NURS 145 Lake Region State College -Med Surg Exam 1
Questions | 2026/2027 | Answers Correct | With Complete
Solutions
Anaphylactic Shock
Extreme hypertensive reaction to antigen. Education: allergy
avoidance methods. Most common: food allergy. Carry
epinephrine auto-injector. Carry medical allergy information.
Seek medical care immediately.
Septic Shock
Goal is to reduce mortality. Identify sepsis quickly to treat
promptly. Symptoms: tachycardia, hypotension, fever, shivering,
shortness of breath, clammy, sweating skin, confusion, pain.
Neurogenic Shock
Rare, Extensive dilation of peripheral blood vessels.
List data to collect when caring for patients in shock.
A: Airway. B: Breathing. C: Circulation, capillary refill,
cyanosis. D: Disability
Plan nursing care for patients in shock.
Begin with ABCD, maintain airway, oxygenation, monitor vital
signs, monitor intake and output, provide fluids as ordered,
provide warmth, relieve pain.
Prioritize care for a patient in shock.
, Airway management, breathing and respiratory support,
cardiovascular support, maintenance of circulatory volume,
control of bleeding if present, monitoring of neurologic status,
treatment of life-threatening injuries, determination and
treatment of the cause of shock.
Identify findings that demonstrate a positive response to
therapeutic measures for shock.
Urine output is at least 30 mL/hr., patient becomes more alert,
oriented, and less restless, MAP is over 65, systolic BP returns
towards baseline, decrease in tachycardia, HR returns to normal
range, skin becomes warm and dry, capillary refill time returns
to less than 2 seconds. Lab markers: serum lactate decreases,
ABG - resolution of metabolic acidosis and improving PaO2,
central venous pressure normalizes and suggest adequate fluid
volume.
Dehydration
Thirst, rapid and weak pulse, low blood pressure, dry skin and
mucous membranes, skin tenting, decreased urine output, and
increased temperature.
Interventions - Replace fluids and resolve the cause of
dehydration, isotonic solutions such as normal saline is used.
Fluid Excess
Bounding pulse, elevated blood pressure, respiratory changes,
edema, increased urine output, weight gain, heart failure.
Interventions - once the patients breathing is supported, the goal
Questions | 2026/2027 | Answers Correct | With Complete
Solutions
Anaphylactic Shock
Extreme hypertensive reaction to antigen. Education: allergy
avoidance methods. Most common: food allergy. Carry
epinephrine auto-injector. Carry medical allergy information.
Seek medical care immediately.
Septic Shock
Goal is to reduce mortality. Identify sepsis quickly to treat
promptly. Symptoms: tachycardia, hypotension, fever, shivering,
shortness of breath, clammy, sweating skin, confusion, pain.
Neurogenic Shock
Rare, Extensive dilation of peripheral blood vessels.
List data to collect when caring for patients in shock.
A: Airway. B: Breathing. C: Circulation, capillary refill,
cyanosis. D: Disability
Plan nursing care for patients in shock.
Begin with ABCD, maintain airway, oxygenation, monitor vital
signs, monitor intake and output, provide fluids as ordered,
provide warmth, relieve pain.
Prioritize care for a patient in shock.
, Airway management, breathing and respiratory support,
cardiovascular support, maintenance of circulatory volume,
control of bleeding if present, monitoring of neurologic status,
treatment of life-threatening injuries, determination and
treatment of the cause of shock.
Identify findings that demonstrate a positive response to
therapeutic measures for shock.
Urine output is at least 30 mL/hr., patient becomes more alert,
oriented, and less restless, MAP is over 65, systolic BP returns
towards baseline, decrease in tachycardia, HR returns to normal
range, skin becomes warm and dry, capillary refill time returns
to less than 2 seconds. Lab markers: serum lactate decreases,
ABG - resolution of metabolic acidosis and improving PaO2,
central venous pressure normalizes and suggest adequate fluid
volume.
Dehydration
Thirst, rapid and weak pulse, low blood pressure, dry skin and
mucous membranes, skin tenting, decreased urine output, and
increased temperature.
Interventions - Replace fluids and resolve the cause of
dehydration, isotonic solutions such as normal saline is used.
Fluid Excess
Bounding pulse, elevated blood pressure, respiratory changes,
edema, increased urine output, weight gain, heart failure.
Interventions - once the patients breathing is supported, the goal
