ATI Med Surg test questions Shock and Multiple Organ Dysfunction
Syndrome 100% Correct Answers, Download to Score A
A nurse in the ICU is planning the care of a patient who is being treated for shock.
Which of the following statements best describes the pathophysiology of this patient's
health problem?
A) Blood is shunted from vital organs to peripheral areas of the body.
B) Cells lack an adequate blood supply and are deprived of oxygen and nutrients.
C) Circulating blood volume is decreased with a resulting change in the osmotic
pressure gradient.
D) Hemorrhage occurs as a result of trauma, depriving vital organs of adequate
perfusion. - Ans: B
Feedback:
Shock is a life-threatening condition with a variety of underlying causes. Shock is
caused when the cells have a lack of adequate blood supply and are deprived of
oxygen and nutrients. In cases of shock, blood is shunted from peripheral areas of the
body to the vital organs. Hemorrhage and decreased blood volume are associated with
some, but not all, types of shock.
In an acute care setting, the nurse is assessing an unstable patient. When prioritizing
the patient's care, the nurse should recognize that the patient is at risk for hypovolemic
shock in which of the following circumstances?
A) Fluid volume circulating in the blood vessels decreases.
B) There is an uncontrolled increase in cardiac output.
C) Blood pressure regulation becomes irregular.
D) The patient experiences tachycardia and a bounding pulse. - Ans: A
Feedback:
Hypovolemic shock is characterized by a decrease in intravascular volume. Cardiac
output is decreased, blood pressure decreases, and pulse is fast, but weak.
The emergency nurse is admitting a patient experiencing a GI bleed who is believed to
be in the compensatory stage of shock. What assessment finding would be most
consistent with the early stage of compensation?
A) Increased urine output
,B) Decreased heart rate
C) Hyperactive bowel sounds
D) Cool, clammy skin - Ans: D
Feedback:
In the compensatory stage of shock, the body shunts blood from the organs, such as
the skin and kidneys, to the brain and heart to ensure adequate blood supply. As a
result, the patient's skin is cool and clammy. Also in this compensatory stage, blood
vessels vasoconstrict, the heart rate increases, bowel sounds are hypoactive, and the
urine output decreases.
The nurse is caring for a patient who is exhibiting signs and symptoms of
hypovolemic shock following injuries suffered in a motor vehicle accident. The nurse
anticipates that the physician will promptly order the administration of a crystalloid IV
solution to restore intravascular volume. In addition to normal saline, which
crystalloid fluid is commonly used to treat hypovolemic shock?
A) Lactated Ringer's
B) Albumin
C) Dextran
D) 3% NaCl - Ans: A
Feedback:
Crystalloids are electrolyte solutions used for the treatment of hypovolemic shock.
Lactated Ringer's and 0.9% sodium chloride are isotonic crystalloid fluids commonly
used to manage hypovolemic shock. Dextran and albumin are colloids, but Dextran,
even as a colloid, is not indicated for the treatment of hypovolemic shock. 3% NaCl is
a hypertonic solution and is not isotonic.
A patient who is in shock is receiving dopamine in addition to IV fluids. What
principle should inform the nurse's care planning during the administration of a
vasoactive drug?
A) The drug should be discontinued immediately after blood pressure increases.
B) The drug dose should be tapered down once vital signs improve.
C) The patient should have arterial blood gases drawn every 10 minutes during
treatment.
, D) The infusion rate should be titrated according the patient's subjective sensation of
adequate perfusion. - Ans: B
Feedback:
When vasoactive medications are discontinued, they should never be stopped abruptly
because this could cause severe hemodynamic instability, perpetuating the shock state.
Subjective assessment data are secondary to objective data. Arterial blood gases
should be carefully monitored, but every10-minute draws are not the norm.
6. A nurse in the ICU receives report from the nurse in the ED about a new patient
being admitted with a neck injury he received while diving into a lake. The ED nurse
reports that his blood pressure is 85/54, heart rate is 53 beats per minute, and his skin
is warm and dry. What does the ICU nurse recognize that that patient is probably
experiencing?
A) Anaphylactic shock
B) Neurogenic shock
C) Septic shock
D) Hypovolemic shock - Ans: B
Feedback:
Neurogenic shock can be caused by spinal cord injury. The patient will present with a
low blood pressure; bradycardia; and warm, dry skin due to the loss of sympathetic
muscle tone and increased parasympathetic stimulation. Anaphylactic shock is caused
by an identifiable offending agent, such as a bee sting. Septic shock is caused by
bacteremia in the blood and presents with a tachycardia. Hypovolemic shock presents
with tachycardia and a probable source of blood loss.
The intensive care nurse caring for a patient in shock is planning assessments and
interventions related to the patient's nutritional needs. What physiologic process
contributes to these increased nutritional needs?
A) The use of albumin as an energy source by the body because of the need for
increased adenosine triphosphate (ATP)
B) The loss of fluids due to decreased skin integrity and decreased stomach acids due
to increased parasympathetic activity
Syndrome 100% Correct Answers, Download to Score A
A nurse in the ICU is planning the care of a patient who is being treated for shock.
