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PN School of Nursing
EST. 2009
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NURS 231 — Shock, MI, & Critical Care
CO M P R E H E N S I V E R E V I E W
INSTITUTION Portage Learning COURSE CODE NURS 231
PROGRAM Nursing ACADEMIC YEAR
EXAM TITLE NURS 231 — Shock, MI, & Critical TOTAL QUESTIONS 31 Questions
Care
COURSE TITLE Nursing Fundamentals FORMAT Multiple Choice — Select the
Single Best Answer
EXAMINATION INSTRUCTIONS
▸ Select the single best answer for each question.
▸ Questions cover shock, myocardial infarction, critical care, and pharmacological management.
▸ Correct answers and detailed rationales appear below each question.
▸ Use these rationales to reinforce key nursing concepts for clinical practice.
, SECTION I — SHOCK & CRITICAL CARE Questions 1 – 31
1. A client in shock has been started on dopamine. What assessment finding requires the
nurse to communicate with the provider immediately?
A. Blood pressure of 98/68 mm Hg
B. Pedal pulses 1+/4+ bilaterally
C. Report of chest heaviness
D. Urine output of 32 mL/hr
CORRECT ANSWER C — Report of chest heaviness
RATIONALE Chest heaviness or pain indicates myocardial ischemia, a possible adverse effect
of dopamine. While taking dopamine, the oxygen requirements of the heart are
increased due to increased myocardial workload, and may cause ischemia. A
urine output of 32 mL/hr is acceptable.
2. The student nurse studying shock understands that the common manifestations of this
condition are directly related to which problems? (Select all that apply.)
A. Anaerobic metabolism
B. Hyperglycemia
C. Hypotension
D. Impaired renal perfusion
E. Increased perfusion
CORRECT ANSWER A, C — Anaerobic metabolism and Hypotension
RATIONALE The common manifestations of shock, no matter the cause, are directly related to
the effects of anaerobic metabolism and hypotension. Hyperglycemia, impaired
renal function, and increased perfusion are not manifestations of shock.
, 3. The nurse caring for hospitalized clients includes which actions on their care plans to
reduce the possibility of the clients developing shock? (Select all that apply.)
A. Assessing and identifying clients at risk
B. Monitoring the daily white blood cell count
C. Performing proper hand hygiene
D. Removing invasive lines as soon as possible
E. Using aseptic technique during procedures
CORRECT ANSWER A, C, D, E — Assessing and identifying clients at risk; Performing proper
hand hygiene; Removing invasive lines as soon as possible; Using aseptic
technique
RATIONALE Assessing and identifying clients at risk for shock is probably the most critical
action the nurse can take to prevent shock from occurring. Proper hand hygiene,
using aseptic technique, and removing IV lines and catheters are also important
actions to prevent shock. Monitoring laboratory values does not prevent shock
but can indicate a change.
4. The nurse caring frequently for older adults in the hospital is aware of risk factors that
place them at a higher risk for shock. For what factors would the nurse assess? (Select all
that apply.)
A. Altered mobility/immobility
B. Decreased thirst response
C. Diminished immune response
D. Malnutrition
E. Overhydration
CORRECT ANSWER A, B, C, D — Altered mobility/immobility; Decreased thirst response;
Diminished immune response; Malnutrition
RATIONALE Immobility, decreased thirst response, diminished immune response, and
malnutrition can place the older adult at higher risk of developing shock.
Overhydration is not a common risk factor for shock.