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Management Of Clients With Shock And Multisystem Disorders

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Question 1
Free
Multiple Choice

Distributive shock is primarily due to

Choose correct answer/s
A

a fluid shift from the vascular space.

B

an increase in the size of the vascular space.

C

inadequate circulating blood volume.

D

inadequate pumping action of the heart.

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Question 2
Free
Multiple Choice

A client has been in a motor vehicle accident and sustained significant injuries. The client is in shock and is semi-conscious, but is restless and moaning. The family is concerned the client is in pain and demands the nurse administer ordered morphine. The priority action by the nurse is to

Choose correct answer/s
A

check the client's oxygen saturation.

B

give morphine as ordered, slowly.

C

politely decline their request.

D

reposition the client.

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Question 3
Free
Multiple Choice

During the progressive stage of shock, lactic acidosis occurs, resulting in

Choose correct answer/s
A

arterial pooling in the periphery.

B

constriction of the microcirculation.

C

increased capillary permeability.

D

movement of fluid into the capillaries.

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Question 4
Free
Multiple Choice

The nurse has formulated the nursing diagnosis Interrupted Family Processes for the family of a critically ill client in the ICU with shock. The nurse would realize that outcomes for this diagnosis may not have been met when

Choose correct answer/s
A

a member of the family insists on using previous coping mechanisms.

B

members of the family seem supportive of each other.

C

the family is willing to participate in decision making.

D

the nurse has to repeat information several times before it is remembered.

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Question 5
Free
Multiple Choice

A client is in shock and is receiving naloxone (Narcan). The client's sibling is an EMT and questions why the client is getting medication for "an overdose." The most appropriate response by the nurse is

Choose correct answer/s
A

"Because of HIPAA laws, I am not allowed to tell you about his/her care."

B

"I don't know but I can have the doctor come and speak with you."

C

"In clients with shock it helps the hypotension and cardiac output."

D

"The client may have gotten too much morphine in the emergency department."

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Question 6
Multiple Choice

The nurse closely assesses clients who experience crushing injuries and are in shock because they are more prone than other clients to develop

Choose correct answer/s
A
adult respiratory distress syndrome.
B
disseminated intravascular clotting.
C
fat emboli and respiratory distress.
D
uncompensated metabolic alkalosis.
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Question 7
Multiple Choice

A client with SIRS is being treated with drotrecogin alfa (Xigris). The client exhibits a decrease in level of consciousness. Which action by the nurse is most important?

Choose correct answer/s
A
Increase the rate of IV infusion.
B
Notify the physician.
C
Order a stat ECG.
D
Take a set of vital signs.
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Question 8
Multiple Choice

The nurse would assess the individual in the most serious stage of shock as a

Choose correct answer/s
A
22-year-old man with a falling BP.
B
35-year-old woman with a pulse pressure of 40.
C
50-year-old woman with a MAP of 90.
D
60-year-old man with a pulse rate of 100.
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Question 9
Multiple Choice

The nurse explains that an advantage of the use of hemoglobin-based oxygen carriers (HBOCs), such as PolyHeme and Hemopure, is that these products

Choose correct answer/s
A
decrease the pH of the blood.
B
do not require type and crossmatch.
C
function as packed cells at less cost.
D
increase hemoglobin.
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Question 10
Multiple Choice

The nurse caring for a client in shock who is being mechanically hyperventilated explains that the rationale for this intervention is to

Choose correct answer/s
A
decrease carbon dioxide levels in the blood.
B
prevent atelectasis and respiratory failure.
C
rest the client to decrease metabolism.
D
stimulate endorphin production.
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Question 11
Multiple Choice

The nurse suspects that the client who has entered the emergency department with severe uterine bleeding is in the early stages of shock. The nurse's first priority is to

Choose correct answer/s
A
administer oxygen per nasal cannula.
B
apply super-absorbent perineal pads.
C
place the client in Trendelenburg position.
D
start an intravenous line.
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Question 12
Multiple Choice

When a client is admitted to the emergency department with a gunshot wound to the abdomen and is experiencing severe blood loss, the nurse anticipates the initial use of

Choose correct answer/s
A
dextran.
B
normal saline.
C
packed red blood cells.
D
whole blood.
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Question 13
Multiple Choice

A client is receiving fluid replacement for treatment of shock and the nurse assesses a central venous pressure (CVP) of 15 cm water. The nurse anticipates which of the following interventions?

Choose correct answer/s
A
Administration of vasoconstrictors
B
Administration of vasodilators
C
Decreasing fluid infusion
D
Increasing fluid infusion
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Question 14
Multiple Choice

The nurse is caring for an elderly client who is receiving vasodilators as part of the treatment of shock. The alteration in care the nurse should plan for this client is to

Choose correct answer/s
A
ensure a patent Foley catheter.
B
keep the head of the bed flat.
C
provide oxygen by nasal cannula.
D
run IV fluids at a lower rate.
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Question 15
Multiple Choice

During treatment for shock, the client receives fluid volume replacement. The nurse determines that renal perfusion is being maintained if the urine output is at least

Choose correct answer/s
A
0.25 ml/kg/hour.
B
0.5 ml/kg/hour.
C
1.0 ml/kg/hour.
D
1.5 ml/kg/hour.
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Question 16
Multiple Choice

Nursing care for a client in hypovolemic shock caused by trauma should include

Choose correct answer/s
A
giving narcotics for pain relief.
B
maintaining a cool environment.
C
placing the client in Trendelenburg position.
D
providing nasogastric suctioning.
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Question 17
Multiple Choice

A client in hypovolemic shock has a low pulmonary capillary wedge pressure. This should indicate to the nurse that

Choose correct answer/s
A
fluid replacement is needed.
B
pulmonary edema may be developing.
C
resuscitative measures are adequate.
D
the client's left ventricle is failing.
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Question 18
Multiple Choice

A client in the ICU has shock and is getting blood glucose levels drawn and treatment with subcutaneous insulin. The client's spouse is upset seeing this and says "Now s/he's a diabetic, too?" The best response by the nurse is

Choose correct answer/s
A
"Blood sugar goes up with physical stress and insulin controls it, and clients seem to do better."
B
"High blood sugar is a common side effect of all these medications we are giving the client."
C
"No, no, s/he is not yet a diabetic. I hope we can prevent it by giving insulin now."
D
"Under great physical stress, blood glucose elevates and people can become diabetic."
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Question 19
Multiple Choice

The nurse assessing acutely ill clients who are at risk for multiple organ dysfunction syndrome (MODS) would assess for the usual precipitating manifestation of

Choose correct answer/s
A
bradycardia.
B
cerebral anoxia.
C
high creatinine level.
D
hypotension.
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Question 20
Multiple Choice

A client is at risk for MODS. In caring for this client, the nurse should place the highest priority on

Choose correct answer/s
A
assisting with incentive spirometry.
B
hourly monitoring of urinary output.
C
maintaining adequate oral intake.
D
performing range-of-motion exercises.
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