Which of the following statements best describes the pathophysiology of this patient's
health problem?
A) Blood is shunted from vital organs to peripheral areas of the body.
B) Cells lack an adequate blood supply and are deprived of oxygen and nutrients.
C) Circulating blood volume is decreased with a resulting change in the osmotic
pressure gradient.
D) Hemorrhage occurs as a result of trauma, depriving vital organs of adequate
perfusion. - Ans: B
Feedback:
Shock is a life-threatening condition with a variety of underlying causes. Shock is
caused when the cells have a lack of adequate blood supply and are deprived of
oxygen and nutrients. In cases of shock, blood is shunted from peripheral areas of the
body to the vital organs. Hemorrhage and decreased blood volume are associated with
some, but not all, types of shock.
In an acute care setting, the nurse is assessing an unstable patient. When prioritizing
the patient's care, the nurse should recognize that the patient is at risk for hypovolemic
shock in which of the following circumstances?
A) Fluid volume circulating in the blood vessels decreases.
B) There is an uncontrolled increase in cardiac output.
C) Blood pressure regulation becomes irregular.
D) The patient experiences tachycardia and a bounding pulse. - Ans: A
Feedback:
Hypovolemic shock is characterized by a decrease in intravascular volume. Cardiac
output is decreased, blood pressure decreases, and pulse is fast, but weak.
The emergency nurse is admitting a patient experiencing a GI bleed who is believed to
be in the compensatory stage of shock. What assessment finding would be most
consistent with the early stage of compensation?
A) Increased urine output
,B) Decreased heart rate
C) Hyperactive bowel sounds
D) Cool, clammy skin - Ans: D
Feedback:
In the compensatory stage of shock, the body shunts blood from the organs, such as
the skin and kidneys, to the brain and heart to ensure adequate blood supply. As a
result, the patient's skin is cool and clammy. Also in this compensatory stage, blood
vessels vasoconstrict, the heart rate increases, bowel sounds are hypoactive, and the
urine output decreases.
The nurse is caring for a patient who is exhibiting signs and symptoms of
hypovolemic shock following injuries suffered in a motor vehicle accident. The nurse
anticipates that the physician will promptly order the administration of a crystalloid IV
solution to restore intravascular volume. In addition to normal saline, which
crystalloid fluid is commonly used to treat hypovolemic shock?
A) Lactated Ringer's
B) Albumin
C) Dextran
D) 3% NaCl - Ans: A
Feedback:
Crystalloids are electrolyte solutions used for the treatment of hypovolemic shock.
Lactated Ringer's and 0.9% sodium chloride are isotonic crystalloid fluids commonly
used to manage hypovolemic shock. Dextran and albumin are colloids, but Dextran,
even as a colloid, is not indicated for the treatment of hypovolemic shock. 3% NaCl is
a hypertonic solution and is not isotonic.
A patient who is in shock is receiving dopamine in addition to IV fluids. What
principle should inform the nurse's care planning during the administration of a
vasoactive drug?
A) The drug should be discontinued immediately after blood pressure increases.
B) The drug dose should be tapered down once vital signs improve.
C) The patient should have arterial blood gases drawn every 10 minutes during
treatment.
, D) The infusion rate should be titrated according the patient's subjective sensation of
adequate perfusion. - Ans: B
Feedback:
When vasoactive medications are discontinued, they should never be stopped abruptly
because this could cause severe hemodynamic instability, perpetuating the shock state.
Subjective assessment data are secondary to objective data. Arterial blood gases
should be carefully monitored, but every10-minute draws are not the norm.
6. A nurse in the ICU receives report from the nurse in the ED about a new patient
being admitted with a neck injury he received while diving into a lake. The ED nurse
reports that his blood pressure is 85/54, heart rate is 53 beats per minute, and his skin
is warm and dry. What does the ICU nurse recognize that that patient is probably
experiencing?
A) Anaphylactic shock
B) Neurogenic shock
C) Septic shock
D) Hypovolemic shock - Ans: B
Feedback:
Neurogenic shock can be caused by spinal cord injury. The patient will present with a
low blood pressure; bradycardia; and warm, dry skin due to the loss of sympathetic
muscle tone and increased parasympathetic stimulation. Anaphylactic shock is caused
by an identifiable offending agent, such as a bee sting. Septic shock is caused by
bacteremia in the blood and presents with a tachycardia. Hypovolemic shock presents
with tachycardia and a probable source of blood loss.
The intensive care nurse caring for a patient in shock is planning assessments and
interventions related to the patient's nutritional needs. What physiologic process
contributes to these increased nutritional needs?
A) The use of albumin as an energy source by the body because of the need for
increased adenosine triphosphate (ATP)
B) The loss of fluids due to decreased skin integrity and decreased stomach acids due
to increased parasympathetic activity
