NSG 411 Exam 2 UPDATED Exam
Questions and CORRECT Answers
inadequate oxygen delivery to meet metabolic demands - CORRECT ANSWER - shock
syndrome characterized by decreased tissue perfusion and impaired cellular metabolism -
CORRECT ANSWER - shock
what does shock result in - CORRECT ANSWER - global tissue hypo perfusion and
metabolic acidosis
what can shock occur with - CORRECT ANSWER - a normal blood pressure
what can hypotension occur without - CORRECT ANSWER - shock
what does inadequate oxygen delivery activate to maintain systemic oxygen delivery -
CORRECT ANSWER - autonomic responses
what neurotransmitters does the SNS release - CORRECT ANSWER - norepinephrine
epinephrine
dopamine
cortisol
what does the renin angiotensin system conserve and vasoconstrict - CORRECT
ANSWER - water and sodium
what is the goal of the renin angiotensin system to maintain - CORRECT ANSWER -
cerebral and cardiac perfusion
,what does shock lead to - CORRECT ANSWER - systemic metabolic lactic acidosis
what does systemic metabolic lactic acidosis overcome - CORRECT ANSWER - the
body's compensatory mechanisms
marker for cellular hypoxia - CORRECT ANSWER - lactate
inability of oxygen delivery to meet demand - CORRECT ANSWER - tissue hypoxia
4 stages of shock - CORRECT ANSWER - 1. initial
2. compensatory
3. progressive
4. refractory
which stage of shock is NOT clinically apparent - CORRECT ANSWER - initial
manifestations of the compensatory stage of shock - CORRECT ANSWER - - restlessness
- tachycardia
- hypotension
- tachypnea
- oliguria
- hyperglycemia
- decreased bowel sounds
- weak pulses
- cool extremities
manifestations of the progressive stage of shock - CORRECT ANSWER - - hypotension
- weak peripheral pulses
,- anuria
- ischemia of distal extremities
- lethargy
- absent bowel sounds
- dysrhythmias
- metabolic or respiratory acidosis
manifestations of the refractory stage of shock - CORRECT ANSWER - - profound
hypotension
- tachycardia
- peripheral tissue ischemia
- multisystem organ failure
- coma
result of multiorgan dysfunction syndrome - CORRECT ANSWER - end organ failure
what does hypovolemia require - CORRECT ANSWER - definitive treatment
what is given for non hemorrhagic hypovolemic shock - CORRECT ANSWER -
crystalloids
what is given for hemorrhagic hypovolemic shock - CORRECT ANSWER - packed red
blood cells
Which finding is the best indicator that the fluid resuscitation for a 90-kg patient with
hypovolemic shock has been effective?
A. Hemoglobin is within normal limits
B. Urine output is 65 mL over the past hour
C. Central venous pressure (CVP) is normal
, D. Mean arterial pressure (MAP) is 72 mm Hg - CORRECT ANSWER - B. Urine output
is 65 mL over the past hour
A patient who has been involved in a motor vehicle crash arrives in the emergency department
(ED) with cool, clammy skin; tachycardia; and hypotension. Which intervention ordered by the
health care provider should the nurse implement first?
