NUR 265 EXAM 3 | ADVANCED CONCEPTS
OF MEDICAL SURGICAL NURSING EXAM
3 | RATED A+ | LATEST 2025/2026 GUIDE |
GALEN
What can brain abscess be a complication of?
- Correct Answer - meningitis
What is the main trigger of hypovolemic shock?
- Correct Answer - sustained decrease MAP (drop of 5-10)
How can decreased MAP be detected?
- Correct Answer - baroreceptors
When MAP stays low, what will increase?
- Correct Answer - lactic acid and cause metabolic acidosis
What are the stages of hypovolemic shock?
- Correct Answer - • Initial Stage
• Nonprogressive Stage
• Progressive Stage
• Refractory Stage"
What happens with the initial stage?
- Correct Answer - baseline map decreases by less than 10
oxygen perfusion is maintained
,increased anaerobic metabolism w/ production of lactic acid
What is the only thing we might pick up on for initial stage?
- Correct Answer - increase HR & RR or increase BP
What happens with the nonprogressive stage
- Correct Answer - baseline MAP decreases by less than 10-15
renin triggered
urine op decrease
ADH increase water resorption in kidney
tissue hypoxia occurs, but not great enough to cause perm damage
metabolic acidosis
reversible
What are s/s in nonprogressive stage
- Correct Answer - hyperkalemia
falling systolic pressure
cool extremities
What happens with progressive stage?
- Correct Answer - sustained decrease in MAP of more than 20
no longer compesating
ischemic & organs start to die
Can progressive stage be saved?
- Correct Answer - if corrected w/in 1hr or less
What are s/s of progressive stage?
- Correct Answer - confused
,rapid weak pulse
low BP
low PH
rising lactic
hyperkalemia
impending doom
What happens in refractory stage?
- Correct Answer - too much cell death & having organ failure/damage
no longer reversible
massive release of toxic metabolites & enzymes
small clots form & cause more tissue perfusion blockages
fluid replacement no longer effective, pt is going to die
What are s/s of refractory stage?
- Correct Answer - nonpalpable pulse
cold dusky extremities
liver, heart, brain & kidney function lost first
What is first sign of shock?
- Correct Answer - tachycardia
What to ask about with shock?
- Correct Answer - aspirins, diuretics, I&O
What labs to check with shock?
- Correct Answer - ABGs
lactic will be high
, sepsis & septic shock #1?
- Correct Answer - local infection
With the local infection?
- Correct Answer - no fever
cap leak allowing plasma to leak into tissues which causes swelling
sepsis & septic shock #2?
- Correct Answer - Sepsis & Systemic inflammatory response syndrome
(SIRS)
What happens with SIRS?
- Correct Answer - sepsis
increase bacteria in the bloodstream
inappropriate clotting
full prognosis if treated early
What are s/s with SIRS? - Correct Answer - fever
hypotension
decrease U op
increase RR
increased WBC
sepsis & septic shock #3? - Correct Answer - severe sepsis
What happens with severe sepsis? - Correct Answer - closts spread to
the big organs
anaerobic metabolism continues
increased DIC
OF MEDICAL SURGICAL NURSING EXAM
3 | RATED A+ | LATEST 2025/2026 GUIDE |
GALEN
What can brain abscess be a complication of?
- Correct Answer - meningitis
What is the main trigger of hypovolemic shock?
- Correct Answer - sustained decrease MAP (drop of 5-10)
How can decreased MAP be detected?
- Correct Answer - baroreceptors
When MAP stays low, what will increase?
- Correct Answer - lactic acid and cause metabolic acidosis
What are the stages of hypovolemic shock?
- Correct Answer - • Initial Stage
• Nonprogressive Stage
• Progressive Stage
• Refractory Stage"
What happens with the initial stage?
- Correct Answer - baseline map decreases by less than 10
oxygen perfusion is maintained
,increased anaerobic metabolism w/ production of lactic acid
What is the only thing we might pick up on for initial stage?
- Correct Answer - increase HR & RR or increase BP
What happens with the nonprogressive stage
- Correct Answer - baseline MAP decreases by less than 10-15
renin triggered
urine op decrease
ADH increase water resorption in kidney
tissue hypoxia occurs, but not great enough to cause perm damage
metabolic acidosis
reversible
What are s/s in nonprogressive stage
- Correct Answer - hyperkalemia
falling systolic pressure
cool extremities
What happens with progressive stage?
- Correct Answer - sustained decrease in MAP of more than 20
no longer compesating
ischemic & organs start to die
Can progressive stage be saved?
- Correct Answer - if corrected w/in 1hr or less
What are s/s of progressive stage?
- Correct Answer - confused
,rapid weak pulse
low BP
low PH
rising lactic
hyperkalemia
impending doom
What happens in refractory stage?
- Correct Answer - too much cell death & having organ failure/damage
no longer reversible
massive release of toxic metabolites & enzymes
small clots form & cause more tissue perfusion blockages
fluid replacement no longer effective, pt is going to die
What are s/s of refractory stage?
- Correct Answer - nonpalpable pulse
cold dusky extremities
liver, heart, brain & kidney function lost first
What is first sign of shock?
- Correct Answer - tachycardia
What to ask about with shock?
- Correct Answer - aspirins, diuretics, I&O
What labs to check with shock?
- Correct Answer - ABGs
lactic will be high
, sepsis & septic shock #1?
- Correct Answer - local infection
With the local infection?
- Correct Answer - no fever
cap leak allowing plasma to leak into tissues which causes swelling
sepsis & septic shock #2?
- Correct Answer - Sepsis & Systemic inflammatory response syndrome
(SIRS)
What happens with SIRS?
- Correct Answer - sepsis
increase bacteria in the bloodstream
inappropriate clotting
full prognosis if treated early
What are s/s with SIRS? - Correct Answer - fever
hypotension
decrease U op
increase RR
increased WBC
sepsis & septic shock #3? - Correct Answer - severe sepsis
What happens with severe sepsis? - Correct Answer - closts spread to
the big organs
anaerobic metabolism continues
increased DIC
