Barron's CCRN: Multisystem Exam 2025 Questions and Answers

Barron's CCRN: Multisystem Exam
2025 Questions and Answers


Shock - ANSWER-*Cellular disease* d/t either inadequate perfusion (O2

demand> O2 delivered) or inability to utilize the delivered O2

3 phases of shock - ANSWER-Compensatory

Progressive

Refractory

Shock: compensatory phase S/S - ANSWER-BP is maintained d/t sympathetic

nervous system and activation of renin-angiotensin-aldosterone system (RAAS)

Tachycardia

Tachypnea, respiratory alkalosis

Normal PaO2

Oliguria

Skin pale, cool

Restlessness, anxiety




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,Complaints of thirst

*BP maintained*

Shock: Progressive phase - ANSWER-*Hypotension*

Worsening tachycardia, tachypnea, oliguria

Metabolic acidosis

Decreased PaO2

Clammy, mottled skin

Further change in LOC

May complain of nausea

Shock: Refractory phase - ANSWER-*Not responsive to interventions*

Severe systemic hypoperfusion, *multisystem organ dysfunction*

May survive shock, die from failure of one or more organs

--Pulmonary (ARDS)

--Kidney (acute tubular necrosis)

--Heart (failure, ischemia)

--Hematologic (DIC)

--Neurological (encephalopathy, stroke)




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, --Liver (failure)

Sympathetic nervous system activation in shock - ANSWER-Decrease in CO/

circulating volume or increased oxygen utilization

↓

Sympathetic stimulation

↓

Vasoconstriction, Increased HR, Increased contractility

↓

BP maintained during compensatory phase

renin-angiotensin-aldosterone system - ANSWER-a hormone cascade pathway that

helps regulate blood pressure and blood volume

Types of shock - ANSWER-Hypovolemic

Septic

Anaphylactic

Cardiogenic

Neurogenic (not on test)

Obstructive

--Tension pneumothorax, Massive PE, Cardiac tamponade


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