,PATHOPHYSIOLOGY.THE BIOLOGIC BASIS FOR DISEASESIN ADULTS AND CHILDREN
Test Bank - Pathophysiology: The Biologic Basis for Disease in Adults and Children (8th) 502
Chapter : Shock, Multiple Organ Dysfunction Syndrome, and Burns in
Children
MULTIPLE CHOICE
1. What is the most common type of shock in children?
a. Hypovolemic
b. Cardiogenic
c. Neurogenic
d. Septic
ANS: A
Hypovolemic shock, the most common type of shock in children, is associated with a reduction
in the intravascular volume relative to the vascular space. It is most frequently caused by
dehydration and trauma.
PTS: 1 DIF: Cognitive Level: Remembering
2. Hypotension is likely to occur when an infant or child is greater than _____ % dehydrated.
a. 2
b. 5
c. 7
d. 10
ANS: D
Hypotension typically develops when dehydration is greater than 10% in the infant or child or
greater than 6% in the adolescent.
PTS: 1 DIF: Cognitive Level: Remembering
3. A healthcare professional assesses that a child’s capillary refill time is 4 sec. What does the
healthcare professional evaluate that finding to mean?
a. The child is in shock.
b. The child must have septic shock.
c. The child has compensated shock.
d. This finding is normal.
ANS: A
Normal capillary refill time is <2 sec (brisk). A refill time of 4 sec in prolonged and indicates a
perfusion deficit possibly from shock. In septic shock, the capillary refill time may be normal or
faster than normal due to vasodilation.
PTS: 1 DIF: Cognitive Level: Applying
4. A 2-year-old is in shock. The healthcare professional assesses the child’s heart rate as 52
beats/min. What action by the healthcare professional is most appropriate?
,PATHOPHYSIOLOGY.THE BIOLOGIC BASIS FOR DISEASESIN ADULTS AND CHILDREN
Test Bank - Pathophysiology: The Biologic Basis for Disease in Adults and Children (8th) 503
a. Get an ECG.
b. Increase the intravenous rate.
c. Sedate the child.
d. Begin CPR.
ANS: D
Bradycardia often indicates impending cardiovascular collapse or cardiac arrest and is the most
common terminal cardiac rhythm observed in children. The normal resting heart rate in a toddler
is 80 to 120 beats/min, so a heart rate of 52 beats/min is too slow. The provider would assess
perfusion and if the heart rate does not rise, begin CPR. The provider would not take the time to
order an ECG. There is no reason to increase the fluid rate, or sedate the child at this moment.
PTS: 1 DIF: Cognitive Level: Applying
5. A child has a burn injury. What does the healthcare provider assess for when determining the
child’s chance of surviving?
a. Immunosuppression
b. Hypermetabolism
c. Inhalation injury
d. Hypertrophic scarring
ANS: C
The leading cause of death in children after burn injury, as in adults, is an inhalation injury.
Inhalation injuries cause approximately 50% of all deaths in children with burns. Burn victims
do have immune dysfunction, hypermetabolism, and scarring, but those do not contribute to the
majority of pediatric burn deaths.
PTS: 1 DIF: Cognitive Level: Applying
6. A child is in cardiogenic shock and the parents ask why the child has hepatomegaly and
periorbital edema. What explanation by the healthcare professional is best?
a. Mass vasodilation as a result of chemical mediators released from the myocardium
b. Low cardiac output and systemic venous congestion
c. Tissue damage to the myocardium, causing increased capillary permeability
d. Reduced renal perfusion, stimulating the RAAS system
ANS: B
Cardiogenic shock is generally associated with low cardiac output and systemic venous
congestion, leading to signs of fluid backup into organs and tissues. The professional would
explain that this is the cause of the hepatomegaly and edema. It is not the result of mass
vasodilation, tissue damage, or the RAAS system activation.
