NURS 400 UNIT 4 EXAM QUESTIONS WITH
VERIFIED ANSWERS
Chapter c18 cShock cand cMultiple cOrgan cDysfunction cSyndrome c- cCORRECT cANS✔✔
1. cA cnurse cin cthe cICU cis cplanning cthe ccare cof ca cpatient cwho cis cbeing ctreated cfor cshock.
Which cof cthe cfollowing cstatements cbest cdescribes cthe cpathophysiology cof cthis cpatients
health cproblem?
A) cBlood cis cshunted cfrom cvital corgAns cto cperipheral careas cof cthe cbody.
B) cCells clack can cadequate cblood csupply cand care cdeprived cof coxygen cand cnutrients.
C) cCirculating cblood cvolume cis cdecreased cwith ca cresulting cchange cin cthe cosmotic
pressure cgradient.
D) cHemorrhage coccurs cas ca cresult cof ctrauma, cdepriving cvital corgAns cof cadequate
perfusion. c- cCORRECT cANS✔✔B
2. cIn can cacute ccare csetting, cthe cnurse cis cassessing can cunstable cpatient. cWhen cprioritizing cthe
patients ccare, cthe cnurse cshould crecognize cthat cthe cpatient cis cat crisk cfor chypovolemic cshock
in cwhich cof cthe cfollowing ccircumstances?
A) cFluid cvolume ccirculating cin cthe cblood cvessels cdecreases.
B) cThere cis can cuncontrolled cincrease cin ccardiac coutput.
C) cBlood cpressure cregulation cbecomes cirregular.
D) cThe cpatient cexperiences ctachycardia cand ca cbounding cpulse. c- cCORRECT cANS✔✔A
3. cThe cemergency cnurse cis cadmitting ca cpatient cexperiencing ca cGI cbleed cwho cis cbelieved cto
be cin cthe ccompensatory cstage cof cshock. cWhat cassessment cfinding cwould cbe cmost
consistent cwith cthe cearly cstage cof ccompensation?
A) cIncreased curine coutput
B) cDecreased cheart crate
C) cHyperactive cbowel csounds
D) cCool, cclammy cskin c- cCORRECT cANS✔✔D
4. cThe cnurse cis ccaring cfor ca cpatient cwho cis cexhibiting csigns cand csymptoms cof chypovolemic
shock cfollowing cinjuries csuffered cin ca cmotor cvehicle caccident. cThe cnurse canticipates cthat
the cphysician cwill cpromptly corder cthe cadministration cof ca ccrystalloid cIV csolution cto
restore cintravascular cvolume. cIn caddition cto cnormal csaline, cwhich ccrystalloid cfluid cis
commonly cused cto ctreat chypovolemic cshock?
,C) cSeptic cshock
D) cHypovolemic cshock c- cCORRECT cANS✔✔B
7. cThe cintensive ccare cnurse ccaring cfor ca cpatient cin cshock cis cplanning cassessments cand
interventions crelated cto cthe cpatients cnutritional cneeds. cWhat cphysiologic cprocess
contributes cto cthese cincreased cnutritional cneeds?
A) cThe cuse cof calbumin cas can cenergy csource cby cthe cbody cbecause cof cthe cneed cfor
increased cadenosine ctriphosphate c(ATP)
B) cThe closs cof cfluids cdue cto cdecreased cskin cintegrity cand cdecreased cstomach cacids cdue
to cincreased cparasympathetic cactivity
C) cThe crelease cof ccatecholamines cthat ccreates can cincrease cin cmetabolic crate cand ccaloric
requirements
D) cThe cincrease cin cGI cperistalsis cduring cshock cand cthe cresulting cdiarrhea c- cCORRECT cANS✔
8. cThe cnurse cis ctrAnsferring ca cpatient cwho cis cin cthe cprogressive cstage cof cshock cinto cICU cfro
the cmedical cunit. cThe cmedical cnurse cis caware cthat cshock caffects cmany corgan csystems cand
that cnursing cmanagement cof cthe cpatient cwill cfocus con cwhat cintervention?
