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NURS 400 EXAM 6 QUESTIONS AND ANSWERS
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NURS 400 EXAM 6 QUESTIONS AND ANSWERS
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NURS 400 Unit 4 QUESTIONS ANDANSWERS
Chapters18sShocksandsMultiplesOrgansDysfunctionsSyndromes-sans--
1.sAsnursesinsthesICUsissplanningsthescaresofsaspatientswhosissbeingstreatedsforsshock.
Whichsofsthesfollowingsstatementssbestsdescribessthespathophysiologysofsthisspatients
healthsproblem?
A)sBloodsissshuntedsfromsvitalsorgAnsstosperipheralsareassofsthesbody.
B)sCellsslacksansadequatesbloodssupplysandsaresdeprivedsofsoxygensandsnutrients.
C)sCirculatingsbloodsvolumesissdecreasedswithsasresultingschangesinsthesosmotic
pressuresgradient.
D)sHemorrhagesoccurssassasresultsofstrauma,sdeprivingsvitalsorgAnssofsadequate
perfusion.s-sans--B
2.sInsansacutescaressetting,sthesnursesissassessingsansunstablespatient.sWhensprioritizingsth
e
patientsscare,sthesnursesshouldsrecognizesthatsthespatientsissatsrisksforshypovolemicsshock
inswhichsofsthesfollowingscircumstances?
A)sFluidsvolumescirculatingsinsthesbloodsvesselssdecreases.
B)sTheresissansuncontrolledsincreasesinscardiacsoutput.
C)sBloodspressuresregulationsbecomessirregular.
D)sThespatientsexperiencesstachycardiasandsasboundingspulse.s-sans--A
3.sThesemergencysnursesissadmittingsaspatientsexperiencingsasGIsbleedswhosissbelievedsto
besinsthescompensatorysstagesofsshock.sWhatsassessmentsfindingswouldsbesmost
consistentswithsthesearlysstagesofscompensation?
A)sIncreasedsurinesoutput
B)sDecreasedsheartsrate
C)sHyperactivesbowelssounds
D)sCool,sclammysskins-sans--D
4.sThesnursesisscaringsforsaspatientswhosissexhibitingssignssandssymptomssofshypovolemic
shocksfollowingsinjuriesssufferedsinsasmotorsvehiclesaccident.sThesnursesanticipatessthat
thesphysicianswillspromptlysordersthesadministrationsofsascrystalloidsIVssolutionsto
restoresintravascularsvolume.sInsadditionstosnormalssaline,swhichscrystalloidsfluidsis
commonlysusedstostreatshypovolemicsshock?
A)sLactatedsRingers
B)sAlbumin
C)sDextran
D)s3%sNaCls-sans--A
,5.sAspatientswhosissinsshocksissreceivingsdopaminesinsadditionstosIVsfluids.sWhatsprinciple
shouldsinformsthesnursesscaresplanningsduringsthesadministrationsofsasvasoactivesdrug?
A)sThesdrugsshouldsbesdiscontinuedsimmediatelysaftersbloodspressuresincreases.
B)sThesdrugsdosesshouldsbestaperedsdownsoncesvitalssignssimprove.
C)sThespatientsshouldshavesarterialsbloodsgasessdrawnseverys10sminutessduring
treatment.
D)sThesinfusionsratesshouldsbestitratedsaccordingsthespatientsssubjectivessensationsof
adequatesperfusion.s-sans--B
6.sAsnursesinsthesICUsreceivessreportsfromsthesnursesinsthesEDsaboutsasnewspatientsbeing
admittedswithsasnecksinjuryshesreceivedswhilesdivingsintosaslake.sThesEDsnursesreports
thatshissbloodspressuresiss85/54,sheartsratesiss53sbeatsspersminute,sandshissskinsisswarm
andsdry.sWhatsdoessthesICUsnursesrecognizesthatsthatspatientsissprobablysexperiencing?
A)sAnaphylacticsshock
B)sNeurogenicsshock
C)sSepticsshock
D)sHypovolemicsshocks-sans--B
7.sThesintensivescaresnursescaringsforsaspatientsinsshocksissplanningsassessmentssand
interventionssrelatedstosthespatientssnutritionalsneeds.sWhatsphysiologicsprocess
contributesstosthesesincreasedsnutritionalsneeds?
