NRSG 327 FINAL EXAM | QUESTIONS AND ANSWERS | VERIFIED
AND ACCURATE ANSWERS GRADED A+ | LATEST UPDATE
2026/2027
shock - CORRECT ANSWER- syndrome characterized by decreased tissue
perfusion and impaired cellular metabolism
results in an imbalance btween supply and demand for oxygen and nutrients
classifications of shock - CORRECT ANSWER- hypovolemic
cardiogenic
distributive (sepsis, anaphylaxis and neurogenic)
Cardiac Output (CO) and calculation - CORRECT ANSWER- Amount of
blood pumped in 1 minute (~5 L)
stroke volume x heart rate
preload and what is it determined by? - CORRECT ANSWER- the volume of
blood in the ventricles at the end of diastole
determined by:
- venous return
-ability of ventricle to stretch, relax and fill
afterload and what is it determined by? - CORRECT ANSWER- the force, or
resistance, against which the ventricles have to pump in order to eject the blood
,3 Vs it is determined by:
-vessel tone
-valve
-viscosity
what is contractility determined by? - CORRECT ANSWER- -preload
-the stimulatory effect of the SNS
-external factors that affect the amount of calcium in myocardial cell
What is Starling's Law? - CORRECT ANSWER- Stretching of heart muscle
fibers causes increased force of contraction (e.g., more blood going to heart ->
heart pumps harder> more CO)
In HF - this mechanism doesn't work (more blood coming in, but heart doesn't
pump harder)
Mean arterial pressure equation - CORRECT ANSWER- SBP+2(DBP)/3
Compensated stage of shock - CORRECT ANSWER- -refers to a state in
which the body has activated hormonal and chemical compensatory
mechanisms to help maintain homeostasis
-the body is able to maintain CO and SV
-CELLULAR DAMAGE IS STILL OCCURING
-if it is corrected at this stage, pt will recover
neural compensatory mechanisms in shock - CORRECT ANSWER- SNS
activation
-baroreceptors in the aortic arch and carotid bodies sense changes in blood flow
,-stimulates release of epinephrine and norepinephrine
epinephrine mechanism - CORRECT ANSWER- -beta receptors increase HR
(chronotropic),
-increases BP (afterload),
-vasoconstriction to legs,
-increase myocardial contractility,
-and bronchodilation.
norepinephrine mechanisms - CORRECT ANSWER- -alpha receptors increase
bp (afterload)
-increase vasoconstriction
-secretion of sweat (so does epi)
-inhibits insulin release and stimulates liver to release glucagon to increase
glucose
-stimulates spleen and liver to release RBCs, platelets etc.
biochemical compensatory mechanisms in compensatory stage of shock -
CORRECT ANSWER- -chemoreceptors in aortic arch, carotid bodies and
medulla sense decreased pH, O2, and increased CO2
-stimulation causes increase in RR and HR
-CO2 is a powerful vasodilator
hormonal compensatory mechanisms in compensatory stage of shock -
CORRECT ANSWER- -RAAS is activated as kidneys sense a decrease in
circulating volume (SNS innervation of kidneys)
RAAS system - CORRECT ANSWER- -kidneys release renin
, -renin converts angiotensinogen to angiotensin I
-ACE converts I to angiotensin II, which is a powerful vasoconstrictor. (it
increases afterload and bp)
-AII stimulates pituitary to release ADH (vasopressin) causing vasoconstriction
(increasing afterload and BP)
-AII also stimulates adrenal cortex to stimulate release of aldosterone
(increasing blood volume and preload)
signs and symptoms in the compensatory stage of shock - CORRECT
ANSWER- -skin normal or slightly pale, cool periphery
-increased RR (chemoreceptors), normal WOB, normal SPO2
-thirst
-slightly restless, possible mild confusion, decreased concentration, increased
glucose
-mild tachycardia, strong pulses centrally, possible slightly weaker peripherally,
normal bp (decreased bp is one of the first changes)
-decrease urine output, urine conc, hypoactive bowels
uncompensated (progressive ) stage of shock - CORRECT ANSWER- -stage
when compensatory mechanisms fail
-O2 supply and demand becomes imbalanced
-decreased cellular perfusion =decreased O2/glucose delivery
and leads to inability to remove waste
-accumulation of CO2= vasodilation
what happens when there is decreased perfusion? - CORRECT ANSWER- -
less o2 delivery
-cell functions fail the Na/K pump so more Na in cell therefore more water