A) cReviewing cthe ccause cof cshock cand cprioritizing cthe cpatients cpsychosocial cneeds
B) cAssessing cand cunderstanding cshock cand cthe csignificant cchanges cin cassessment cdata
to cguide cthe cplan cof ccare
C) cGiving cthe cprescribed ctreatment, cbut cshifting cfocus cto cproviding cfamily ctime cas cthe
patient cis cunlikely cto csurvive
D) cPromoting cthe cpatients ccoping cskills cin can ceffort cto cbetter cdeal cwith cthe cphysiologic
changes caccompanying cshock c- cCORRECT cANS✔✔B
9. cWhen ccaring cfor ca cpatient cin cshock, cone cof cthe cmajor cnursing cgoals cis cto creduce cthe crisk
that cthe cpatient cwill cdevelop ccomplications cof cshock. cHow ccan cthe cnurse cbest cachieve cthis
goal?
A) cProvide ca cdetailed cdiagnosis cand cplan cof ccare cin corder cto cpromote cthe cpatients cand
familys ccoping.
B) cKeep cthe cphysician cupdated cwith cthe cmost caccurate cinformation cbecause cin ccases cof
shock cthe cnurse coften ccannot cprovide crelevant cinterventions.
C) cMonitor cfor csignificant cchanges cand cevaluate cpatient coutcomes con ca cscheduled
basis cfocusing con cblood cpressure cand cskin ctemperature.
D) cUnderstand cthe cunderlying cmechanisms cof cshock, crecognize cthe csubtle cand cmore
obvious csigns, cand cthen cprovide crapid cassessment. c- cCORRECT cANS✔✔D
10. cThe cnurse cis ccaring cfor ca cpatient cin cthe cICU cwho chas cbeen cdiagnosed cwith cmultiple corga
dysfunction csyndrome c(MODS). cThe cnurses cplan cof ccare cshould cinclude cwhich cof cthe
following cinterventions?
A) cEncouraging cthe cfamily cto cstay chopeful cand ceducating cthem cto cthe cfact cthat, cin
nearly call ccases, cthe cprognosis cis cgood
B) cEncouraging cthe cfamily cto cleave cthe chospital cand cto ctake ctime cfor cthemselves cas
acute ccare cof cMODS cpatients cmay clast cfor cseveral cmonths
C) cPromoting ccommunication cwith cthe cpatient cand cfamily calong cwith caddressing cendof-life cissu
D) cDiscussing corgan cdonation con ca cnumber cof cdifferent coccasions cto callow cthe cfamily
time cto cadjust cto cthe cidea c- cCORRECT cANS✔✔C
11. cThe cacute ccare cnurse cis cproviding ccare cfor can cadult cpatient cwho cis cin chypovolemic cshock
The cnurse crecognizes cthat cantidiuretic chormone c(ADH) cplays ca csignificant crole cin cthis
health cproblem. cWhat cassessment cfinding cwill cthe cnurse clikely cobserve crelated cto cthe crole
of cthe cADH cduring chypovolemic cshock?
A) cIncreased chunger
B) cDecreased cthirst
C) cDecreased curinary coutput
, assessment cand cinterventions cspecific cto cthe cadministration cof cvasoactive cmedications?
A) cFrequent cmonitoring cof cvital csigns, cmonitoring cthe ccentral cline csite, cand cproviding
accurate cdrug ctitration
B) cReviewing cmedications, cperforming ca cfocused ccardiovascular cassessment, cand
providing cpatient ceducation
C) cReviewing cthe claboratory cfindings, cmonitoring curine coutput, cand cassessing cfor
peripheral cedema
D) cRoutine cmonitoring cof cvital csigns, cmonitoring cthe cperipheral cIV csite, cand cproviding
early cdischarge cinstructions c- cCORRECT cANS✔✔A
15. cThe cnurse cin cthe cICU cis cadmitting ca c57-year-old cman cwith ca cdiagnosis cof cpossible cseptic
shock. cThe cnurses cassessment creveals cthat cthe cpatient chas ca cnormal cblood cpressure,
increased cheart crate, cdecreased cbowel csounds, cand ccold, cclammy cskin. cThe cnurses
analysis cof cthese cdata cshould clead cto cwhat cpreliminary cconclusion?
