In which type of shock does the patient experiences a mismatch of blood flow to the cells? a) Distributive Distributive or vasogenic shock results from displacement of blood volume, creating a relative hypovolemia. b) Cardiogenic Cardiogenic shock results from the failure of a heart as a pump. c) Hypovolemic In hypovolemic shock, there is a decrease in the intravascular volume. d) Septic In septic shock, overwhelming infection results in a relative hypovolemia.

In which type of shock does the patient experiences a mismatch
of blood flow to the cells?
a) Distributive
Distributive or vasogenic shock results from displacement of blood
volume, creating a relative hypovolemia.
b) Cardiogenic
Cardiogenic shock results from the failure of a heart as a pump.
c) Hypovolemic
In hypovolemic shock, there is a decrease in the intravascular volume.
d) Septic
In septic shock, overwhelming infection results in a relative
hypovolemia.
by

1 Answer

Answer :

a) Distributive
Distributive or vasogenic shock results from displacement of blood
volume, creating a relative hypovolemia.
by

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Last Answer : a) Septic Septic shock is associated with immunosuppression, extremes of age, malnourishment, chronic illness, and invasive procedures.

A 22-year-old man sustains a single stab wound to the left chest and presents to the emergency room with hypotension. Which of the following statement(s) is/are true concerning his diagnosis and management? a. The patient likely is suffering from hypovolemic shock and should respond quickly to fluid resuscitation b. Beck’s triad will likely be an obvious indication of compressive cardiogenic shock due to pericardial tamponade c. Echocardiography is the most sensitive noninvasive approach for diagnosis of pericardial tamponade d. The placement of bilateral chest tubes will likely resolve the problem

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Last Answer : Answer: c Shock from cardiac compression occurs when external pressure on the heart impairs ventricular filling. Because ventricular filling is a function of venous return and myocardial compliance, ... sternotomy. Chest tube placement would not be appropriate as the sole treatment in this patient

Which of the following statement(s) is/are true concerning the various types of shock? a. Traumatic shock is more commonly associated with subsequent organ injury and multiorgan failure syndrome than hemorrhagic shock b. Cardiogenic shock can be of either an intrinsic or compressive nature c. Hypodynamic septic shock is associated with a decreased mortality risk when compared with hyperdynamic septic shock d. Hypoadrenal shock usually responds quickly to resuscitation e. Neurogenic shock occurs with the absence of sympathetic activity

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A classic sign of cardiogenic shock is a) Tissue hypoperfusion Tissue hypoperfusion is manifested as cerebral hypoxia (restlessness, confusion, agitation). b) High blood pressure Low blood pressure is a classic sign of cardiogenic shock. c) Hyperactive bowel sounds Hypoactive bowel sounds are classic signs of cardiogenic shock. d) Increased urinary output Decreased urinary output is a classic sign of cardiogenic shock.

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Which of the following vasoactive drugs used in treating shock results in reduced preload and afterload, reducing oxygen demand of the heart? a) Nitroprusside (Nipride) A disadvantage of nitroprusside is that it causes hypotension. b) Dopamine (Intropin) Dopamine improves contractility, increases stroke volume, and increases cardiac output. c) Epinephrine (adrenaline) Epinephrine improves contractility, increases stroke volume, and increases cardiac output. d) Methoxamine (Vasoxyl) Methoxamine increases blood pressure by vasoconstriction.

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Which of the following colloids is expensive but rapidly expands plasma volume? a) Albumin Albumin is a colloid that requires human donors, is limited in supply, and can cause congestive heart failure. b) Dextran Dextran is a colloid, synthetic plasma expander that interferes with platelet aggregation and is not recommended for hemorrhagic shock. c) Lactated Ringers Lactated ringers is a crystalloid, not a colloid. d) Hypertonic Saline Hypertonic saline is a crystalloid, not a colloid.