therefore more swelling
AND ACCURATE ANSWERS GRADED A+ | LATEST UPDATE
2026/2027
shock - CORRECT ANSWER- syndrome characterized by decreased tissue
perfusion and impaired cellular metabolism
results in an imbalance btween supply and demand for oxygen and nutrients
classifications of shock - CORRECT ANSWER- hypovolemic
cardiogenic
distributive (sepsis, anaphylaxis and neurogenic)
Cardiac Output (CO) and calculation - CORRECT ANSWER- Amount of
blood pumped in 1 minute (~5 L)
stroke volume x heart rate
preload and what is it determined by? - CORRECT ANSWER- the volume of
blood in the ventricles at the end of diastole
determined by:
- venous return
-ability of ventricle to stretch, relax and fill
afterload and what is it determined by? - CORRECT ANSWER- the force, or
resistance, against which the ventricles have to pump in order to eject the blood
,3 Vs it is determined by:
-vessel tone
-valve
-viscosity
what is contractility determined by? - CORRECT ANSWER- -preload
-the stimulatory effect of the SNS
-external factors that affect the amount of calcium in myocardial cell
What is Starling's Law? - CORRECT ANSWER- Stretching of heart muscle
fibers causes increased force of contraction (e.g., more blood going to heart ->
heart pumps harder> more CO)
In HF - this mechanism doesn't work (more blood coming in, but heart doesn't
pump harder)
Mean arterial pressure equation - CORRECT ANSWER- SBP+2(DBP)/3
Compensated stage of shock - CORRECT ANSWER- -refers to a state in
which the body has activated hormonal and chemical compensatory
mechanisms to help maintain homeostasis
-the body is able to maintain CO and SV
-CELLULAR DAMAGE IS STILL OCCURING
-if it is corrected at this stage, pt will recover
neural compensatory mechanisms in shock - CORRECT ANSWER- SNS
activation
-baroreceptors in the aortic arch and carotid bodies sense changes in blood flow
,-stimulates release of epinephrine and norepinephrine
epinephrine mechanism - CORRECT ANSWER- -beta receptors increase HR
(chronotropic),
-increases BP (afterload),
-vasoconstriction to legs,
-increase myocardial contractility,
-and bronchodilation.
norepinephrine mechanisms - CORRECT ANSWER- -alpha receptors increase
bp (afterload)
-increase vasoconstriction
-secretion of sweat (so does epi)
-inhibits insulin release and stimulates liver to release glucagon to increase
glucose
-stimulates spleen and liver to release RBCs, platelets etc.
biochemical compensatory mechanisms in compensatory stage of shock -
CORRECT ANSWER- -chemoreceptors in aortic arch, carotid bodies and
medulla sense decreased pH, O2, and increased CO2
-stimulation causes increase in RR and HR
-CO2 is a powerful vasodilator
hormonal compensatory mechanisms in compensatory stage of shock -
CORRECT ANSWER- -RAAS is activated as kidneys sense a decrease in
circulating volume (SNS innervation of kidneys)
RAAS system - CORRECT ANSWER- -kidneys release renin
, -renin converts angiotensinogen to angiotensin I
-ACE converts I to angiotensin II, which is a powerful vasoconstrictor. (it
increases afterload and bp)
-AII stimulates pituitary to release ADH (vasopressin) causing vasoconstriction
(increasing afterload and BP)
-AII also stimulates adrenal cortex to stimulate release of aldosterone
(increasing blood volume and preload)
signs and symptoms in the compensatory stage of shock - CORRECT
ANSWER- -skin normal or slightly pale, cool periphery
-increased RR (chemoreceptors), normal WOB, normal SPO2
-thirst
-slightly restless, possible mild confusion, decreased concentration, increased
glucose
-mild tachycardia, strong pulses centrally, possible slightly weaker peripherally,
normal bp (decreased bp is one of the first changes)
-decrease urine output, urine conc, hypoactive bowels
uncompensated (progressive ) stage of shock - CORRECT ANSWER- -stage
when compensatory mechanisms fail
-O2 supply and demand becomes imbalanced
-decreased cellular perfusion =decreased O2/glucose delivery
and leads to inability to remove waste
-accumulation of CO2= vasodilation
what happens when there is decreased perfusion? - CORRECT ANSWER- -
less o2 delivery
-cell functions fail the Na/K pump so more Na in cell therefore more water
therefore more swelling