A) cThe cpatient cis cin cthe ccompensatory cstage cof cshock.
B) cThe cpatient cis cin cthe cprogressive cstage cof cshock.
C) cThe cpatient cwill cstabilize cand cbe creleased cby ctomorrow.
D) cThe cpatient cis cin cthe cirreversible cstage cof cshock. c- cCORRECT cANS✔✔A
16. cThe cnurse, ca cmember cof cthe chealth ccare cteam cin cthe cED, cis ccaring cfor ca cpatient cwho cis
determined cto cbe cin cthe cirreversible cstage cof cshock. cWhat cwould cbe cthe cmost cappropriate
nursing cintervention?
A) cProvide copportunities cfor cthe cfamily cto cspend ctime cwith cthe cpatient, cand chelp cthem
to cunderstand cthe cirreversible cstage cof cshock.
B) cInform cthe cpatients cfamily cimmediately cthat cthe cpatient cwill clikely cnot csurvive cto
allow cthe cfamily ctime cto cmake cplAns cand cmove cforward.
C) cClosely cmonitor cfluid creplacement ctherapy, cand cinform cthe cfamily cthat cthe cpatient
will cprobably csurvive cand creturn cto cnormal clife.
D) cProtect cthe cpatients cairway, coptimize cintravascular cvolume, cand cinitiate cthe cearly
rehabilitation cprocess. c- cCORRECT cANS✔✔A
17. cThe cnurse cin ca crural cnursing coutpost chas cjust cbeen cnotified cthat cshe cwill cbe creceiving ca
patient cin chypovolemic cshock cdue cto ca cmassive cpostpartum chemorrhage cafter cher chome
birth. cYou cknow cthat cthe cbest cchoice cfor cfluid creplacement cfor cthis cpatient cis cwhat?
A) c5% calbumin cbecause cit cis cinexpensive cand cis calways creadily cavailable
B) cDextran cbecause cit cincreases cintravascular cvolume cand ccounteracts ccoagulopathy
C) cWhatever cfluid cis cmost creadily cavailable cin cthe cclinic, cdue cto cthe cnature cof cthe
emergency
D) cLactated cRingers csolution cbecause cit cincreases cvolume, cbuffers cacidosis, cand cis cthe
best cchoice cfor cpatients cwith cliver cfailure c- cCORRECT cANS✔✔C
18. cThe cnurse cin cthe cICU cis ccaring cfor ca c47-year-old, cobese cmale cpatient cwho cis cin cshock
following ca cmotor cvehicle caccident. cThe cnurse cis caware cthat cpatients cin cshock cpossess
excess cenergy crequirements. cWhat cwould cbe cthe cmain cchallenge cin cmeeting cthis cpatients
elevated cenergy crequirements cduring cprolonged crehabilitation?
A) cLoss cof cadipose ctissue
B) cLoss cof cskeletal cmuscle
C) cInability cto cconvert cadipose ctissue cto cenergy
D) cInability cto cmaintain cnormal cbody cmass c- cCORRECT cANS✔✔B
19. cThe cnurse cin cthe cED cis ccaring cfor ca cpatient crecently cadmitted cwith ca clikely cmyocardial
infarction. cThe cnurse cunderstands cthat cthe cpatients cheart cis cpumping can cinadequate csupply
of coxygen cto cthe ctissues. cFor cwhat chealth cproblem cshould cthe cnurse cassess?
