Test 3: Critical Care
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1. A nurse in the ICU is planning the care of a patient B) Cells lack an adequate
who is being treated for shock. Which of the following blood supply and are de-
statements best describes the pathophysiology of this prived of oxygen and nu-
patient's health problem? trients.
A) Blood is shunted from vital organs to peripheral Feedback: Shock is a
areas of the body. life-threatening condition
B) Cells lack an adequate blood supply and are de- with a variety of underlying
prived of oxygen and nutrients. causes. Shock is caused
C) Circulating blood volume is decreased with a result- when the cells have a lack
ing change in the osmotic pressure gradient. of adequate blood supply
D) Hemorrhage occurs as a result of trauma, depriving and are deprived of oxy-
vital organs of adequate perfusion. gen and nutrients. In cases
of shock, blood is shunt-
ed 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.
2. A nurse in the ICU receives report from the nurse in B. Neurogenic shock
the ED about a new patient being admitted with a neck
injury he received while diving into a lake. The ED nurse Feedback: Neurogenic
reports that his blood pressure is 85/54, heart rate is shock can be caused by
53 beats per minute, and his skin is warm and dry. spinal cord injury. The pa-
What does the ICU nurse recognize that that patient tient will present with a low
is probably experiencing? blood pressure; bradycar-
dia; and warm, dry skin
A. Anaphylactic shock due to the loss of sym-
B. Neurogenic shock pathetic muscle tone and
increased parasympathet-
, Test 3: Critical Care
Study online at https://quizlet.com/_9xbt2u
C. Septic shock ic stimulation. Anaphylac-
D. Hypovolemic shock tic 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 tachy-
cardia. Hypovolemic shock
presents with tachycardia
and a probable source of
blood loss.
3. The ICU nurse is caring for a patient in neurogenic C. Bradycardia
shock following an overdose of antianxiety medica-
tion. When assessing this patient, the nurse should Feedback: In neurogenic
recognize what characteristic of neurogenic shock? shock, the sympathetic
system is not able to
A. Hypertension respond to body stres-
B. Cool, moist skin sors. Therefore, the clini-
C. Bradycardia cal characteristics of neu-
D. Signs of sympathetic stimulation rogenic shock are signs
of parasympathetic stimu-
lation. It is characterized by
dry, warm skin rather than
the cool, moist skin seen
in hypovolemic shock. An-
other characteristic is hy-
potension with bradycar-
dia, rather than the tachy-
cardia that characterizes
other forms of shock.
, Test 3: Critical Care
Study online at https://quizlet.com/_9xbt2u
4. The intensive care nurse caring for a patient in shock is C) The release of cate-
planning assessments and interventions related to the cholamines that creates an
patient's nutritional needs. What physiologic process increase in metabolic rate
contributes to these increased nutritional needs? and caloric requirements
A) The use of albumin as an energy source by the body Feedback: Nutritional sup-
because of the need for increased adenosine triphos- port is an important as-
phate (ATP) pect of care for patients
B) The loss of fluids due to decreased skin integrity and in shock. Patients in shock
decreased stomach acids due to increased parasympa- may require 3,000 calo-
thetic activity ries daily. This caloric
C) The release of catecholamines that creates an in- need is directly related
crease in metabolic rate and caloric requirements to the release of cate-
D) The increase in GI peristalsis during shock and the cholamines and the result-
resulting diarrhea ing increase in metabol-
ic rate and caloric require-
ments. Albumin is not pri-
marily metabolized as an
energy source. The spe-
cial nutritional needs of
shock are not related to
increased parasympathet-
ic activity but are instead
related to increased sym-
pathetic activity. GI func-
tion does not increase
during shock.
5. In all types of shock, nutritional demands increase D) It promotes GI function
rapidly as the body depletes its stores of glycogen. through direct exposure to
Enteral nutrition is the preferred method of meeting nutrients.
these increasing energy demands. What is the basis
, Test 3: Critical Care
Study online at https://quizlet.com/_9xbt2u
for enteral nutrition being the preferred method of Feedback: Parenteral or
meeting the bodys needs? enteral nutritional support
should be initiated as soon
A) It slows the proliferation of bacteria and viruses as possible. Enteral nutri-
during shock. tion is preferred, promot-
B) It decreases the energy expended through the func- ing GI function through
tioning of the GI system. direct exposure to nu-
C) It assists in expanding the intravascular volume of trients and limiting in-
the body. fectious complications as-
D) It promotes GI function through direct exposure to sociated with parenteral
nutrients. feeding. Enteral feeding
does not decrease the
proliferation of microor-
ganisms, or the amount of
energy expended through
the functioning of the GI
system, and it does not as-
sist in expanding the in-
travascular volume of the
body.
6. The acute care nurse is providing care for an adult C) Decreased urinary out-
patient who is in hypovolemic shock. The nurse rec- put
ognizes that antidiuretic hormone (ADH) plays a sig-
nificant role in this health problem. What assessment Feedback: During hypo-
finding will the nurse likely observe related to the role volemic shock, a state
of the ADH during hypovolemic shock? of hypernatremia occurs.
