Shock and Multiple Organ Dysfunction Syndrome Part 2

21. The nurse is providing care for a patient who is in shock after massive blood loss from injury. The nurse recognizes that many of the findings from the most recent assessment compensatory mechanisms. What is a compensatory mechanism to increase cardiac output hypovolemic states? A) Third spacing of fluid B) Dysrhythmias C) Tachycardia D) Gastric hypermotility Ans: C 22. The intensive care nurse is responsible for the care of a patient with shock. What cardi symptoms would suggest to the nurse that the patient may be experiencing acute organ Select all that apply. A) Drop in systolic blood pressure of 40 mm Hg from baselines B) Hypotension that responds to bolus fluid resuscitation C) Exaggerated response to vasoactive medications D) Serum lactate >4 mmol/L E) Mean arterial pressure (MAP) of 65 mm Hg Ans: A, D, E 23. An adult patient has survived an episode of shock and will be discharged home to finis phase of his disease process. The home health nurse plays an integral part in monitorin What aspect of his care should be prioritized by the home health nurse? A) Providing supervision to home health aides in providing necessary patient care B) Assisting the patient and family to identify and mobilize community resources C) Providing ongoing medical care during the familys rehabilitation phase D) Reinforcing the importance of continuous assessment with the family Ans: B 24. A critical care nurse is aware of similarities and differences between the treatments for d shock. Which of the following interventions is used in all types of shock? A) Aggressive hypoglycemic control B) Administration of hypertonic IV fluids C) Early provision of nutritional support D) Aggressive antibiotic therapy Ans: C 25. In all types of shock, nutritional demands increase rapidly as the body depletes its stores Enteral nutrition is the preferred method of meeting these increasing energy demands. Wh for enteral nutrition being the preferred method of meeting the bodys needs? A) It slows the proliferation of bacteria and viruses during shock. B) It decreases the energy expended through the functioning of the GI system. C) It assists in expanding the intravascular volume of the body. D) It promotes GI function through direct exposure to nutrients. Ans: D 26. The ICU nurse is caring for a patient with multiple organ dysfunction syndrome (MODS) What nursing action should be prioritized at this point during care? A) Providing information and support to family members B) Preparing the family for a long recovery process C) Educating the patient regarding the use of supportive fluids D) Facilitating the rehabilitation phase of treatment Ans: A 27. A critical care nurse is planning assessments in the knowledge that patients in shock are developing fluid replacement complications. For what signs and symptoms should the nurs patient? Select all that apply. A) Hypovolemia B) Difficultybreathing C) Cardiovascularoverload D) Pulmonaryedema E) Hypoglycemia Ans: B, C, D 28. When circulatory shock occurs, there is massive vasodilation causing pooling of the blood periphery of the body. An ICU nurse caring for a patient in circulatory shock should k pooling of blood in the periphery leads to what pathophysiological effect? A) Increased stroke volume B) Increased cardiac output C) Decreased heart rate D) Decreased venous return Ans: D 29. A team of nurses are reviewing the similarities and differences between the different clas  A) Anaphylactic B) Hypovolemic C) Cardiogenic D) Septic E) Neurogenic Ans: A, D, E 30. A triage nurse in the ED is on shift when a grandfather carries his 4-year-old grandson child is not breathing, and the grandfather states the boy was stung by a bee in a ne were waiting for the boys mother to get off work. Which of the following would lead suspectthattheboyisexperiencinganaphylacticshock? A) Rapid onset of acute hypertension B) Rapid onset of respiratory distress C) Rapid onset of neurologic compensation D) Rapid onset of cardiac arrest Ans: B 31. The ICU nurse is caring for a patient in neurogenic shock following an overdose of ant medication. When assessing this patient, the nurse should recognize what characteristic of shock? A) Hypertension B) Cool, moist skin C) Bradycardia D) Signs of sympathetic stimulation Ans: C  shock. The nurse knows that vasoactive medications are given in all forms of shock. W goal of this aspect of treatment? A) To prevent the formation of infarcts of emboli B) To limit stroke volume and cardiac output C) To prevent pulmonary and peripheral edema D) To maintain adequate mean arterial pressure Ans: D 33.The ICU nurse caring for a patient in shock is administering vasoactive medications as p nurse should know that vasoactive medications should be administered in what way? A) Through a central venous line B) By a gravity infusion IV set C) By IV push for rapid onset of action D) Mixed with parenteral feedings to balance osmosis Ans: A 34. The ICU nurse is caring for a patient in hypovolemic shock following a postpartum hem what serious complication of treatment should the nurse monitor the patient? A) Anaphylaxis B) Decreased oxygen consumption C) Abdominal compartment syndrome D) Decreased serum osmolality Ans: C  progression. As the ICU nurse caring for a patient with sepsis, the nurse knows that ti declines during sepsis and the patient begins to show signs of organ dysfunction. What indicate to the nurse that end-organ damage may be occurring? A) Urinary output increases B) Skin becomes warm and dry C) Adventitious lung sounds occur in the upper airway D) Heart and respiratory rates are elevated Ans: D 36. An 11-year-old boy has been brought to the ED by his teacher, who reports that the bo really bad allergic reaction to peanuts after trading lunches with a peer. The triage nurs assessment reveals the presence of respiratory and cardiac arrest. What interventions shoul prioritize? A) Establishing central venous access and beginning fluid resuscitation B) Establishing a patent airway and beginning cardiopulmonary resuscitation C) Establishing peripheral IV access and administering IV epinephrine D) Performing a comprehensive assessment and initiating rapid fluid replacement Ans: B 37. A patient is responding poorly to interventions aimed at treating shock and appears to be the irreversible stage of shock. What action should the intensive care nurse include duri n the patients care? A) Communicate clearly and frequently with the patients family. B) Taper down interventions slowly when the prognosis worsens. C) Transfer the patient to a subacute unit when recovery appears unlikely . D) Ask the patients family how they would prefer treatment to proceed. Ans: A 38. A critical care nurse is aware of the high incidence of ventilator-associated pneumonia (V who are being treated for shock. What intervention should be specified in the patients p the patient is ventilated? A) Performing frequent oral care B) Maintaining the patient in a supine position C) Suctioning the patient every 15 minutes unless contraindicated D) Administering prophylactic antibiotics, as ordered Ans: A  aggressive interventions, the patients mean arterial pressure (MAP) has fallen to 55 mm should gauge the onset of acute kidney injury by referring to what laboratory findings? apply. A) Blood urea nitrogen (BUN) level B) Urine specific gravity C) Alkaline phosphatase level D) Creatinine level E) Serum albumin level Ans: A,B,D 40. An immunocompromised older adult has developed a urinary tract infection and the care recognizes the need to prevent an exacerbation of the patients infection that could result septic shock. What action should the nurse p erform to reduce the patients risk of septic A) Apply an antibiotic ointment to the patients mucous membranes, as ordered. B) Perform passive range-of-motion exercises unless contraindicated C) Initiate total parenteral nutrition (TPN) D) Remove invasive devices as soon as they are no longer needed Ans: D