A) cDysrhythmias
B) cIncrease cin cblood cpressure
VERIFIED ANSWERS
Chapter c18 cShock cand cMultiple cOrgan cDysfunction cSyndrome c- cCORRECT cANS✔✔
1. cA cnurse cin cthe cICU cis cplanning cthe ccare cof ca cpatient cwho cis cbeing ctreated cfor cshock.
Which cof cthe cfollowing cstatements cbest cdescribes cthe cpathophysiology cof cthis cpatients
health cproblem?
A) cBlood cis cshunted cfrom cvital corgAns cto cperipheral careas cof cthe cbody.
B) cCells clack can cadequate cblood csupply cand care cdeprived cof coxygen cand cnutrients.
C) cCirculating cblood cvolume cis cdecreased cwith ca cresulting cchange cin cthe cosmotic
pressure cgradient.
D) cHemorrhage coccurs cas ca cresult cof ctrauma, cdepriving cvital corgAns cof cadequate
perfusion. c- cCORRECT cANS✔✔B
2. cIn can cacute ccare csetting, cthe cnurse cis cassessing can cunstable cpatient. cWhen cprioritizing cthe
patients ccare, cthe cnurse cshould crecognize cthat cthe cpatient cis cat crisk cfor chypovolemic cshock
in cwhich cof cthe cfollowing ccircumstances?
A) cFluid cvolume ccirculating cin cthe cblood cvessels cdecreases.
B) cThere cis can cuncontrolled cincrease cin ccardiac coutput.
C) cBlood cpressure cregulation cbecomes cirregular.
D) cThe cpatient cexperiences ctachycardia cand ca cbounding cpulse. c- cCORRECT cANS✔✔A
3. cThe cemergency cnurse cis cadmitting ca cpatient cexperiencing ca cGI cbleed cwho cis cbelieved cto
be cin cthe ccompensatory cstage cof cshock. cWhat cassessment cfinding cwould cbe cmost
consistent cwith cthe cearly cstage cof ccompensation?
A) cIncreased curine coutput
B) cDecreased cheart crate
C) cHyperactive cbowel csounds
D) cCool, cclammy cskin c- cCORRECT cANS✔✔D
4. cThe cnurse cis ccaring cfor ca cpatient cwho cis cexhibiting csigns cand csymptoms cof chypovolemic
shock cfollowing cinjuries csuffered cin ca cmotor cvehicle caccident. cThe cnurse canticipates cthat
the cphysician cwill cpromptly corder cthe cadministration cof ca ccrystalloid cIV csolution cto
restore cintravascular cvolume. cIn caddition cto cnormal csaline, cwhich ccrystalloid cfluid cis
commonly cused cto ctreat chypovolemic cshock?
,C) cSeptic cshock
D) cHypovolemic cshock c- cCORRECT cANS✔✔B
7. cThe cintensive ccare cnurse ccaring cfor ca cpatient cin cshock cis cplanning cassessments cand
interventions crelated cto cthe cpatients cnutritional cneeds. cWhat cphysiologic cprocess
contributes cto cthese cincreased cnutritional cneeds?
A) cThe cuse cof calbumin cas can cenergy csource cby cthe cbody cbecause cof cthe cneed cfor
increased cadenosine ctriphosphate c(ATP)
B) cThe closs cof cfluids cdue cto cdecreased cskin cintegrity cand cdecreased cstomach cacids cdue
to cincreased cparasympathetic cactivity
C) cThe crelease cof ccatecholamines cthat ccreates can cincrease cin cmetabolic crate cand ccaloric
requirements
D) cThe cincrease cin cGI cperistalsis cduring cshock cand cthe cresulting cdiarrhea c- cCORRECT cANS✔
8. cThe cnurse cis ctrAnsferring ca cpatient cwho cis cin cthe cprogressive cstage cof cshock cinto cICU cfro
the cmedical cunit. cThe cmedical cnurse cis caware cthat cshock caffects cmany corgan csystems cand
that cnursing cmanagement cof cthe cpatient cwill cfocus con cwhat cintervention?
