Shock, Sepsis, and Multiple Organ Dysfunction Syndrome
1. What is the key factor in describing any type of shock?
a. Hypoxemia
b. Hypotension
c. Vascular collapse
d. Decreased tissue perfusion
2. When shock occurs in a patient with pulmonary embolism or abdominal
compartment syndrome, what type of shock would that be?
a. Distributive shock
b. Obstructive shock
c. Cardiogenic shock
d. Hypovolemic shock
3. What physical problems can precipitate hypovolemic shock (select all that
apply)?
a. Burns
b. Ascites
c. Vaccines
d. Insect bites
e. Hemorrhage
f. Ruptured spleen
4. Patient-Centered Care: A 70-year-old patient with malnourishment and a
history of type 2 diabetes is admitted from the nursing home with
pneumonia and tachypnea. Which kind of shock is this patient most likely to
develop?
a. Septic shock
b. Neurogenic shock
c. Cardiogenic shock
d. Anaphylactic shock
5. Which hemodynamic monitoring description of the identified shock is
accurate?
a. Tachycardia with hypertension is characteristic of neurogenic shock.
b. Increased pulmonary artery wedge pressure (PAWP) and a decreased
cardiac output (CO) occur in cardiogenic shock.
c. Anaphylactic shock is characterized by increased systemic vascular
resistance (SVR), decreased CO, and decreased PAWP.
d. In septic shock, bacterial endotoxins cause vascular changes that result in
increased SVR, decreased CO, and increased heart rate.
, 6. In the compensatory stage of hypovolemic shock, to what organs does
blood flow decrease after the sympathetic nervous system activates the α-
adrenergic stimulation (select all that apply)?
a. Skin
b. Brain
c. Heart
d. Kidneys
e. Gastrointestinal (GI) tract
7. As the body continues to try to compensate for hypovolemic shock, there
is increased angiotensin II from the activation of the renin-angiotensin-
aldosterone system. What physiologic change occurs related to the
increased angiotensin II?
a. Vasodilation
b. Decreased BP and CO
c. Aldosterone release results in sodium and water excretion
d. Antidiuretic hormone (ADH) release increases water reabsorption
8. What clinical manifestations would the nurse observe when a patient is in
the compensatory stage of shock (select all that apply)?
a. Pale and cool
b. Unresponsive
c. Lower BP than baseline
d. Moist crackles in the lungs
e. Hyperactive bowel sounds
f. Tachypnea and tachycardia
9. Which laboratory test result indicates to the nurse sepsis as a cause of
shock?
a. Hypokalemia
b. Thrombocytopenia
c. Decreased hemoglobin
d. Increased blood urea nitrogen (BUN)
10. Progressive tissue hypoxia leading to anaerobic metabolism and
metabolic acidosis is characteristic of the progressive stage of shock. What
changes in the heart contribute to this increasing tissue hypoxia?
a. Coronary artery constriction causes decreased perfusion.
b. Cardiac vasoconstriction decreases blood flow to pulmonary capillaries. c.
Increased capillary permeability and profound vasoconstriction cause
increased hydrostatic pressure.
d. Decreased perfusion occurs, leading to dysrhythmias, decreased CO, and
decreased oxygen delivery to cells.
11. A patient with severe trauma has been treated for hypovolemic shock.
What assessment finding is consistent with the refractory stage of shock?
1. What is the key factor in describing any type of shock?
a. Hypoxemia
b. Hypotension
c. Vascular collapse
d. Decreased tissue perfusion
2. When shock occurs in a patient with pulmonary embolism or abdominal
compartment syndrome, what type of shock would that be?
a. Distributive shock
b. Obstructive shock
c. Cardiogenic shock
d. Hypovolemic shock
3. What physical problems can precipitate hypovolemic shock (select all that
apply)?
a. Burns
b. Ascites
c. Vaccines
d. Insect bites
e. Hemorrhage
f. Ruptured spleen
4. Patient-Centered Care: A 70-year-old patient with malnourishment and a
history of type 2 diabetes is admitted from the nursing home with
pneumonia and tachypnea. Which kind of shock is this patient most likely to
develop?
a. Septic shock
b. Neurogenic shock
c. Cardiogenic shock
d. Anaphylactic shock
5. Which hemodynamic monitoring description of the identified shock is
accurate?
a. Tachycardia with hypertension is characteristic of neurogenic shock.
b. Increased pulmonary artery wedge pressure (PAWP) and a decreased
cardiac output (CO) occur in cardiogenic shock.
c. Anaphylactic shock is characterized by increased systemic vascular
resistance (SVR), decreased CO, and decreased PAWP.
d. In septic shock, bacterial endotoxins cause vascular changes that result in
increased SVR, decreased CO, and increased heart rate.
, 6. In the compensatory stage of hypovolemic shock, to what organs does
blood flow decrease after the sympathetic nervous system activates the α-
adrenergic stimulation (select all that apply)?
a. Skin
b. Brain
c. Heart
d. Kidneys
e. Gastrointestinal (GI) tract
7. As the body continues to try to compensate for hypovolemic shock, there
is increased angiotensin II from the activation of the renin-angiotensin-
aldosterone system. What physiologic change occurs related to the
increased angiotensin II?
a. Vasodilation
b. Decreased BP and CO
c. Aldosterone release results in sodium and water excretion
d. Antidiuretic hormone (ADH) release increases water reabsorption
8. What clinical manifestations would the nurse observe when a patient is in
the compensatory stage of shock (select all that apply)?
a. Pale and cool
b. Unresponsive
c. Lower BP than baseline
d. Moist crackles in the lungs
e. Hyperactive bowel sounds
f. Tachypnea and tachycardia
9. Which laboratory test result indicates to the nurse sepsis as a cause of
shock?
a. Hypokalemia
b. Thrombocytopenia
c. Decreased hemoglobin
d. Increased blood urea nitrogen (BUN)
10. Progressive tissue hypoxia leading to anaerobic metabolism and
metabolic acidosis is characteristic of the progressive stage of shock. What
changes in the heart contribute to this increasing tissue hypoxia?
a. Coronary artery constriction causes decreased perfusion.
b. Cardiac vasoconstriction decreases blood flow to pulmonary capillaries. c.
Increased capillary permeability and profound vasoconstriction cause
increased hydrostatic pressure.
d. Decreased perfusion occurs, leading to dysrhythmias, decreased CO, and
decreased oxygen delivery to cells.
11. A patient with severe trauma has been treated for hypovolemic shock.
What assessment finding is consistent with the refractory stage of shock?