Hypernatremia stimulates
A) Increased hunger the release of ADH by the
B) Decreased thirst pituitary gland. ADH caus-
C) Decreased urinary output es the kidneys to retain
D) Increased capillary perfusion water further in an effort
Study online at https://quizlet.com/_9xbt2u
1. A nurse in the ICU is planning the care of a patient B) Cells lack an adequate
who is being treated for shock. Which of the following blood supply and are de-
statements best describes the pathophysiology of this prived of oxygen and nu-
patient's health problem? trients.
A) Blood is shunted from vital organs to peripheral Feedback: Shock is a
areas of the body. life-threatening condition
B) Cells lack an adequate blood supply and are de- with a variety of underlying
prived of oxygen and nutrients. causes. Shock is caused
C) Circulating blood volume is decreased with a result- when the cells have a lack
ing change in the osmotic pressure gradient. of adequate blood supply
D) Hemorrhage occurs as a result of trauma, depriving and are deprived of oxy-
vital organs of adequate perfusion. gen and nutrients. In cases
of shock, blood is shunt-
ed 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.
2. A nurse in the ICU receives report from the nurse in B. Neurogenic shock
the ED about a new patient being admitted with a neck
injury he received while diving into a lake. The ED nurse Feedback: Neurogenic
reports that his blood pressure is 85/54, heart rate is shock can be caused by
53 beats per minute, and his skin is warm and dry. spinal cord injury. The pa-
What does the ICU nurse recognize that that patient tient will present with a low
is probably experiencing? blood pressure; bradycar-
dia; and warm, dry skin
A. Anaphylactic shock due to the loss of sym-
B. Neurogenic shock pathetic muscle tone and
increased parasympathet-
, Test 3: Critical Care
Study online at https://quizlet.com/_9xbt2u
C. Septic shock ic stimulation. Anaphylac-
D. Hypovolemic shock tic 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 tachy-
cardia. Hypovolemic shock
presents with tachycardia
and a probable source of
blood loss.
3. The ICU nurse is caring for a patient in neurogenic C. Bradycardia
shock following an overdose of antianxiety medica-
tion. When assessing this patient, the nurse should Feedback: In neurogenic
recognize what characteristic of neurogenic shock? shock, the sympathetic
system is not able to
A. Hypertension respond to body stres-
B. Cool, moist skin sors. Therefore, the clini-
C. Bradycardia cal characteristics of neu-
D. Signs of sympathetic stimulation rogenic shock are signs
of parasympathetic stimu-
lation. It is characterized by
dry, warm skin rather than
the cool, moist skin seen
in hypovolemic shock. An-
other characteristic is hy-
potension with bradycar-
dia, rather than the tachy-
cardia that characterizes
other forms of shock.
, Test 3: Critical Care
Study online at https://quizlet.com/_9xbt2u
4. The intensive care nurse caring for a patient in shock is C) The release of cate-
planning assessments and interventions related to the cholamines that creates an
patient's nutritional needs. What physiologic process increase in metabolic rate
contributes to these increased nutritional needs? and caloric requirements
A) The use of albumin as an energy source by the body Feedback: Nutritional sup-
because of the need for increased adenosine triphos- port is an important as-
phate (ATP) pect of care for patients
B) The loss of fluids due to decreased skin integrity and in shock. Patients in shock
decreased stomach acids due to increased parasympa- may require 3,000 calo-
thetic activity ries daily. This caloric
C) The release of catecholamines that creates an in- need is directly related
crease in metabolic rate and caloric requirements to the release of cate-
D) The increase in GI peristalsis during shock and the cholamines and the result-
resulting diarrhea ing increase in metabol-
ic rate and caloric require-
ments. Albumin is not pri-
marily metabolized as an
energy source. The spe-
cial nutritional needs of
shock are not related to
increased parasympathet-
ic activity but are instead
related to increased sym-
pathetic activity. GI func-
tion does not increase
during shock.
5. In all types of shock, nutritional demands increase D) It promotes GI function
rapidly as the body depletes its stores of glycogen. through direct exposure to
Enteral nutrition is the preferred method of meeting nutrients.
these increasing energy demands. What is the basis
, Test 3: Critical Care
Study online at https://quizlet.com/_9xbt2u
for enteral nutrition being the preferred method of Feedback: Parenteral or
meeting the bodys needs? enteral nutritional support
should be initiated as soon
A) It slows the proliferation of bacteria and viruses as possible. Enteral nutri-
during shock. tion is preferred, promot-
B) It decreases the energy expended through the func- ing GI function through
tioning of the GI system. direct exposure to nu-
C) It assists in expanding the intravascular volume of trients and limiting in-
the body. fectious complications as-
D) It promotes GI function through direct exposure to sociated with parenteral
nutrients. feeding. Enteral feeding
does not decrease the
proliferation of microor-
ganisms, or the amount of
energy expended through
the functioning of the GI
system, and it does not as-
sist in expanding the in-
travascular volume of the
body.
6. The acute care nurse is providing care for an adult C) Decreased urinary out-
patient who is in hypovolemic shock. The nurse rec- put
ognizes that antidiuretic hormone (ADH) plays a sig-
nificant role in this health problem. What assessment Feedback: During hypo-
finding will the nurse likely observe related to the role volemic shock, a state
of the ADH during hypovolemic shock? of hypernatremia occurs.
Hypernatremia stimulates
A) Increased hunger the release of ADH by the
B) Decreased thirst pituitary gland. ADH caus-
C) Decreased urinary output es the kidneys to retain
D) Increased capillary perfusion water further in an effort
