Examl 2:l NRl 341/l NR341l (Latestl 2026/l
2027l Update)l Complexl Adultl Healthl
Guide|l Q/Al |l Gradel A|l 100%l Correctl
(Verifiedl Answers)l -Chamberlain
Q:l s/sl ofl lowl cardiacl output
Answer:
-l SOB
-l hypotension
-l tachycardia
-l tachypnea
-l dizziness
-l angina
-l decreasedl urinel output
-l pale,l cool,l clamyl skin
-l morel thanl 3l secondl capillaryl refill
Q:l Cardiacl Outputl (CO);l normall =l 4-8L/min
Answer:
HRl Xl SVl =
Q:l Hemodynamics
Answer:
thel sciencel ofl thel bloodl flowl throughl thel circulation
Q:l shock
,**l lackl ofl nutrientsl andl oxygenl tol organs
Answer:
-l responsel ofl thel bodyl resultingl froml inadequatel tissuel perfusion
-l imbalancel ofl supplyl andl demandl ofl oxygenl andl nutrientsl -->l bodyl cellsl willl
eventuallyl diel (multil organl failure)l ifl notl treated
-l earlyl detectionl isl necessary...l perfusionl tol tissuesl needl tol bel restored!
Types:
1.l Hypovolemicl =l inadequatel intravascularl bloodl volume
2.l Cardiogenicl =l heartl failsl tol actl asl anl effectivel pump
3.l Obstructivel =l physicall impairmentl tol adequatel circulatingl bloodl flow
4.l Distributivel =l widespreadl vasodilationl andl decreasedl vascularl tonel resultingl inl al
relativel (stilll fluidl inl thel bodyl butl notl inl thel rightl spot)l hypovolemial (anaphylactic,l
septic,l neurogenic)
Stages:
1.l Initiationl =l nol obviousl clinicall signs
2.l Compensatoryl =l compensatoryl mechanismsl initiated
-l increasedl HR,RR
-l pallorl duel tol bloodl beingl shuntedl froml thel skin/extremitiesl tol thel heartl
-l lackl ofl bloodl flowl tol kidneysl -->l RASl -->l angiotensinl -->l waterl retentionl
-l releasel ofl aldosteronel (sodiuml andl waterl retention;l oliguria)l andl ADHl (waterl
retention)
3.l Progressivel =l profoundl CVl effectsl
-l ICU
-l anaerobicl metabolisml (morel organl function;l increasel ofl lacticl acid)
4.l Refractoryl =l inadequatel tissuel perfusionl unresponsivel tol therapyl
-l acidoticl
-l multil organl failure
-l canl bel unresponsivel tol treatment
-l bradycardia,l bradypnea,l unresponsive,l hypotension
Nursingl actions:
,-l monitorl airwayl andl VS
-l providel hemodynamicl support
-l havel resuscitationl equipmentl available
-l explainl alll proceduresl tol clientl andl family
Q:l earlyl s/sl froml shock
Answer:
Manifestations:
-l restlessness,l agitation,l anxietyl (poorl perfusionl tol brain)l
-l increasedl RRl ratel andl depthl
-l tachycardial
-l weakl andl threadyl orl boundingl pulsel (dependingl onl shockl type)
-l decreasedl COl =l hypotension
-l RASl systeml activatedl =l decreasel inl urinel output;l drugsl can'tl bel metabolizedl properlyl
-l hepaticl =l jaundice;l drugsl can'tl bel metabolizedl properlyl
-l decreasedl bowell soundsl andl peristalsis
-l palel naill beds,l prolongedl capl refill
-l diaphoreticl
-l respiratoryl alkalosisl
-l elevatedl glucosel duel tol cortisoll releasel tol givel thel bodyl energy
Q:l latel manifestationsl ofl shock
Answer:
Manifestations:
-l lethargic,l obtunded,l seizure,l unresponsivel
-l decreasedl RRl ratel andl depthl (shallow;l apnea)
-l bradycardial
-l morel profoundl hypotension,l cardiacl dysrhythmiasl
-l GIl bleeding,l paralyticl ilieusl
-l dustyl coloredl naill bedsl
-l nol perspirationl left
-l respiratory/metabolicl acidosisl
-l increasedl lacticl acidl
-l hypoglycemic
, Q:l hypovolemicl shockl
**l enginel isl working,l butl nol gas..l theyl needl fluids
Answer:
-l inadequatel circulatingl volume
-l decreasedl preload;l increasedl afterloadl
Causes:
-l internall orl externall lossl ofl bloodl orl fluid
-l hemorrhage,l burns,l DKA,l DI,l prolongedl vomiting/diarrhea
Manifestations:
-l decreasedl LOC
-l increasedl RR,l HR
-l hypotension
-l cooll clammyl skin
-l weakl threadyl pulse
-l prolongedl capl refilll
Nursingl actions:
-l stopl fluidl lossl andl replacel lostl volume
-l bloodl andl fluidsl shouldl bel warmedl
-l modifiedl trendelenburgl (lowerl extremitiesl elevated)l tol helpl restorel bloodl flowl tol vitall
organs
Q:l cardiogenicl shockl
**l bel carefull tol notl dropl bloodl pressurel tool low)
**l enginel isl failing,l theyl havel gas..l don'tl needl fluids
Answer:
-l heartl failsl tol actl asl anl effectivel pumpl (impairedl perfusion)
-l myocardiall musclel isl weakl andl cannotl providel enoughl oxygenl tol thel bodyl (decreasedl
CO)
-l increasedl preloadl andl afterloadl
2027l Update)l Complexl Adultl Healthl
Guide|l Q/Al |l Gradel A|l 100%l Correctl
(Verifiedl Answers)l -Chamberlain
Q:l s/sl ofl lowl cardiacl output
Answer:
-l SOB
-l hypotension
-l tachycardia
-l tachypnea
-l dizziness
-l angina
-l decreasedl urinel output
-l pale,l cool,l clamyl skin
-l morel thanl 3l secondl capillaryl refill
Q:l Cardiacl Outputl (CO);l normall =l 4-8L/min
Answer:
HRl Xl SVl =
Q:l Hemodynamics
Answer:
thel sciencel ofl thel bloodl flowl throughl thel circulation
Q:l shock
,**l lackl ofl nutrientsl andl oxygenl tol organs
Answer:
-l responsel ofl thel bodyl resultingl froml inadequatel tissuel perfusion
-l imbalancel ofl supplyl andl demandl ofl oxygenl andl nutrientsl -->l bodyl cellsl willl
eventuallyl diel (multil organl failure)l ifl notl treated
-l earlyl detectionl isl necessary...l perfusionl tol tissuesl needl tol bel restored!