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Which of the following statement(s) is/are true concerning the diagnosis and management of hypovolemic shock? a. A fall in hematocrit or hemoglobin always accompanies hemorrhagic shock b. The treatment of shock is generic regardless of the etiology c. Pharmacologic intervention to increase myocardial contractility in hypovolemic shock is an important part the early management d. Complications are less frequent after treatment of hemorrhagic shock than septic or traumatic shock

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All of the following may be useful in the treatment of cardiogenic shock except: A. Dobutamine. B. Sodium nitroprusside. C. Pneumatic antishock garment. D. Intra-aortic balloon pump.

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The nurse teaches the patient who demonstrates herpes zoster (shingles) that a) the infection results from reactivation of the chickenpox virus. It is assumed that herpes zoster represents a reactivation of latent varicella (chickenpox) virus and reflects lowered immunity.

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Which of the following mitral valve conditions generally produces no symptoms? a) Prolapse Mitral valve prolpase is a deformity that usually produces no symptoms and has been diagnosed more frequently in recent years, probably as a result of improved diagnostic methods. b) Stenosis Mitral valve stenosis usually causes progressive fatigue. c) Regurgitation Mitral valve regurgitation, in its acute stage, usually presents as severe heart failure. d) Infection Mitral valve infection, when acute, will produce symptoms typical of infective endocarditis.

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The nurse recognizes which of the following signs as typical of the patient in shock? a) Rapid, weak, thready pulse Pulse increases as the body tries to compensate. b) Flushed face Pallor is an indicator of shock. c) Warm, dry skin Skin is generally cool and moist in shock. d) Increased urine output Usually, a low blood pressure and concentrated urine are observed in the patient in shock.

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Decrease in absorption of which of the following vitamins in the geriatric patient results in pernicious anemia? a) B12 Vitamin B12 requires the intrinsic factor secreted by the gastric mucosa for absorption. b) C Lack of vitamin C may cause development of signs and symptoms of scurvy. c) D Vitamin D deficiency results in an inability to absorb calcium. d) B6 Vitamin B6 affects neuromuscular function.

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Which of the following observations in the patient who has undergone allograft for treatment of burn site must be reported to the physician immediately? a) Crackles in the lungs Crackles in the lungs may indicate a fluid buildup indicative of congestive heart failure and pulmonary edema.

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The patient with cardiac failure is taught to report which of the following symptoms to the physician or clinic immediately? a) Persistent cough Persistent cough may indicate an onset of left-heart failure. b) Increased appetite Loss of appetite should be reported immediately. c) Weight loss Weight gain should be reported immediately. d) Ability to sleep through the night Frequent urination, causing interruption of sleep, should be reported immediately.

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Which of the following statement(s) is/are true concerning the microvascular and cellular response to shock? a. Osmodically induced mobilization of intracellular fluid is the initial response to restore intravascular volume b. With larger volume hemorrhagic shock deterioration of normal cellular transmembrane potential occurs resulting in an increase in extracellular sodium and water c. The accumulation of anaerobic metabolites override normal homeostatic vasomotor tone and contribute to the maladaptive vasodilatation d. Abnormal intracellular calcium homeostasis may contribute to the cellular dysfunction of shock

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When the nurse notes that the post cardiac surgery patient demonstrates low urine output (< 25 ml/hr) with high specific gravity (> 1.025), the nurse suspects: a) Inadequate fluid volume Urine output of less than 25 ml/hr may indicate a decrease in cardiac output. A high specific gravity indicates increased concentration of solutes in the urine which occurs with inadequate fluid volume. b) Normal glomerular filtration Indices of normal glomerular filtration are output of 25 ml or greater per hour and specific gravity between 1.010 and 1.025. c) Overhydration Overhydration is manifested by high urine output with low specific gravity. d) Anuria The anuric patient does not produce urine.

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Which of the following types of aneurysms results in bleeding into the layers of the arterial wall? a) Dissecting Dissection results from a rupture in the intimal layer, resulting in bleeding between the intimal and medial layers of the arterial wall. b) Saccular Saccular aneurysms collect blood in the weakened outpouching. c) False In a false aneurysm, the mass is actually a pulsating hematoma. d) Anastomotic An anastomotic aneurysm occurs as a result of infection at arterial suture or graft sites.

