Question 1

The most common site for sepsis and septic shock is

Accepted Answer

A)  the respiratory system. 
B)  the gastrointestinal system. 
C)  the genitourinary system. 
D)  the circulatory system. 
A)  the respiratory system. 
B)  the gastrointestinal system. 
C)  the genitourinary system. 
D)  the circulatory system. A

Question 2

An inflammatory biochemical that is secreted in response to endotoxin or noninfectious agents is

Accepted Answer

A)  arachidonic acid metabolite. 
B)  platelet-activating factor. 
C)  tumor necrosis factor. 
D)  the complement system. 
A)  arachidonic acid metabolite. 
B)  platelet-activating factor. 
C)  tumor necrosis factor. 
D)  the complement system. C

Question 3

A patient is admitted to the intensive care unit after she develops disseminated intravascular coagulation (DIC)after a vaginal delivery.DIC is known to occur in patients with retained placental fragments.What is the result of DIC?

Accepted Answer

A)  Hypersensitive response to an antigen, resulting in anaphylaxis 
B)  Depletion of clotting factors and excessive fibrinolysis, resulting in simultaneous microvascular clotting and hemorrhage 
C)  Vasodilatation, resulting in hypotension 
D)  Septic shock, resulting in vasodilation and decreased perfusion 
A)  Hypersensitive response to an antigen, resulting in anaphylaxis 
B)  Depletion of clotting factors and excessive fibrinolysis, resulting in simultaneous microvascular clotting and hemorrhage 
C)  Vasodilatation, resulting in hypotension 
D)  Septic shock, resulting in vasodilation and decreased perfusion B

Question 4

Signs of hypovolemia in the trauma patient include

Accepted Answer

A)  distended neck veins. 
B)  a decreased level of consciousness. 
C)  bounding radial and pedal pulses. 
D)  a widening pulse pressure. 
A)  distended neck veins. 
B)  a decreased level of consciousness. 
C)  bounding radial and pedal pulses. 
D)  a widening pulse pressure.

Question 5

Shock syndrome can best be described as a

Accepted Answer

A)  physiologic state resulting in hypotension and tachycardia. 
B)  generalized systemic response to inadequate tissue perfusion. 
C)  degenerative condition leading to death. 
D)  condition occurring with hypovolemia that results in irreversible hypotension. 
A)  physiologic state resulting in hypotension and tachycardia. 
B)  generalized systemic response to inadequate tissue perfusion. 
C)  degenerative condition leading to death. 
D)  condition occurring with hypovolemia that results in irreversible hypotension.

Question 6

Which of the following drugs promotes bronchodilation and vasoconstriction?

Accepted Answer

A)  Solu-Medrol 
B)  Gentamicin 
C)  Atropine 
D)  Epinephrine 
A)  Solu-Medrol 
B)  Gentamicin 
C)  Atropine 
D)  Epinephrine

Question 7

The patients at highest risk for neurogenic shock are those who have had

Accepted Answer

A)  a stroke. 
B)  a spinal cord injury. 
C)  Guillain-Barré syndrome. 
D)  a craniotomy. 
A)  a stroke. 
B)  a spinal cord injury. 
C)  Guillain-Barré syndrome. 
D)  a craniotomy.

Question 8

When SIRS is the result of infection,it is called

Accepted Answer

A)  inflammation. 
B)  anaphylaxis. 
C)  sepsis. 
D)  pneumonia. 
A)  inflammation. 
B)  anaphylaxis. 
C)  sepsis. 
D)  pneumonia.

Question 9

Evidence-based guidelines for the treatment of septic shock include which of the following?

