ATI Med Surg test questions Shock and Multiple Organ Dysfunction Syndrome 100% Correct Answers,

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1. A nurse in the ICU is planning the care of a patient who is being treated for shock. Which of the

following statements best describes the pathophysiology of this patients health problem?

a. Blood is shunted from vital organs to peripheral areas of the body.

b. Cells lack an adequate blood supply and are deprived of oxygen and nutrients.

c. Circulating blood volume is decreased with a resulting change in the osmotic pressure gradient.

d. Hemorrhage occurs as a result of trauma, depriving vital organs of adequate perfusion.

Ans: B

Feedback:

Shock is a life-threatening condition with a variety of underlying causes. Shock is caused when the cells

have a lack of adequate blood supply and are deprived of oxygen and nutrients. In cases of shock, blood

is shunted 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. In an acute care setting, the nurse is assessing an unstable patient. When prioritizing the patients

care, the nurse should recognize that the patient is at risk for hypovolemic shock in which of the

following circumstances?

a. Fluid volume circulating in the blood vessels decreases.

b. There is an uncontrolled increase in cardiac output.

c. Blood pressure regulation becomes irregular.

d. The patient experiences tachycardia and a bounding pulse.

Ans: A

Feedback:

Hypovolemic shock is characterized by a decrease in intravascular volume. Cardiac output is decreased,

blood pressure decreases, and pulse is fast, but weak.

3. The emergency nurse is admitting a patient experiencing a GI bleed who is believed to be in the

compensatory stage of shock. What assessment finding would be most consistent with the early

stage of compensation?

a. Increased urine output

b. Decreased heart rate

c. Hyperactive bowel sounds

d. Cool, clammy skin

Ans: D

Feedback:

In the compensatory stage of shock, the body shunts blood from the organs, such as the skin and

kidneys, to the brain and heart to ensure adequate blood supply. As a result, the patients skin is cool

and clammy. Also in this compensatory stage, blood vessels vasoconstrict, the heart rate increases,

bowel sounds are hypoactive, and the urine output decreases.

4. The nurse is caring for a patient who is exhibiting signs and symptoms of hypovolemic shock

following injuries suffered in a motor vehicle accident. The nurse anticipates that the physician will

promptly order the administration of a crystalloid IV solution to restore intravascular volume. In

addition to normal saline, which crystalloid fluid is commonly used to treat hypovolemic shock?

a. Lactated Ringers

b. Albumin

c. Dextran

d. 3% NaCl

Ans: A

Feedback:

Crystalloids are electrolyte solutions used for the treatment of hypovolemic shock. Lactated Ringers and

0.9% sodium chloride are isotonic crystalloid fluids commonly used to manage hypovolemic shock.

Dextran and albumin are colloids, but Dextran, even as a colloid, is not indicated for the treatment of

hypovolemic shock. 3% NaCl is a hypertonic solution and is not isotonic.

5. A patient who is in shock is receiving dopamine in addition to IV fluids. What principle should inform

the nurses care planning during the administration of a vasoactive drug?

a. The drug should be discontinued immediately after blood pressure increases.

b. The drug dose should be tapered down once vital signs improve.

c. The patient should have arterial blood gases drawn every 10 minutes during treatment.

d. The infusion rate should be titrated according the patients subjective sensation of adequate

perfusion.

Ans: B

Feedback:

When vasoactive medications are discontinued, they should never be stopped abruptly because this

could cause severe hemodynamic instability, perpetuating the shock state. Subjective assessment data

are secondary to objective data. Arterial blood gases should be carefully monitored, but every10-minute

draws are not the norm.

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