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In which stage of COPD is the forced expiratory volume (FEV1) < 30%? a) III Stage III patients demonstrate FEV1 < 30% with respiratory failure or clinical signs of right heart failure b) II Stage II patients demonstrate FEV1 between > 30% and 80% c) I Stage I is mild COPD with FEV1 < 70%. d) O Stage O is characterized by normal spirometry

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The patient with Herpes Simplex Virus (HSV) encephalitis is receiving acyclovir (Zovirax). The nurse monitors blood chemistry test results and urinary output for a) renal complications related to acyclovir therapy. Monitoring of blood chemistry test results and urinary output will alert the nurse to the presence of renal complications related to acyclovir therapy.

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When assisting the patient to interpret a negative HIV test result, the nurse informs the patient that the results mean a) his body has not produced antibodies to the AIDS virus. A negative test result indicates that antibodies to the AIDS virus are not present in the blood at the time the blood sample for the test is drawn.

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Last Answer : a) his body has not produced antibodies to the AIDS virus. A negative test result indicates that antibodies to the AIDS virus are not present in the blood at the time the blood sample for the test is drawn.

Which stage of anesthesia is termed surgical anesthesia? a) III With proper administration of the anesthetic, this stage may be maintained for hours. b) I Stage I is beginning anesthesia, as the patient breathes in the anesthetic mixture and experiences warmth, dizziness, and a feeling of detachment. c) II Stage II is the excitement stage, which may be characterized by struggling, singing, laughing, or crying. d) IV Stage IV is a stage of medullary depression and is reached when too much anesthesia has been administered.

Description : Which stage of anesthesia is termed surgical anesthesia? a) III With proper administration of the anesthetic, this stage may be maintained for hours. b) I Stage I is beginning anesthesia, as the ... IV is a stage of medullary depression and is reached when too much anesthesia has been administered.

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Which of the following statement(s) is/are true concerning septic shock? a. The clinical picture of gram negative septic shock is specifically different than shock associated with other infectious agents b. The circulatory derangements of septic shock precede the development of metabolic abnormalities c. Splanchnic vascular resistance falls in similar fashion to overall systemic vascular resistance d. Despite normal mechanisms of intrinsic expansion of the circulating blood volume, exogenous volume resuscitation is necessary

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Last Answer : Answer: d The clinical findings in sepsis and septic shock represent the host response to infection. Gram-positive and gram-negative bacteria, viruses, fungi, rickettsiae, and ... intravascular volume, exogenous volume resuscitation must be provided to restore venous return and ventricular filling

Which of the following statements reflects the nursing management of the patient with West Nile Virus infection? There is no treatment for West Nile Virus infection. Patients are supported by fluid replacement, airway management, and standard nursing care support during the time that the patient has meningitis symptoms. a) The incubation period is three to five days. The incubation period (from mosquito bite until onset of symptoms) is between 5–15 days.

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Which of the following statements reflect the treatment of HIV infection? a) Treatment of HIV infection for an individual patient is based on the clinical condition of the patient, CD4 T cell count level, and HIV RNA (viral load). Although specific therapies vary, treatment of HIV infection for an individual patient is based on three factors: the clinical condition of the patient, CD4 T cell count level, and HIV RNA (viral load).

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When caring for a patient with an uncomplicated, mild urinary tract infection (UTI), the nurse knows that recent studies have shown which of the following drugs to be a good choice for shortcourse (e.g. 3-day) therapy? a) Levofloxacin (Levaquin) Levofloxacin, a floroquinolone, is a good choice for short-course therapy of uncomplicated, mild to moderate UTI. Clinical trial data show high patient compliance with the 3-day regimen (95.6%) and a high eradication rate for all pathogens (96.4%).