PTS: 1 DIF: Cognitive Level: Understanding
7. Approximately 80% of all hospital-acquired infections in children are a result of which type of
organism?
a. Bacteria
b. Viruses
c. Fungi
,PATHOPHYSIOLOGY.THE BIOLOGIC BASIS FOR DISEASESIN ADULTS AND CHILDREN
Test Bank - Pathophysiology: The Biologic Basis for Disease in Adults and Children (8th) 504
d. Rickettsia
ANS: A
In adults and children, approximately 40% of all hospital-acquired infections are linked to gram-
negative infections, 40% to gram-positive infections, and 21% each to viruses and fungi.
PTS: 1 DIF: Cognitive Level: Remembering
8. A student asks the healthcare professional to explain reperfusion injuries. What explanation by
the professional is best?
a. Tissue damage that can occur with blood transfusions
b. Tissue destruction during rewarming in frostbite
c. Damage from restored blood flow and exposure to oxygen
d. Fluid overload from intravenous therapy that is too rapid
ANS: C
Reperfusion (reoxygenation) injury is associated with cell damage caused by the restoration of
blood flow and physiologic concentrations of oxygen to cells that have been exposed to injurious
but nonlethal hypoxic conditions. It is not related to blood transfusions, rewarming specifically,
or fluid overload.
PTS: 1 DIF: Cognitive Level: Understanding
9. The healthcare professional plans care for a child in shock. What are the primary goals for the
treatment of shock?
a. Maximizing oxygen delivery and minimizing oxygen demand
b. Maintaining hydration and adequate urinary output
c. Supporting all facets of the cardiovascular system
d. Maintaining all vital signs within normal functioning ranges
ANS: A
The primary goals of the treatment of shock are maximizing oxygen delivery and minimizing
oxygen demand. The other goals are desirable, but do not take priority over maximizing oxygen
delivery and minimizing demand. If those goals are met, the others will be as a result.
PTS: 1 DIF: Cognitive Level: Remembering
10. To determine a child’s response to fluid therapy for shock, the healthcare professional should
monitor which measurements as the priority?
a. Hematocrit and hemoglobin levels
b. Urine output and specific gravity
c. Blood pressure and pulse
d. Arterial blood gases and heart rate
ANS: B
Monitoring of the volume of urine output and specific gravity is most useful in determining the
child’s response to fluid therapy.
PTS: 1 DIF: Cognitive Level: Remembering
Test Bank - Pathophysiology: The Biologic Basis for Disease in Adults and Children (8th) 502
Chapter : Shock, Multiple Organ Dysfunction Syndrome, and Burns in
Children
MULTIPLE CHOICE
1. What is the most common type of shock in children?
a. Hypovolemic
b. Cardiogenic
c. Neurogenic
d. Septic
ANS: A
Hypovolemic shock, the most common type of shock in children, is associated with a reduction
in the intravascular volume relative to the vascular space. It is most frequently caused by
dehydration and trauma.
PTS: 1 DIF: Cognitive Level: Remembering
2. Hypotension is likely to occur when an infant or child is greater than _____ % dehydrated.
a. 2
b. 5
c. 7
d. 10
ANS: D
Hypotension typically develops when dehydration is greater than 10% in the infant or child or
greater than 6% in the adolescent.
PTS: 1 DIF: Cognitive Level: Remembering
3. A healthcare professional assesses that a child’s capillary refill time is 4 sec. What does the
healthcare professional evaluate that finding to mean?
a. The child is in shock.
b. The child must have septic shock.
c. The child has compensated shock.
d. This finding is normal.
ANS: A
Normal capillary refill time is <2 sec (brisk). A refill time of 4 sec in prolonged and indicates a
perfusion deficit possibly from shock. In septic shock, the capillary refill time may be normal or
faster than normal due to vasodilation.
PTS: 1 DIF: Cognitive Level: Applying
4. A 2-year-old is in shock. The healthcare professional assesses the child’s heart rate as 52
beats/min. What action by the healthcare professional is most appropriate?
,PATHOPHYSIOLOGY.THE BIOLOGIC BASIS FOR DISEASESIN ADULTS AND CHILDREN
Test Bank - Pathophysiology: The Biologic Basis for Disease in Adults and Children (8th) 503
a. Get an ECG.
b. Increase the intravenous rate.
c. Sedate the child.
d. Begin CPR.
