SHOCK NCLEX QUESTIONS-
CRITICAL CARE, SEPSIS
NCLEX, CH 67: SHOCK, SIRS,
MODS EXAM 2025 |
COMPLETE
A patient is admitted to the emergency department after sustaining
abdominal injuries and a broken femur from a motor vehicle accident.
The patient is pale, diaphoretic, and is not talking coherently. Vital signs
upon admission are temperature 98 F (36 C), heart rate 130
beats/minute, respiratory rate 34 breaths/minute, blood pressure 50/40
mmHg. The healthcare provider suspects which type of shock?
a.) Hypovolemic
b.) Cardiogenic
c.) Neurogenic
d.) Distributive - ACCURATE ANSWERS✔✔ a.) Hypovolemic
1. A patient with septic shock has a urine output of 20 mL/hr for the past
3 hours. The pulse
rate is 120 and the central venous pressure and pulmonary artery wedge
pressure are low.
,Which of these orders by the health care provider will the nurse
question?
a. Give furosemide (Lasix) 40 mg IV.
b. Increase normal saline infusion to 150 mL/hr.
c. Administer hydrocortisone (SoluCortef) 100 mg IV.
d. Prepare to give drotrecogin alpha (Xigris) 24 mcg/kg/hr. -
ACCURATE ANSWERS✔✔ ANS: A
Furosemide will lower the filling pressures and renal perfusion further
for the patient
with septic shock. The other orders are appropriate.
DIF: Cognitive Level: Application REF: 1724-1726 | 1731 | 1733
TOP: Nursing Process: Implementation MSC: NCLEX: Physiological
Integrity
What will the nurse identify as symptoms of hypovolemic shock in a
patient?
Note: Credit will be given only if all correct choices and no incorrect
choices are selected.
Standard Text: Select all that apply.
1. Temperature of 97.6°F (36.4°C)
2. Restlessness
3. Decrease in blood pressure of 20 mm Hg when the patient sits up
4. Capillary refill time greater than 3 seconds
,5. Sinus bradycardia of 55 beats per minute - ACCURATE
ANSWERS✔✔ Correct Answer: 2,3,4
Rationale 1: Fever will increase oxygen demands but is unrelated to
hypovolemic shock unless prolonged fever has caused severe
dehydration, reducing the circulating blood volume. Hypovolemic shock
reduces temperatures by peripheral shunting of blood away from the
extremities and reducing the core metabolic rate.
Rationale 2: Due to decreased blood flow to the brain and peripheral
areas when blood is shunted to maintain the vital organs, cerebral
hypoxia occurs, leading to a change in mental status.
Rationale 3: Orthostatic hypotension is a manifestation of hypovolemic
shock.
Rationale 4: Due to decreased blood flow to the brain and peripheral
areas when blood is shunted to maintain the vital organs, capillary refill
time will be reduced.
Rationale 5: Bradycardia is not present. The compensatory response is to
increase the heart rate to circulate the blood faster to make up for the
fluids that are not present in hypovolemic shock.
Why are the manifestations of most types of shock the same regardless
of what specific events or condition caused the shock to occur?
A. The blood, blood vessels, and heart are directly connected to each
other so that when one is affected, all three are affected.
B. Because blood loss occurs with all types of shock, the most common
first manifestation is hypotension.
, C. Every type of shock interferes with oxygenation and metabolism of
all cells in the same sequence.
D. The sympathetic nervous system is triggered by any type of shock
and initiates the stress response. - ACCURATE ANSWERS✔✔ ANS: D
Rationale: Most manifestations of shock are similar regardless of what
starts the process or which tissues are affected first. These common
manifestations result from physiologic adjustments (compensatory
mechanisms) in an attempt to ensure continued oxygenation of vital
organs. These adjustment actions are performed by the sympathetic
nervous system triggering the stress response and activating the
endocrine and cardiovascular systems.
2. A patient with shock of unknown etiology whose hemodynamic
monitoring indicates BP
92/54, pulse 64, and an elevated pulmonary artery wedge pressure has
the following
collaborative interventions prescribed. Which intervention will the nurse
question?
a. Infuse normal saline at 250 mL/hr.
b. Keep head of bed elevated to 30 degrees.
c. Give nitroprusside (Nipride) unless systolic BP <90 mm Hg.
d. Administer dobutamine (Dobutrex) to keep systolic BP >90 mm Hg. -
ACCURATE ANSWERS✔✔ ANS: A
The patient's elevated pulmonary artery wedge pressure indicates
volume excess. A
CRITICAL CARE, SEPSIS
NCLEX, CH 67: SHOCK, SIRS,
MODS EXAM 2025 |
COMPLETE
A patient is admitted to the emergency department after sustaining
abdominal injuries and a broken femur from a motor vehicle accident.