A)sThesusesofsalbuminsassansenergyssourcesbysthesbodysbecausesofsthesneedsfor
increasedsadenosinestriphosphates(ATP)
B)sTheslosssofsfluidssduestosdecreasedsskinsintegritysandsdecreasedsstomachsacidssdue
tosincreasedsparasympatheticsactivity
C)sThesreleasesofscatecholaminessthatscreatessansincreasesinsmetabolicsratesandscaloric
requirements
D)sThesincreasesinsGIsperistalsissduringsshocksandsthesresultingsdiarrheas-sans--C
8.sThesnursesisstrAnsferringsaspatientswhosissinsthesprogressivesstagesofsshocksintosICUsfro
m
thesmedicalsunit.sThesmedicalsnursesissawaresthatsshocksaffectssmanysorganssystemssand
thatsnursingsmanagementsofsthespatientswillsfocussonswhatsintervention?
A)sReviewingsthescausesofsshocksandsprioritizingsthespatientsspsychosocialsneeds
B)sAssessingsandsunderstandingsshocksandsthessignificantschangessinsassessmentsdata
tosguidesthesplansofscare
C)sGivingsthesprescribedstreatment,sbutsshiftingsfocusstosprovidingsfamilystimesassthe
patientsissunlikelystossurvive
D)sPromotingsthespatientsscopingsskillssinsanseffortstosbettersdealswithsthesphysiologic
changessaccompanyingsshocks-sans--B
9.sWhenscaringsforsaspatientsinsshock,sonesofsthesmajorsnursingsgoalssisstosreducesthesrisk
thatsthespatientswillsdevelopscomplicationssofsshock.sHowscansthesnursesbestsachievesthis
goal?
A)sProvidesasdetailedsdiagnosissandsplansofscaresinsorderstospromotesthespatientssand
,familysscoping.
B)sKeepsthesphysiciansupdatedswithsthesmostsaccuratesinformationsbecausesinscasessof
shocksthesnursesoftenscannotsprovidesrelevantsinterventions.
C)sMonitorsforssignificantschangessandsevaluatespatientsoutcomessonsasscheduled
basissfocusingsonsbloodspressuresandsskinstemperature.
D)sUnderstandsthesunderlyingsmechanismssofsshock,srecognizesthessubtlesandsmore
obviousssigns,sandsthensprovidesrapidsassessment.s-sans--D
10.sThesnursesisscaringsforsaspatientsinsthesICUswhoshassbeensdiagnosedswithsmultiplesorga
n
dysfunctionssyndromes(MODS).sThesnursessplansofscaresshouldsincludeswhichsofsthe
followingsinterventions?
A)sEncouragingsthesfamilystosstayshopefulsandseducatingsthemstosthesfactsthat,sin
nearlysallscases,sthesprognosississgood
B)sEncouragingsthesfamilystosleavestheshospitalsandstostakestimesforsthemselvessas
acutescaresofsMODSspatientssmayslastsforsseveralsmonths
C)sPromotingscommunicationswithsthespatientsandsfamilysalongswithsaddressingsendof-
lifesissues
D)sDiscussingsorgansdonationsonsasnumbersofsdifferentsoccasionsstosallowsthesfamily
timestosadjuststosthesideas-sans--C
11.sThesacutescaresnursesissprovidingscaresforsansadultspatientswhosissinshypovolemicsshoc
k.
Thesnursesrecognizessthatsantidiureticshormones(ADH)splayssassignificantsrolesinsthis
healthsproblem.sWhatsassessmentsfindingswillsthesnurseslikelysobservesrelatedstosthesrole
ofsthesADHsduringshypovolemicsshock?
A)sIncreasedshunger
B)sDecreasedsthirst
C)sDecreasedsurinarysoutput
D)sIncreasedscapillarysperfusions-sans--C
12.sThesnursesisscaringsforsaspatientswhosesprogressingsinfectionsplacesshersatshighsrisksfor
shock.sWhatsassessmentsfindingswouldsthesnursesconsidersaspotentialssignsofsshock?