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In patients receiving massive blood transfusion for acute blood loss, which of the following is/are correct? A. Packed red blood cells and crystalloid solution should be infused to restore oxygen-carrying capacity and intravascular volume. B. Two units of FFP should be given with every 5 units of packed red blood cells in most cases. C. A “six pack” of platelets should be administered with every 10 units of packed red blood cells in most cases. D. One to two ampules of sodium bicarbonate should be administered with every 5 units of packed red blood cells to avoid acidosis. E. One ampule of calcium chloride should be administered with every 5 units of packed red blood cells to avoid hypocalcemia.

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Hypovolemic shock?

Description : Hypovolemic shock?

Last Answer : DefinitionHypovolemic shock is an emergency condition in which severe blood and fluid loss makes the heart unable to pump enough blood to the body. This type of shock ... or agitationCool, clammy skinConfusionDecreased or no urine outputGeneral weaknessPale skin color(pallor)Rapid breathingSweatin

Which type of chest configuration is typical of the patient with COPD? a) Barrel chest “Barrel chest” results from fixation of the ribs in the inspiratory position. b) Pigeon chest Pigeon chest results from a displaced sternum. c) Flail chest Flail chest results when the ribs are fractured. d) Funnel chest Funnel chest occurs when there is a depression in the lower portion of the sternum and is associated with Mafan’s syndrome or rickets.

Description : Which type of chest configuration is typical of the patient with COPD? a) Barrel chest Barrel chest results from fixation of the ribs in the inspiratory position. b) Pigeon chest Pigeon chest ... depression in the lower portion of the sternum and is associated with Mafan's syndrome or rickets.

Last Answer : a) Barrel chest “Barrel chest” results from fixation of the ribs in the inspiratory position.

Which type of jaundice in adults is the result of increased destruction of red blood cells? a) Hemolytic Hemolytic jaundice results because, although the liver is functioning normally, it cannot excrete the bilirubin as quickly as it is formed.

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Which of the following terms refers to failure of fragments of a fractured bone to heal together? a) Nonunion When nonunion occurs, the patient complains of persistent discomfort and movement at the fracture site.

Description : Which of the following terms refers to failure of fragments of a fractured bone to heal together? a) Nonunion When nonunion occurs, the patient complains of persistent discomfort and movement at the ... growth of the fragments of a fractured bone in a faulty position, forming an imperfect union.

Last Answer : a) Nonunion When nonunion occurs, the patient complains of persistent discomfort and movement at the fracture site.

When the indication for surgery is without delay, the nurse recognizes that the surgery will be classified as a) emergency. Emergency surgery means that the patient requires immediate attention and the disorder may be life-threatening. b) urgent. Urgent surgery means that the patient requires prompt attention within 24-30 hours. c) required. Required surgery means that the patient needs to have surgery, and it should be planned within a few weeks or months. d) elective. Elective surgery means that there is an indication for surgery, but failure to have surgery will not be catastrophic.

Description : When the indication for surgery is without delay, the nurse recognizes that the surgery will be classified as a) emergency. Emergency surgery means that the patient requires immediate attention and the ... there is an indication for surgery, but failure to have surgery will not be catastrophic.

Last Answer : a) emergency. Emergency surgery means that the patient requires immediate attention and the disorder may be life-threatening.

Which of the following statements about septic shock are true? A. A circulating myocardial depressant factor may account for the cardiac dysfunction sometimes seen with shock due to sepsis or SIRS. B. A cardiac index (CI) of 6 liters per minute per square meter of body surface, a pulmonary capillary wedge pressure of 15 mm. Hg, and a systemic vascular resistance index (SVRI) of 800 dynes-sec/(cm 5-m 2) is a hemodynamic profile consistent with septic shock. C. An increase in SvO 2 in septic patients may be explained by the finding of anatomic arteriovenous shunts. D. Results of human trials employing antimediator therapy, such as antiendotoxin antibodies, IL-1 receptor antagonist, and tumor necrosis factor (TNF) antibodies, have confirmed animal studies that demonstrate a significant im

Description : Which of the following statements about septic shock are true? A. A circulating myocardial depressant factor may account for the cardiac dysfunction sometimes seen with shock due to sepsis or ... animal studies that demonstrate a significant improvement in survival with the use of such agents.