A. Insert two large-bore IV catheters
B. Provide O2 at 100% per non-rebreather mask
C. Draw blood to type and crossmatch for transfusions
D. Initiate continuous electrocardiogram (ECG) monitoring - CORRECT ANSWER - B.
Provide O2 at 100% per non-rebreather mask
type of shock: An 81-year-old female resident of a nursing home presents to the ED with altered
mental status. She is febrile to 101°and is hypotensive, tachycardia, with warm extremities. -
CORRECT ANSWER - septic
what vital sign can be normal with septic shock - CORRECT ANSWER - blood pressure
manifestations of septic shock - CORRECT ANSWER - - hyper/hypothermia
- tachycardia
- widening pulse pressure
- SBP <90
- mental status changes
treatment for septic shock - CORRECT ANSWER - oxygen
IV fluids
empiric antibiotics
appropriate antibiotic
Questions and CORRECT Answers
inadequate oxygen delivery to meet metabolic demands - CORRECT ANSWER - shock
syndrome characterized by decreased tissue perfusion and impaired cellular metabolism -
CORRECT ANSWER - shock
what does shock result in - CORRECT ANSWER - global tissue hypo perfusion and
metabolic acidosis
what can shock occur with - CORRECT ANSWER - a normal blood pressure
what can hypotension occur without - CORRECT ANSWER - shock
what does inadequate oxygen delivery activate to maintain systemic oxygen delivery -
CORRECT ANSWER - autonomic responses
what neurotransmitters does the SNS release - CORRECT ANSWER - norepinephrine
epinephrine
dopamine
cortisol
what does the renin angiotensin system conserve and vasoconstrict - CORRECT
ANSWER - water and sodium
what is the goal of the renin angiotensin system to maintain - CORRECT ANSWER -
cerebral and cardiac perfusion
,what does shock lead to - CORRECT ANSWER - systemic metabolic lactic acidosis
what does systemic metabolic lactic acidosis overcome - CORRECT ANSWER - the
body's compensatory mechanisms
marker for cellular hypoxia - CORRECT ANSWER - lactate
inability of oxygen delivery to meet demand - CORRECT ANSWER - tissue hypoxia
4 stages of shock - CORRECT ANSWER - 1. initial
2. compensatory
3. progressive
4. refractory
which stage of shock is NOT clinically apparent - CORRECT ANSWER - initial
manifestations of the compensatory stage of shock - CORRECT ANSWER - - restlessness
- tachycardia
- hypotension
- tachypnea
- oliguria
- hyperglycemia
- decreased bowel sounds
- weak pulses
- cool extremities
manifestations of the progressive stage of shock - CORRECT ANSWER - - hypotension
- weak peripheral pulses
,- anuria
- ischemia of distal extremities
- lethargy
- absent bowel sounds
- dysrhythmias
- metabolic or respiratory acidosis
manifestations of the refractory stage of shock - CORRECT ANSWER - - profound
hypotension
- tachycardia
- peripheral tissue ischemia
- multisystem organ failure
- coma
result of multiorgan dysfunction syndrome - CORRECT ANSWER - end organ failure
what does hypovolemia require - CORRECT ANSWER - definitive treatment
what is given for non hemorrhagic hypovolemic shock - CORRECT ANSWER -
crystalloids
what is given for hemorrhagic hypovolemic shock - CORRECT ANSWER - packed red
blood cells
Which finding is the best indicator that the fluid resuscitation for a 90-kg patient with
hypovolemic shock has been effective?
A. Hemoglobin is within normal limits
B. Urine output is 65 mL over the past hour
C. Central venous pressure (CVP) is normal
, D. Mean arterial pressure (MAP) is 72 mm Hg - CORRECT ANSWER - B. Urine output
is 65 mL over the past hour
A patient who has been involved in a motor vehicle crash arrives in the emergency department
(ED) with cool, clammy skin; tachycardia; and hypotension. Which intervention ordered by the
health care provider should the nurse implement first?
A. Insert two large-bore IV catheters
B. Provide O2 at 100% per non-rebreather mask
C. Draw blood to type and crossmatch for transfusions
D. Initiate continuous electrocardiogram (ECG) monitoring - CORRECT ANSWER - B.
Provide O2 at 100% per non-rebreather mask
type of shock: An 81-year-old female resident of a nursing home presents to the ED with altered
mental status. She is febrile to 101°and is hypotensive, tachycardia, with warm extremities. -
CORRECT ANSWER - septic
what vital sign can be normal with septic shock - CORRECT ANSWER - blood pressure
manifestations of septic shock - CORRECT ANSWER - - hyper/hypothermia
- tachycardia
- widening pulse pressure
- SBP <90
- mental status changes
treatment for septic shock - CORRECT ANSWER - oxygen
IV fluids
empiric antibiotics
appropriate antibiotic