Types:
1.l Hypovolemicl =l inadequatel intravascularl bloodl volume
2.l Cardiogenicl =l heartl failsl tol actl asl anl effectivel pump
3.l Obstructivel =l physicall impairmentl tol adequatel circulatingl bloodl flow
4.l Distributivel =l widespreadl vasodilationl andl decreasedl vascularl tonel resultingl inl al
relativel (stilll fluidl inl thel bodyl butl notl inl thel rightl spot)l hypovolemial (anaphylactic,l
septic,l neurogenic)
Stages:
1.l Initiationl =l nol obviousl clinicall signs
2.l Compensatoryl =l compensatoryl mechanismsl initiated
-l increasedl HR,RR
-l pallorl duel tol bloodl beingl shuntedl froml thel skin/extremitiesl tol thel heartl
-l lackl ofl bloodl flowl tol kidneysl -->l RASl -->l angiotensinl -->l waterl retentionl
-l releasel ofl aldosteronel (sodiuml andl waterl retention;l oliguria)l andl ADHl (waterl
retention)
3.l Progressivel =l profoundl CVl effectsl
-l ICU
-l anaerobicl metabolisml (morel organl function;l increasel ofl lacticl acid)
4.l Refractoryl =l inadequatel tissuel perfusionl unresponsivel tol therapyl
-l acidoticl
-l multil organl failure
-l canl bel unresponsivel tol treatment
-l bradycardia,l bradypnea,l unresponsive,l hypotension
Nursingl actions:
,-l monitorl airwayl andl VS
-l providel hemodynamicl support
-l havel resuscitationl equipmentl available
-l explainl alll proceduresl tol clientl andl family
Q:l earlyl s/sl froml shock
Answer:
Manifestations:
-l restlessness,l agitation,l anxietyl (poorl perfusionl tol brain)l
-l increasedl RRl ratel andl depthl
-l tachycardial
-l weakl andl threadyl orl boundingl pulsel (dependingl onl shockl type)
-l decreasedl COl =l hypotension
-l RASl systeml activatedl =l decreasel inl urinel output;l drugsl can'tl bel metabolizedl properlyl
-l hepaticl =l jaundice;l drugsl can'tl bel metabolizedl properlyl
-l decreasedl bowell soundsl andl peristalsis
-l palel naill beds,l prolongedl capl refill
-l diaphoreticl
-l respiratoryl alkalosisl
-l elevatedl glucosel duel tol cortisoll releasel tol givel thel bodyl energy
Q:l latel manifestationsl ofl shock
Answer:
Manifestations:
-l lethargic,l obtunded,l seizure,l unresponsivel
-l decreasedl RRl ratel andl depthl (shallow;l apnea)
-l bradycardial
-l morel profoundl hypotension,l cardiacl dysrhythmiasl
-l GIl bleeding,l paralyticl ilieusl
-l dustyl coloredl naill bedsl
-l nol perspirationl left
-l respiratory/metabolicl acidosisl
-l increasedl lacticl acidl
-l hypoglycemic
, Q:l hypovolemicl shockl
**l enginel isl working,l butl nol gas..l theyl needl fluids
Answer:
-l inadequatel circulatingl volume
-l decreasedl preload;l increasedl afterloadl
Causes:
-l internall orl externall lossl ofl bloodl orl fluid
-l hemorrhage,l burns,l DKA,l DI,l prolongedl vomiting/diarrhea
Manifestations:
-l decreasedl LOC
-l increasedl RR,l HR
-l hypotension
-l cooll clammyl skin
-l weakl threadyl pulse
-l prolongedl capl refilll
Nursingl actions:
-l stopl fluidl lossl andl replacel lostl volume
-l bloodl andl fluidsl shouldl bel warmedl
-l modifiedl trendelenburgl (lowerl extremitiesl elevated)l tol helpl restorel bloodl flowl tol vitall
organs
Q:l cardiogenicl shockl
**l bel carefull tol notl dropl bloodl pressurel tool low)
**l enginel isl failing,l theyl havel gas..l don'tl needl fluids
Answer:
-l heartl failsl tol actl asl anl effectivel pumpl (impairedl perfusion)
-l myocardiall musclel isl weakl andl cannotl providel enoughl oxygenl tol thel bodyl (decreasedl
CO)
-l increasedl preloadl andl afterloadl