Last Answer : Answer: AB DISCUSSION: Shock due to sepsis or SIRS frequently manifests as a hyperdynamic cardiovascular response, consisting of an elevated CI and a decreased SVR or SVRI. Occasionally, ... been encouraging thus far in human clinical trials, despite the promising results from many animal studies

Of the following categories of medications, which is used in combination with bismuth salts to eradicate Helicobacter pylori? a) Antibiotics Antibiotics and bismuth salts are given to eradicate H. pylori. b) Antacids Antacids are given to manage gastric acidity. c) Proton pump inhibitors Proton pump inhibitors are given to decrease acid secretion. d) Histamine-2 receptor antagonists Histamine-2 receptor antagonists are given to decrease the acid secretion in the stomach.

Description : Of the following categories of medications, which is used in combination with bismuth salts to eradicate Helicobacter pylori? a) Antibiotics Antibiotics and bismuth salts are given to eradicate ... antagonists Histamine-2 receptor antagonists are given to decrease the acid secretion in the stomach.

Last Answer : a) Antibiotics Antibiotics and bismuth salts are given to eradicate H. pylori.

The patient receiving mitoxantrone (Novantrone) for treatment of secondary progressive multiple sclerosis (MS) is closely monitored for a) leukopenia and cardiac toxicity. Mitoxantrone is an antineoplastic agent used primarily to treat leukemia and lyphoma but is also used to treat secondary progressive MS. Patients need to have laboratory tests ordered and the results closely monitored due to the potential for leukopenia and cardiac toxicity.

Description : The patient receiving mitoxantrone (Novantrone) for treatment of secondary progressive multiple sclerosis (MS) is closely monitored for a) leukopenia and cardiac toxicity. Mitoxantrone is an ... d) hypoxia. Patients receiving mitoxantrone are closely monitored for leukopenia and cardiac toxicity.

Last Answer : a) leukopenia and cardiac toxicity. Mitoxantrone is an antineoplastic agent used primarily to treat leukemia and lyphoma but is also used to treat secondary progressive MS. Patients need to have ... ordered and the results closely monitored due to the potential for leukopenia and cardiac toxicity.

Of the following disorders, which results from excessive secretion of somatotropin? a) Acromegaly The patient with acromegaly demonstrates progressive enlargement of peripheral body parts, most commonly the face, head, hands, and feet.

Description : Of the following disorders, which results from excessive secretion of somatotropin? a) Acromegaly The patient with acromegaly demonstrates progressive enlargement of peripheral body parts, most ... syndrome is the result of abnormal secretion of adrenocortical hormones, especially androgen.

Last Answer : a) Acromegaly The patient with acromegaly demonstrates progressive enlargement of peripheral body parts, most commonly the face, head, hands, and feet.

When interpreting the results of a Mantoux test, the nurse explains to the patient that a reaction occurs when the intradermal injection site shows a) redness and induration. The site is inspected for redness and palpated for hardening. b) drainage. Drainage at the site does not indicate a reaction to the tubercle bacillus. c) tissue sloughing. Sloughing of tissue at the site of injection does not indicate a reaction to the tubercle bacillus. d) bruising. Bruising of tissue at the site may occur from the injection, but does not indicate a reaction to the tubercle bacillus.

Description : When interpreting the results of a Mantoux test, the nurse explains to the patient that a reaction occurs when the intradermal injection site shows a) redness and induration. The site is inspected for ... site may occur from the injection, but does not indicate a reaction to the tubercle bacillus.

Last Answer : a) redness and induration. The site is inspected for redness and palpated for hardening.