The patient is pale, diaphoretic, and is not talking coherently. Vital signs
upon admission are temperature 98 F (36 C), heart rate 130
beats/minute, respiratory rate 34 breaths/minute, blood pressure 50/40
mmHg. The healthcare provider suspects which type of shock?
a.) Hypovolemic
b.) Cardiogenic
c.) Neurogenic
d.) Distributive - ACCURATE ANSWERS✔✔ a.) Hypovolemic
1. A patient with septic shock has a urine output of 20 mL/hr for the past
3 hours. The pulse
rate is 120 and the central venous pressure and pulmonary artery wedge
pressure are low.
,Which of these orders by the health care provider will the nurse
question?
a. Give furosemide (Lasix) 40 mg IV.
b. Increase normal saline infusion to 150 mL/hr.
c. Administer hydrocortisone (SoluCortef) 100 mg IV.
d. Prepare to give drotrecogin alpha (Xigris) 24 mcg/kg/hr. -
ACCURATE ANSWERS✔✔ ANS: A
Furosemide will lower the filling pressures and renal perfusion further
for the patient
with septic shock. The other orders are appropriate.
DIF: Cognitive Level: Application REF: 1724-1726 | 1731 | 1733
TOP: Nursing Process: Implementation MSC: NCLEX: Physiological
Integrity
What will the nurse identify as symptoms of hypovolemic shock in a
patient?
Note: Credit will be given only if all correct choices and no incorrect
choices are selected.
Standard Text: Select all that apply.
1. Temperature of 97.6°F (36.4°C)
2. Restlessness
3. Decrease in blood pressure of 20 mm Hg when the patient sits up
4. Capillary refill time greater than 3 seconds
,5. Sinus bradycardia of 55 beats per minute - ACCURATE
ANSWERS✔✔ Correct Answer: 2,3,4
Rationale 1: Fever will increase oxygen demands but is unrelated to
hypovolemic shock unless prolonged fever has caused severe
dehydration, reducing the circulating blood volume. Hypovolemic shock
reduces temperatures by peripheral shunting of blood away from the
extremities and reducing the core metabolic rate.
Rationale 2: Due to decreased blood flow to the brain and peripheral
areas when blood is shunted to maintain the vital organs, cerebral
hypoxia occurs, leading to a change in mental status.
Rationale 3: Orthostatic hypotension is a manifestation of hypovolemic
shock.
Rationale 4: Due to decreased blood flow to the brain and peripheral
areas when blood is shunted to maintain the vital organs, capillary refill
time will be reduced.
Rationale 5: Bradycardia is not present. The compensatory response is to
increase the heart rate to circulate the blood faster to make up for the
fluids that are not present in hypovolemic shock.
Why are the manifestations of most types of shock the same regardless
of what specific events or condition caused the shock to occur?
A. The blood, blood vessels, and heart are directly connected to each
other so that when one is affected, all three are affected.
B. Because blood loss occurs with all types of shock, the most common
first manifestation is hypotension.
, C. Every type of shock interferes with oxygenation and metabolism of
all cells in the same sequence.
D. The sympathetic nervous system is triggered by any type of shock
and initiates the stress response. - ACCURATE ANSWERS✔✔ ANS: D
Rationale: Most manifestations of shock are similar regardless of what
starts the process or which tissues are affected first. These common
manifestations result from physiologic adjustments (compensatory
mechanisms) in an attempt to ensure continued oxygenation of vital
organs. These adjustment actions are performed by the sympathetic
nervous system triggering the stress response and activating the
endocrine and cardiovascular systems.
2. A patient with shock of unknown etiology whose hemodynamic
monitoring indicates BP
92/54, pulse 64, and an elevated pulmonary artery wedge pressure has
the following
collaborative interventions prescribed. Which intervention will the nurse
question?
a. Infuse normal saline at 250 mL/hr.
b. Keep head of bed elevated to 30 degrees.
c. Give nitroprusside (Nipride) unless systolic BP <90 mm Hg.
d. Administer dobutamine (Dobutrex) to keep systolic BP >90 mm Hg. -
ACCURATE ANSWERS✔✔ ANS: A
The patient's elevated pulmonary artery wedge pressure indicates
volume excess. A