Accepted Answer

A)  Fluid resuscitation to maintain central venous pressure at 8 mm Hg or greater 
B)  Low-dose dopamine for renal protection 
C)  High-dose corticosteroids 
D)  Administration of activated protein C 
E)  Achieve central venous oxygen saturation of 70% or more 
A)  Fluid resuscitation to maintain central venous pressure at 8 mm Hg or greater 
B)  Low-dose dopamine for renal protection 
C)  High-dose corticosteroids 
D)  Administration of activated protein C 
E)  Achieve central venous oxygen saturation of 70% or more

Question 10

With anaphylactic shock,which mechanism results in a decreased cardiac output?

Accepted Answer

A)  Peripheral vasodilation 
B)  Increased cardiac output 
C)  Decreased alveolar ventilation 
D)  Fluid retention resulting in congestive heart failure 
A)  Peripheral vasodilation 
B)  Increased cardiac output 
C)  Decreased alveolar ventilation 
D)  Fluid retention resulting in congestive heart failure

Question 11

The nursing measure that can best enhance large volumes of fluid replacement in hypovolemic shock is

Accepted Answer

A)  insertion of a large-diameter peripheral intravenous catheter. 
B)  positioning the patient in the Trendelenburg position. 
C)  forcing at least 240 mL of fluid each hour. 
D)  administering intravenous lines under pressure. 
A)  insertion of a large-diameter peripheral intravenous catheter. 
B)  positioning the patient in the Trendelenburg position. 
C)  forcing at least 240 mL of fluid each hour. 
D)  administering intravenous lines under pressure.

Question 12

A patient has been on the medical floor for 1 week after a vaginal hysterectomy.A urinary catheter was inserted.Complete blood cell count results have revealed escalating white blood cell counts.The patient is transferred to the critical care unit when her condition deteriorates.Septic shock is diagnosed.The medical management of the patient's condition is aimed toward

Accepted Answer

A)  limiting fluids to minimize the possibility of congestive heart failure. 
B)  finding and eradicating the cause of infection. 
C)  discontinuing invasive monitoring as a possible cause of sepsis. 
D)  administering vasodilator substances to increase blood flow to vital organs. 
A)  limiting fluids to minimize the possibility of congestive heart failure. 
B)  finding and eradicating the cause of infection. 
C)  discontinuing invasive monitoring as a possible cause of sepsis. 
D)  administering vasodilator substances to increase blood flow to vital organs.

Question 13

Which medications are not effective in the immediate treatment of acute anaphylaxis?

Accepted Answer

A)  Epinephrine 
B)  Vasopressors 
C)  Diphenhydramine (Benadryl) IV 
D)  Corticosteroids 
A)  Epinephrine 
B)  Vasopressors 
C)  Diphenhydramine (Benadryl) IV 
D)  Corticosteroids

Question 14

The gastrointestinal system is a common target organ for MODS related to

Accepted Answer

A)  anorexia. 
B)  limited or absent food ingestion. 
C)  disruption of the mucosal barrier from hypoperfusion. 
D)  a decrease in hydrochloric acid secretion. 
A)  anorexia. 
B)  limited or absent food ingestion. 
C)  disruption of the mucosal barrier from hypoperfusion. 
D)  a decrease in hydrochloric acid secretion.

Question 15

Which medication is not recommended in the treatment of shock-related lactic acidosis?

Accepted Answer

A)  Glucose 
B)  Sodium bicarbonate 
C)  Vasoconstrictor 
D)  Large quantity of crystalloids fluids 
A)  Glucose 
B)  Sodium bicarbonate 
C)  Vasoconstrictor 
D)  Large quantity of crystalloids fluids

Question 16

Hypovolemic shock that results from an internal shifting of fluid from the intravascular space to the extravascular space is known as

Accepted Answer

A)  absolute hypovolemia. 
B)  distributive hypovolemia. 
C)  relative hypovolemia. 
D)  compensatory hypovolemia. 
A)  absolute hypovolemia. 
B)  distributive hypovolemia. 
C)  relative hypovolemia. 
D)  compensatory hypovolemia.

Question 17

Which of the following clinical manifestations is not suggestive of systemic inflammatory response syndrome (SIRS)?