The preferred route of administration of medication in the most acute care situations is which of the following routes? a) Intravenous The IV route is the preferred parenteral route in most acute care situations because it is much more comfortable for the patient, and peak serum levels and pain relief occur more rapidly and reliably. b) Epidural Epidural administration is used to control postoperative and chronic pain. c) Subcutaneous Subcutaneous administration results in slow absorption of medication. d) Intramuscular Intramuscular administration of medication is absorbed more slowly than intravenously administered medication.

Description : The preferred route of administration of medication in the most acute care situations is which of the following routes? a) Intravenous The IV route is the preferred ... ) Intramuscular Intramuscular administration of medication is absorbed more slowly than intravenously administered medication.

Last Answer : a) Intravenous The IV route is the preferred parenteral route in most acute care situations because it is much more comfortable for the patient, and peak serum levels and pain relief occur more rapidly and reliably.

The most important intervention in the nutritional support of a patient with a burn injury is to provide adequate nutrition and calories to: a) decrease catabolism. The most important intervention in the nutritional support of a patient with a burn injury is to provide adequate nutrition and calories to decrease catabolism. Nutritional support with optimized protein intake can decrease the protein losses by approximately 50%.

Description : The most important intervention in the nutritional support of a patient with a burn injury is to provide adequate nutrition and calories to: a) decrease catabolism. The most important intervention ... the energy source is seen after a burn injury; interventions are instituted to decrease catabolism.

Last Answer : a) decrease catabolism. The most important intervention in the nutritional support of a patient with a burn injury is to provide adequate nutrition and calories to decrease catabolism. Nutritional support with optimized protein intake can decrease the protein losses by approximately 50%.

Antimicrobial barrier?Acticoat dressings used in the treatment of burn wounds can be left in place for five days. a) antimicrobial barrier dressings can be left in place for?Acticoat up to five days thus helping to decrease discomfort to the patient, decrease costs of dressing supplies, and decrease nursing time involved in burn dressing changes.

Description : Antimicrobial barrier?Acticoat dressings used in the treatment of burn wounds can be left in place for five days. a) antimicrobial barrier dressings can be left in place for?Acticoat up to five days ... ) two days. antimicrobial barrier dressings can be left in?Acticoat place for up to five days.

Last Answer : a) antimicrobial barrier dressings can be left in place for?Acticoat up to five days thus helping to decrease discomfort to the patient, decrease costs of dressing supplies, and decrease nursing time involved in burn dressing changes.

Which of the following statements reflects nursing care of the woman with mild to moderate ovarian hyperstimulation syndrome (OHSS)? a) Advise the patient to decrease her activity, monitor her urine output and to return for frequent office visits. Management in mild and moderate cases of OHSS consists of decreased activity, monitoring of urine output and frequent office visits as designated by the reproductive endocrinologist.

Description : Which of the following statements reflects nursing care of the woman with mild to moderate ovarian hyperstimulation syndrome (OHSS)? a) Advise the patient to decrease her activity, monitor ... for immediate hospitalization. The patient with severe OHSS is hospitalized for monitoring and treatment.

Last Answer : a) Advise the patient to decrease her activity, monitor her urine output and to return for frequent office visits. Management in mild and moderate cases of OHSS consists of decreased activity, monitoring of urine output and frequent office visits as designated by the reproductive endocrinologist.

To prevent footdrop, the patient is positioned in: a) Order to keep the feet at right angles to the leg When the patient is supine in bed, padded splints or protective boots are used. b) A semi-sitting position in bed Semi-fowlers positioning is used to decrease the pressure of abdominal contents on the diaphragm. c) A sitting position with legs hanging off the side of the bed In order to prevent footdrop, the feet must be supported. d) A side-lying position Side-lying positions do not provide support to prevent footdrop.

Description : To prevent footdrop, the patient is positioned in: a) Order to keep the feet at right angles to the leg When the patient is supine in bed, padded splints or protective boots are used. b) ... must be supported. d) A side-lying position Side-lying positions do not provide support to prevent footdrop.

Last Answer : a) Order to keep the feet at right angles to the leg When the patient is supine in bed, padded splints or protective boots are used.