ANS: D
Bradycardia often indicates impending cardiovascular collapse or cardiac arrest and is the most
common terminal cardiac rhythm observed in children. The normal resting heart rate in a toddler
is 80 to 120 beats/min, so a heart rate of 52 beats/min is too slow. The provider would assess
perfusion and if the heart rate does not rise, begin CPR. The provider would not take the time to
order an ECG. There is no reason to increase the fluid rate, or sedate the child at this moment.
PTS: 1 DIF: Cognitive Level: Applying
5. A child has a burn injury. What does the healthcare provider assess for when determining the
child’s chance of surviving?
a. Immunosuppression
b. Hypermetabolism
c. Inhalation injury
d. Hypertrophic scarring
ANS: C
The leading cause of death in children after burn injury, as in adults, is an inhalation injury.
Inhalation injuries cause approximately 50% of all deaths in children with burns. Burn victims
do have immune dysfunction, hypermetabolism, and scarring, but those do not contribute to the
majority of pediatric burn deaths.
PTS: 1 DIF: Cognitive Level: Applying
6. A child is in cardiogenic shock and the parents ask why the child has hepatomegaly and
periorbital edema. What explanation by the healthcare professional is best?
a. Mass vasodilation as a result of chemical mediators released from the myocardium
b. Low cardiac output and systemic venous congestion
c. Tissue damage to the myocardium, causing increased capillary permeability
d. Reduced renal perfusion, stimulating the RAAS system
ANS: B
Cardiogenic shock is generally associated with low cardiac output and systemic venous
congestion, leading to signs of fluid backup into organs and tissues. The professional would
explain that this is the cause of the hepatomegaly and edema. It is not the result of mass
vasodilation, tissue damage, or the RAAS system activation.
PTS: 1 DIF: Cognitive Level: Understanding
7. Approximately 80% of all hospital-acquired infections in children are a result of which type of
organism?
a. Bacteria
b. Viruses
c. Fungi
,PATHOPHYSIOLOGY.THE BIOLOGIC BASIS FOR DISEASESIN ADULTS AND CHILDREN
Test Bank - Pathophysiology: The Biologic Basis for Disease in Adults and Children (8th) 504
d. Rickettsia
ANS: A
In adults and children, approximately 40% of all hospital-acquired infections are linked to gram-
negative infections, 40% to gram-positive infections, and 21% each to viruses and fungi.
PTS: 1 DIF: Cognitive Level: Remembering
8. A student asks the healthcare professional to explain reperfusion injuries. What explanation by
the professional is best?
a. Tissue damage that can occur with blood transfusions
b. Tissue destruction during rewarming in frostbite
c. Damage from restored blood flow and exposure to oxygen
d. Fluid overload from intravenous therapy that is too rapid
ANS: C
Reperfusion (reoxygenation) injury is associated with cell damage caused by the restoration of
blood flow and physiologic concentrations of oxygen to cells that have been exposed to injurious
but nonlethal hypoxic conditions. It is not related to blood transfusions, rewarming specifically,
or fluid overload.
PTS: 1 DIF: Cognitive Level: Understanding
9. The healthcare professional plans care for a child in shock. What are the primary goals for the
treatment of shock?
a. Maximizing oxygen delivery and minimizing oxygen demand
b. Maintaining hydration and adequate urinary output
c. Supporting all facets of the cardiovascular system
d. Maintaining all vital signs within normal functioning ranges
ANS: A
The primary goals of the treatment of shock are maximizing oxygen delivery and minimizing
oxygen demand. The other goals are desirable, but do not take priority over maximizing oxygen
delivery and minimizing demand. If those goals are met, the others will be as a result.
PTS: 1 DIF: Cognitive Level: Remembering
10. To determine a child’s response to fluid therapy for shock, the healthcare professional should
monitor which measurements as the priority?
a. Hematocrit and hemoglobin levels
b. Urine output and specific gravity
c. Blood pressure and pulse
d. Arterial blood gases and heart rate
ANS: B
Monitoring of the volume of urine output and specific gravity is most useful in determining the
child’s response to fluid therapy.
PTS: 1 DIF: Cognitive Level: Remembering
