1. a.) Hypovolemic A patient is admitted to the emergency
department after sustaining abdominal in-
juries and a broken femur from a motor
vehicle accident. The patient is pale, di-
aphoretic, and is not talking coherently. Vi-
tal signs upon admission are temperature
98 F (36 C), heart rate 130 beats/minute,
respiratory rate 34 breaths/minute, blood
pressure 50/40 mmHg. The healthcare
provider suspects which type of shock?
a.) Hypovolemic
b.) Cardiogenic
c.) Neurogenic
d.) Distributive
2. d.) Increase the IV infusion rate The healthcare provider is caring for a
patient with a diagnosis of hemorrhagic
pancreatitis. The patient's central venous
pressure (CVP) reading is 2, blood pres-
sure is 90/50 mmHg, lung sounds are
clear, and jugular veins are flat. Which of
these actions is most appropriate for the
nurse to take?
a.) Slow the IV infusion rate
b.) Administer dopamine
c.) No interventions are needed at this
time
d.) Increase the IV infusion rate
3. c.) Obstructive A patient who has pericarditis related to
radiation therapy, becomes dyspneic, and
Rationale: has a rapid, weak pulse. Heart sounds
Obstructive shock can be are muffled, and a 12 mmHg drop in
caused by anything that im- blood pressure is noted on inspiration.
pedes the heart's ability to con- The healthcare provider's interventions
tract and pump blood around are aimed at preventing which type of
shock?
, SHOCK NCLEX QUESTIONS WITH 100% VERIFIED SOLUTIONS
the body, as with cardiac tam-
ponade. a.) Distributive
b.) Neurogenic
c.) Obstructive
d.) Cardiogenic
4. c.) IV fluids to increase intravas- The healthcare provider is caring for a pa-
cular volume. tient who has septic shock. Which of these
should the healthcare provider administer
Rationale: to the patient first?
Circulation and perfusion are
addressed first so IV fluids a.) Antibiotics to treat the underlying infec-
will be started immediately. tion.
After blood cultures are ob- b.) Corticosteroids to reduce inflamma-
tained, broad-spectrum antibi- tion.
otics should be administered c.) IV fluids to increase intravascular vol-
without delay. Vasopressors are ume.
administered if the patient is d.) Vasopressors to increase blood pres-
not responding to the fluid sure.
challenge. Corticosteroids may
be considered to address the
inflammatory-induced vasodila-
tion and capillary leakage.
5. c.) Establish vascular access A 4.5 kg infant is admitted to the pedi-
atric intensive care unit after 33 days of
Rationale: watery diarrhea. The infant is diagnosed
Vascular access should be es- with severe dehydration. The infant's skin
tablished quickly in order to re- is mottled and turgor is poor. Capillary re-
place lost volume before shock fill is delayed, and there is an absence
progresses. of tears with crying. Which intervention
should be the priority action by the health-
care provider?
a.) Calculate the mean arterial pressure
b.) Draw blood for a complete blood count
c.) Establish vascular access
d.) Take a complete set of vital signs
, SHOCK NCLEX QUESTIONS WITH 100% VERIFIED SOLUTIONS
6. c.) Tachycardia Which of the following assessment find-
ings is an early indication of hypovolemic
Rationale: shock?
Tachycardia is an early symp-
tom as the body compensates a.) Diminished bowel sounds
for a declining blood pressure b.) Increased urinary output
the heart rate increases to circu- c.) Tachycardia
late the blood faster to prevent d.) Hypertension
tissue hypoxia.
7. d.) Cardiac output (CO) and When compensatory mechanisms for hy-
blood pressure (BP). povolemic shock are activated, the nurse
would expect which two patient findings to
normalize?
a.) Intensity of peripheral pulses and body
temperature.
b.) Peripheral pulses and heart rate (HR).
c.) Metabolic alkalosis and oxygen satura-
tion.
d.) Cardiac output (CO) and blood pres-
sure (BP).
8. a.) Lactated Ringers (LR) Which type of fluid is most appropriate
for volume replacement for a patient with
non-hemorrhagic hypovolemic shock?
a.) Lactated Ringers (LR)
b.) 10% Dextrose in Water (D 10 W)
c.) One-half Normal Saline (1/2% NS)
d.) Packed Red Blood Cells (PRBC)
9. c.) Demonstrating MODS. A client is progressing into the third stage
d.) Buildup of metabolic wastes. of shock. The nurse will expect this client
to demonstrate:
Choose all that apply:
a.) Intractable circulatory failure.