A)sElevatedssystolicsbloodspressure
B)sElevatedsmeansarterialspressures(MAP)
C)sShallow,srapidsrespirations
D)sBradycardias-sans--C
13.sYousarespreceptingsasnewsgraduatesnursesinsthesICU.sYousarescollaboratingsinsthescares
of
aspatientswhosissreceivingslargesvolumessofscrystalloidsfluidstostreatshypovolemicsshock.
Inslightsofsthissintervention,sforswhatssignswouldsyousteachsthesnewsnursestosmonitorsthe
patient?
A)sHypothermia
B)sBradycardia
C)sCoffeesgroundsemesis
, D)sPains-sans--A
14.sThesnursesisscaringsforsaspatientsinsthesICUswhosesconditionsissdeteriorating.sThesnurse
receivessordersstosinitiatesansinfusionsofsdopamine.sWhatswouldsbesthespriority
assessmentsandsinterventionssspecificstosthesadministrationsofsvasoactivesmedications?
A)sFrequentsmonitoringsofsvitalssigns,smonitoringsthescentralslinessite,sandsproviding
accuratesdrugstitration
B)sReviewingsmedications,sperformingsasfocusedscardiovascularsassessment,sand
providingspatientseducation
C)sReviewingstheslaboratorysfindings,smonitoringsurinesoutput,sandsassessingsfor
peripheralsedema
D)sRoutinesmonitoringsofsvitalssigns,smonitoringsthesperipheralsIVssite,sandsproviding
earlysdischargesinstructionss-sans--A
15.sThesnursesinsthesICUsissadmittingsas57-year-oldsmanswithsasdiagnosissofspossiblesseptic
shock.sThesnursessassessmentsrevealssthatsthespatientshassasnormalsbloodspressure,
increasedsheartsrate,sdecreasedsbowelssounds,sandscold,sclammysskin.sThesnurses
analysissofsthesesdatasshouldsleadstoswhatspreliminarysconclusion?
A)sThespatientsissinsthescompensatorysstagesofsshock.
B)sThespatientsissinsthesprogressivesstagesofsshock.
C)sThespatientswillsstabilizesandsbesreleasedsbystomorrow.
D)sThespatientsissinsthesirreversiblesstagesofsshock.s-sans--A
16.sThesnurse,sasmembersofstheshealthscaresteamsinsthesED,sisscaringsforsaspatientswhosis
determinedstosbesinsthesirreversiblesstagesofsshock.sWhatswouldsbesthesmostsappropriate
nursingsintervention?
A)sProvidesopportunitiessforsthesfamilystosspendstimeswithsthespatient,sandshelpsthem
tosunderstandsthesirreversiblesstagesofsshock.
B)sInformsthespatientssfamilysimmediatelysthatsthespatientswillslikelysnotssurvivesto
allowsthesfamilystimestosmakesplAnssandsmovesforward.
C)sCloselysmonitorsfluidsreplacementstherapy,sandsinformsthesfamilysthatsthespatient
willsprobablyssurvivesandsreturnstosnormalslife.
D)sProtectsthespatientssairway,soptimizesintravascularsvolume,sandsinitiatesthesearly
rehabilitationsprocess.s-sans--A
17.sThesnursesinsasruralsnursingsoutpostshassjustsbeensnotifiedsthatssheswillsbesreceivingsa
patientsinshypovolemicsshocksduestosasmassivespostpartumshemorrhagesaftershershome
birth.sYousknowsthatsthesbestschoicesforsfluidsreplacementsforsthisspatientsisswhat?
A)s5%salbuminsbecausesitsissinexpensivesandsissalwayssreadilysavailable
B)sDextransbecausesitsincreasessintravascularsvolumesandscounteractsscoagulopathy
C)sWhateversfluidsissmostsreadilysavailablesinsthesclinic,sduestosthesnaturesofsthe
emergency
D)sLactatedsRingersssolutionsbecausesitsincreasessvolume,sbufferssacidosis,sandsissthe
bestschoicesforspatientsswithsliversfailures-sans--C
18.sThesnursesinsthesICUsisscaringsforsas47-year-old,sobesesmalespatientswhosissinsshock
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