Question 1

A 7-year-old patient with insulin-dependent diabetes is evaluated in the emergency department due to ketoacidosis.What type of shock is most commonly associated with diabetic ketoacidosis?

Accepted Answer

A)  Hypovolemic
B)  Cardiogenic
C)  Obstructive
D)  Distributive A

Question 2

A child has been treated for shock with 60 mL/kg of normal saline.What should be considered at this time?

Accepted Answer

A)  Administer an additional 20 mL/kg bolus of fluids
B)  Switch to lactated Ringer's solution
C)  Start vasopressors
D)  Alternate normal saline and Ringer's solution C

Question 3

A child is receiving aggressive therapy for shock.Cardiac failure has developed.Which of the following inotropes is the most frequently used under these circumstances?

Accepted Answer

A)  Epinephrine
B)  Dopamine
C)  Norepinephrine
D)  Digitalis B

Question 4

A respiratory therapist has intubated a child with septic shock who has also received intravenous fluids and vasopressors.What condition could explain a lack of response to therapy?

Accepted Answer

A)  Administration of the wrong fluid
B)  Inadequate dose of vasopressors
C)  Hypoxia
D)  Adrenal insufficiency

Question 5

Which of the following types of shock is the most common among children?

Accepted Answer

A)  Hypovolemic
B)  Cardiogenic
C)  Obstructive
D)  Distributive

Question 6

Which vascular site would provide the most reliable measurement of the beat-to-beat monitoring of the blood pressure in an infant who is suspected of having shock?

Accepted Answer

A)  Any vessel
B)  Any peripheral vein
C)  A peripheral or central artery
D)  A central vein

Question 7

How should the therapist interpret a capillary refill time of approximately 1 second in a pediatric patient?

Accepted Answer

A)  Adequate cardiac output
B)  Increased afterload
C)  Inadequate cardiac output
D)  Decreased preload

Question 8

Assessment of an infant suspected of having shock reveals skin that is warm,pink,and well perfused.How should the therapist interpret these findings?

Accepted Answer

A)  The infant has hypovolemic shock.
B)  The infant has late cardiogenic shock.
C)  The patient has decreased cardiac output.
D)  The patient may have early septic shock.

Question 9

What is the mainstay of therapy for patients with anaphylactic shock?

Accepted Answer

A)  Vasopressin
B)  Dopamine
C)  Epinephrine
D)  IV fluids

Question 10

During the treatment of sepsis,what intervention may be needed if hypotension persists despite the maximal application of inotropic and vasomotor support?

Accepted Answer

A)  Endotracheal intubation and mechanical ventilation
B)  High-frequency oscillatory ventilation
C)  Extracorporeal membrane oxygenation
D)  Hyperbaric oxygenation

Question 11

Which of the following hemodynamic assessments can be obtained from a pulmonary capillary wedge pressure measurement?

Accepted Answer

A)  Central venous pressure
B)  Right ventricular preload
C)  Left ventricular afterload
D)  Left ventricular preload

Question 12

Which of the following signs is one of the first to indicate decreased peripheral perfusion in children?

Accepted Answer

A)  Tachycardia
B)  Bradycardia
C)  Hypotension
D)  Dyspnea

Question 13

A child admitted to the emergency department with a diagnosis of shock has a cardiac index is 3.5 L/min/m².How should the therapist interpret this value?

Accepted Answer

A)  This cardiac index is associated with an increased risk of mortality.
B)  This cardiac index is in the high range of normal,and it is an indication to wean vasopressors and fluids.
C)  This cardiac index is within normal limits but still requires close monitoring because it is in the low range of normal.
D)  This cardiac index is normal and no action is required.

Question 14

Which of the following can be obtained from a central venous pressure measurement?

Accepted Answer

A)  Stroke volume
B)  Afterload
C)  Preload
D)  Myocardial contractility

Question 15

In which of the following clinical situations may the administration of packed red blood cells be indicated?

Accepted Answer

A)  When a patient demonstrates leukopenia
B)  When a patient shows evidence of anemia
C)  When the risk of sepsis is present
D)  When a patient shows evidence of hypovolemic shock

Question 16

Which of the following microorganisms are currently the leading causes of childhood meningitis?
I.Group B Streptococcus
II.Streptococcus pneumoniae
III.Methicillin-resistant Staphylococcus aureus
IV.Neisseria meningitides

Accepted Answer

A)  I and IV only
B)  II and IV only
C)  I,II,and III only
D)  II,III,and IV only

Question 17

A therapist is calculating oxygen delivery for a patient admitted with a diagnosis of shock.Which of the following parameters should the therapist measure?
I.Hemoglobin
II.Oxygen bound to hemoglobin
III.Dissolved oxygen
IV.Cardiac output

Accepted Answer

A)  I,II,and IV only
B)  II,III,and IV only
C)  I,II,III,and IV
D)  I,II,and III only

Question 18

When cardioversion is indicated,at what point during the cardiac cycle must it be applied?

Accepted Answer

A)  In synchrony with the QRS complex
B)  Synchronously with the appearance of the P wave
C)  Immediately before the ST segment
D)  At any point during the cardiac cycle

Question 19

Which of the following microorganisms are likely responsible for neonatal meningitis?
I.Klebsiella species
II.Neisseria meningitidis
III.Escherichia coli
IV.Listeria monocytogenes

Accepted Answer

A)  I and IV only
B)  II and III only
C)  III and IV only
D)  I,III,and IV only

Question 20

A respiratory therapist is gathering equipment to intubate a patient with anaphylactic shock who has severe bronchospasm.What is one of the most prominent inflammatory mediators responsible for the increase in airway resistance and fall in the PaO₂?

Accepted Answer

A)  Epinephrine
B)  Histamine
C)  Interleukin
D)  IgE

Exam 30: Shock, Sepsis and Anaphylaxis