Shock and Multiple Organ Dysfunction Syndrome Part 1

Shock and Multiple Organ Dysfunction Syndrome  following statements best describes the pathophysiology of this patients health problem? A) Blood is shunted from vital organs to peripheral areas of the body. B) Cells lack an adequate blood supply and are deprived of oxygen and nutrients. C) Circulating blood volume is decreased with a resulting change in the osmotic pressur D) Hemorrhage occurs as a result of trauma, depriving vital organs of adequate perfusin Ans: B 2. In an acute care setting, the nurse is assessing an unstable patient. When prioritizing the the nurse should recognize that the patient is at risk for hypovolemic shock in which o circumstances? A) Fluid volume circulating in the blood vessels decreases. B) There is an uncontrolled increase in cardiac output. C) Blood pressure regulation becomes irregular. D) The patient experiences tachycardia and a bounding pulse. Ans: A  compensatory stage of shock. What assessment finding would be most consistent with th e compensation? A) Increased urine output B) Decreased heart rate C) Hyperactive bowel sounds D) Cool, clammy skin Ans: D  injuries suffered in a motor vehicle accident. The nurse anticipates that the physician wi l the administration of a crystalloid IV solution to restore intravascular volume. In addition saline, which crystalloid fluid is commonly used to treat hypovolemic shock? A) Lactated Ringers B) Albumin C) Dextran D) 3% NaCl Ans: A 5. A) A patient who is in shock is receiving dopamine in addition to IV fluids. What principl the nurses care planning during the administration of a vasoactive drug? The drug should be discontinued immediately after blood pressure increases. B) The drug dose should be tapered down once vital signs improve. C) The patient should have arterial blood gases drawn every 10 minutes during treatmen D) The infusion rate should be titrated according the patients subjective sensation of ade perfusion. Ans: 6. B A nurse in the ICU receives report from the nurse in the ED about a new patient bein neck injury he received while diving into a lake. The ED nurse reports that his blood heart rate is 53 beats per minute, and his skin is warm and dry. What does the ICU that patient is probably experiencing? A) Anaphylactic shock B) Neurogenic shock C) Septic shock D) Hypovolemic shock Ans: B 7. A) The intensive care nurse caring for a patient in shock is planning assessments and interv to the patients nutritional needs. What physiologic process contributes to these increased n needs? The use of albumin as an energy source by the body because of the need for incr triphosphate (ATP)  D) The increase in GI peristalsis during shock and the resulting diarrhea Ans: C 8. The nurse is transferring a patient who is in the progressive stage of shock into ICU f unit. The medical nurse is aware that shock affects many organ systems and that nursin the patient will focus on what intervention? A) Reviewing the cause of shock and prioritizing the patients psychosocial needs B) Assessing and understanding shock and the significant changes in assessment data to of care C) Giving the prescribed treatment, but shifting focus to providing family time as the p unlikely to survive D) Promoting the patients coping skills in an effort to better deal with the physiologic accompanying shock Ans: 9. B When caring for a patient in shock, one of the major nursing goals is to reduce the ri will develop complications of shock. How can the nurse best achieve this goal?  B) Keep the physician updated with the most accurate information because in cases of often cannot provide relevant interventions. C) Monitor for significant changes and evaluate patient outcomes on a scheduled basis f blood pressure and skin temperature. D) Understand the underlying mechanisms of shock, recognize the subtle and more obvio then provide rapid assessment. Ans: D 10.The nurse is caring for a patient in the ICU who has been diagnosed with multiple org syndrome (MODS). The nurses plan of care should include which of the following interv A) Encouraging the family to stay hopeful and educating them to the fact that, in near prognosis is good B) Encouraging the family to leave the hospital and to take time for themselves as ac u MODS patients may last for several months C) Promoting communication with the patient and family along with addressing end-of-life D) Discussing organ donation on a number of different occasions to allow the family ti the idea Ans: C 11. The acute care nurse is providing care for an adult patient who is in hypovolemic shock recognizes that antidiuretic hormone (ADH) plays a significant role in this health problem assessment finding will the nurse likely observe related to the role of the ADH during shock? A) Increased hunger B) Decreased thirst C) Decreased urinary output D) Increased capillary perfusion Ans: C 12. The nurse is caring for a patient whose progressing infection places her at high risk for assessment finding would the nurse consider a potential sign of shock? A) Elevated systolic blood pressure B) Elevated mean arterial pressure (MAP) C) Shallow, rapid respirations D) Bradycardia Ans: C  is receiving large volumes of crystalloid fluid to treat hypovolemic shock. In light of th for what sign would you teach the new nurse to monitor the patient? A) Hypothermia B) Bradycardia C) Coffee ground emesis D) Pain Ans: A 14. The nurse is caring for a patient in the ICU whose condition is deteriorating. The nurse to initiate an infusion of dopamine. What would be the priority assessment and intervent the administration of vasoactive medications? A) Frequent monitoring of vital signs, monitoring the central line site, and providing acc titration B) Reviewing medications, performing a focused cardiovascular assessment, and providing education C) Reviewing the laboratory findings, monitoring urine output, and assessing for periphera D) Routine monitoring of vital signs, monitoring the peripheral IV site, and providing ea instructions Ans: A 15. The nurse in the ICU is admitting a 57-year-old man with a diagnosis of possible septic nurses assessment reveals that the patient has a normal blood pressure, increased heart ra bowel sounds, and cold, clammy skin. The nurses analysis of these data should lead to conclusion? A) The patient is in the compensatory stage of shock. B) The patient is in the progressive stage of shock. C) The patient will stabilize and be released by tomorrow. D) The patient is in the irreversible stage of shock. Ans: A 16. The nurse, a member of the health care team in the ED, is caring for a patient who the irreversible stage of shock. What would be the most appropriate nursing intervention? A) Provide opportunities for the family to spend time with the patient, and help them irreversible stage of shock. B) Inform the patients family immediately that the patient will likely not survive to all o time to make plans and move forward. C) Closely monitor fluid replacement therapy, and inform the family that the patient wil l survive and return to normal life. D) Protect the patients airway, optimize intravascular volume, and initiate the early rehab i process. Ans: A 17. The nurse in a rural nursing outpost has just been notified that she will be receiving a hypovolemic shock due to a massive postpartum hemorrhage after her home birth. You k best choice for fluid replacement for this patient is what? A) 5% albumin because it is inexpensive and is always readily available B) Dextran because it increases intravascular volume and counteracts coagulopathy C) Whatever fluid is most readily available in the clinic, due to the nature of the eme D) Lactated Ringers solution because it increases volume, buffers acidosis, and is the be patients with liver failure Ans: C  vehicle accident. The nurse is aware that patients in shock possess excess energy require would be the main challenge in meeting this patients elevated energy requirements during rehabilitation? A) Loss of adipose tissue B) Loss of skeletal muscle C) Inability to convert adipose tissue to energy D) Inability to maintain normal body mass Ans: B  nurse understands that the patients heart is pumping an inadequate supply of oxygen to what health problem should the nurse assess? A) Dysrhythmias B) Increase in blood pressure C) Increase in heart rate D) Decrease in oxygen demands Ans: A 20. The nurse is caring for a patient admitted with cardiogenic shock. The patient is experie and there is an order for the administration of morphine. In addition to pain control, w rationale for administering morphine to this patient? A) It promotes coping and slows catecholamine release. B) It stimulates the patient so he or she is more alert. C) It decreases gastric secretions. D) It dilates the blood vessels. Ans: D