A) cReviewing cthe ccause cof cshock cand cprioritizing cthe cpatients cpsychosocial cneeds
B) cAssessing cand cunderstanding cshock cand cthe csignificant cchanges cin cassessment cdata
to cguide cthe cplan cof ccare
C) cGiving cthe cprescribed ctreatment, cbut cshifting cfocus cto cproviding cfamily ctime cas cthe
patient cis cunlikely cto csurvive
D) cPromoting cthe cpatients ccoping cskills cin can ceffort cto cbetter cdeal cwith cthe cphysiologic
changes caccompanying cshock c- cCORRECT cANS✔✔B
9. cWhen ccaring cfor ca cpatient cin cshock, cone cof cthe cmajor cnursing cgoals cis cto creduce cthe crisk
that cthe cpatient cwill cdevelop ccomplications cof cshock. cHow ccan cthe cnurse cbest cachieve cthis
goal?
A) cProvide ca cdetailed cdiagnosis cand cplan cof ccare cin corder cto cpromote cthe cpatients cand
familys ccoping.
B) cKeep cthe cphysician cupdated cwith cthe cmost caccurate cinformation cbecause cin ccases cof
shock cthe cnurse coften ccannot cprovide crelevant cinterventions.
C) cMonitor cfor csignificant cchanges cand cevaluate cpatient coutcomes con ca cscheduled
basis cfocusing con cblood cpressure cand cskin ctemperature.
D) cUnderstand cthe cunderlying cmechanisms cof cshock, crecognize cthe csubtle cand cmore
obvious csigns, cand cthen cprovide crapid cassessment. c- cCORRECT cANS✔✔D
10. cThe cnurse cis ccaring cfor ca cpatient cin cthe cICU cwho chas cbeen cdiagnosed cwith cmultiple corga
dysfunction csyndrome c(MODS). cThe cnurses cplan cof ccare cshould cinclude cwhich cof cthe
following cinterventions?
A) cEncouraging cthe cfamily cto cstay chopeful cand ceducating cthem cto cthe cfact cthat, cin
nearly call ccases, cthe cprognosis cis cgood
B) cEncouraging cthe cfamily cto cleave cthe chospital cand cto ctake ctime cfor cthemselves cas
acute ccare cof cMODS cpatients cmay clast cfor cseveral cmonths
C) cPromoting ccommunication cwith cthe cpatient cand cfamily calong cwith caddressing cendof-life cissu
D) cDiscussing corgan cdonation con ca cnumber cof cdifferent coccasions cto callow cthe cfamily
time cto cadjust cto cthe cidea c- cCORRECT cANS✔✔C
11. cThe cacute ccare cnurse cis cproviding ccare cfor can cadult cpatient cwho cis cin chypovolemic cshock
The cnurse crecognizes cthat cantidiuretic chormone c(ADH) cplays ca csignificant crole cin cthis
health cproblem. cWhat cassessment cfinding cwill cthe cnurse clikely cobserve crelated cto cthe crole
of cthe cADH cduring chypovolemic cshock?
A) cIncreased chunger
B) cDecreased cthirst
C) cDecreased curinary coutput
, assessment cand cinterventions cspecific cto cthe cadministration cof cvasoactive cmedications?
A) cFrequent cmonitoring cof cvital csigns, cmonitoring cthe ccentral cline csite, cand cproviding
accurate cdrug ctitration
B) cReviewing cmedications, cperforming ca cfocused ccardiovascular cassessment, cand
providing cpatient ceducation
C) cReviewing cthe claboratory cfindings, cmonitoring curine coutput, cand cassessing cfor
peripheral cedema
D) cRoutine cmonitoring cof cvital csigns, cmonitoring cthe cperipheral cIV csite, cand cproviding
early cdischarge cinstructions c- cCORRECT cANS✔✔A
15. cThe cnurse cin cthe cICU cis cadmitting ca c57-year-old cman cwith ca cdiagnosis cof cpossible cseptic
shock. cThe cnurses cassessment creveals cthat cthe cpatient chas ca cnormal cblood cpressure,
increased cheart crate, cdecreased cbowel csounds, cand ccold, cclammy cskin. cThe cnurses
analysis cof cthese cdata cshould clead cto cwhat cpreliminary cconclusion?
