caring for a postoperative radical prostatectomy patient. Which assessment finding is consistent with hypovolemic shock?

Answer Options:
Warm, flushed skin
Widening pulse pressure
Increased urinary output
Rapid, weak, thready pulse

Answer: Rapid, weak, thready pulse

 

Question: The ICU nurse is caring for a patient with septic shock and ARDS secondary to pneumonia. Which medication order for this patient does the nurse question?

Answer Options:
Hydrocortisone
10% dextrose in water
Norepinephrine to keep MAP > 65mmHg
Insulin

Answer: Hydrocortisone