Accepted Answer

A)  Temperature of 37.5° C 
B)  Heart rate of 95 beats/min 
C)  Respiratory rate of 24 breath/min 
D)  White blood cell (WB
C)  count of 15,000 cells/mm3 
A)  Temperature of 37.5° C 
B)  Heart rate of 95 beats/min 
C)  Respiratory rate of 24 breath/min 
D)  White blood cell (WB
C)  count of 15,000 cells/mm3

Question 18

Profound weight loss in patients with SIRS or MODS is the result of

Accepted Answer

A)  hypometabolism. 
B)  hypermetabolism. 
C)  hyperglycemia. 
D)  intolerance to enteral feedings. 
A)  hypometabolism. 
B)  hypermetabolism. 
C)  hyperglycemia. 
D)  intolerance to enteral feedings.

Question 19

The key to treatment of septic shock is finding the cause of the infection.Which of the following cultures are obtained before antibiotic therapy is initiated?

Accepted Answer

A)  Blood cultures x 2 
B)  Wound cultures 
C)  Urine cultures 
D)  Sputum cultures 
E)  CBC with differential 
A)  Blood cultures x 2 
B)  Wound cultures 
C)  Urine cultures 
D)  Sputum cultures 
E)  CBC with differential

Question 20

Which of the following historical findings would indicate a high risk for latex allergy?

Accepted Answer

A)  Allergic reaction to anesthetics 
B)  Eczema of the hands 
C)  Congenital urologic disorder 
D)  Asthma 
E)  Health care worker 
A)  Allergic reaction to anesthetics 
B)  Eczema of the hands 
C)  Congenital urologic disorder 
D)  Asthma 
E)  Health care worker

Exam 35: Shock,sepsis,and Multiple Organ Dysfunction Syndrome

The most common site for sepsis and septic shock is

An inflammatory biochemical that is secreted in response to endotoxin or noninfectious agents is

A patient is admitted to the intensive care unit after she develops disseminated intravascular coagulation (DIC)after a vaginal delivery.DIC is known to occur in patients with retained placental fragments.What is the result of DIC?

Signs of hypovolemia in the trauma patient include

Shock syndrome can best be described as a

Which of the following drugs promotes bronchodilation and vasoconstriction?

The patients at highest risk for neurogenic shock are those who have had

When SIRS is the result of infection,it is called

Evidence-based guidelines for the treatment of septic shock include which of the following?

With anaphylactic shock,which mechanism results in a decreased cardiac output?

The nursing measure that can best enhance large volumes of fluid replacement in hypovolemic shock is

Which medications are not effective in the immediate treatment of acute anaphylaxis?

The gastrointestinal system is a common target organ for MODS related to

Which medication is not recommended in the treatment of shock-related lactic acidosis?

Hypovolemic shock that results from an internal shifting of fluid from the intravascular space to the extravascular space is known as

Which of the following clinical manifestations is not suggestive of systemic inflammatory response syndrome (SIRS)?

Profound weight loss in patients with SIRS or MODS is the result of

The key to treatment of septic shock is finding the cause of the infection.Which of the following cultures are obtained before antibiotic therapy is initiated?

Which of the following historical findings would indicate a high risk for latex allergy?

Critical Care Nursing Practice

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Genetics and Genomics in Critical Care

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Sedation,Agitation,Delirium: Assessment and Management

End-Of-Life Issues

Cardiovascular Anatomy and Physiology

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Pulmonary Anatomy and Physiology

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Pulmonary Disorders

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Neurologic Disorders and Therapeutic Management

Kidney Anatomy and Physiology

Kidney Clinical Assessment and Diagnostic Procedures

Kidney Disorders and Therapeutic Management

Gastrointestinal Anatomy and Physiology

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Gastrointestinal Disorders and Therapeutic Management

Endocrine Anatomy and Physiology

Endocrine Clinical Assessment and Diagnostic Procedures

Endocrine Disorders and Therapeutic Management

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