A) cThe cpatient cis cin cthe ccompensatory cstage cof cshock.
B) cThe cpatient cis cin cthe cprogressive cstage cof cshock.
C) cThe cpatient cwill cstabilize cand cbe creleased cby ctomorrow.
D) cThe cpatient cis cin cthe cirreversible cstage cof cshock. c- cCORRECT cANS✔✔A
16. cThe cnurse, ca cmember cof cthe chealth ccare cteam cin cthe cED, cis ccaring cfor ca cpatient cwho cis
determined cto cbe cin cthe cirreversible cstage cof cshock. cWhat cwould cbe cthe cmost cappropriate
nursing cintervention?
A) cProvide copportunities cfor cthe cfamily cto cspend ctime cwith cthe cpatient, cand chelp cthem
to cunderstand cthe cirreversible cstage cof cshock.
B) cInform cthe cpatients cfamily cimmediately cthat cthe cpatient cwill clikely cnot csurvive cto
allow cthe cfamily ctime cto cmake cplAns cand cmove cforward.
C) cClosely cmonitor cfluid creplacement ctherapy, cand cinform cthe cfamily cthat cthe cpatient
will cprobably csurvive cand creturn cto cnormal clife.
D) cProtect cthe cpatients cairway, coptimize cintravascular cvolume, cand cinitiate cthe cearly
rehabilitation cprocess. c- cCORRECT cANS✔✔A
17. cThe cnurse cin ca crural cnursing coutpost chas cjust cbeen cnotified cthat cshe cwill cbe creceiving ca
patient cin chypovolemic cshock cdue cto ca cmassive cpostpartum chemorrhage cafter cher chome
birth. cYou cknow cthat cthe cbest cchoice cfor cfluid creplacement cfor cthis cpatient cis cwhat?
A) c5% calbumin cbecause cit cis cinexpensive cand cis calways creadily cavailable
B) cDextran cbecause cit cincreases cintravascular cvolume cand ccounteracts ccoagulopathy
C) cWhatever cfluid cis cmost creadily cavailable cin cthe cclinic, cdue cto cthe cnature cof cthe
emergency
D) cLactated cRingers csolution cbecause cit cincreases cvolume, cbuffers cacidosis, cand cis cthe
best cchoice cfor cpatients cwith cliver cfailure c- cCORRECT cANS✔✔C
18. cThe cnurse cin cthe cICU cis ccaring cfor ca c47-year-old, cobese cmale cpatient cwho cis cin cshock
following ca cmotor cvehicle caccident. cThe cnurse cis caware cthat cpatients cin cshock cpossess
excess cenergy crequirements. cWhat cwould cbe cthe cmain cchallenge cin cmeeting cthis cpatients
elevated cenergy crequirements cduring cprolonged crehabilitation?
A) cLoss cof cadipose ctissue
B) cLoss cof cskeletal cmuscle
C) cInability cto cconvert cadipose ctissue cto cenergy
D) cInability cto cmaintain cnormal cbody cmass c- cCORRECT cANS✔✔B
19. cThe cnurse cin cthe cED cis ccaring cfor ca cpatient crecently cadmitted cwith ca clikely cmyocardial
infarction. cThe cnurse cunderstands cthat cthe cpatients cheart cis cpumping can cinadequate csupply
of coxygen cto cthe ctissues. cFor cwhat chealth cproblem cshould cthe cnurse cassess?
A) cDysrhythmias
B) cIncrease cin cblood cpressure
