chapter 19 - Chapter 19 Shock MULTIPLE CHOICE 1 A patient...

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Chapter 19: Shock MULTIPLE CHOICE 1. A patient is being sent to the unit from the ER with a diagnosis of shock. The nurse knows that the three types of shock are: 1. multiple organ, cardiogenic, and renal shock. 2. cardiogenic, renal, and hypovolemic shock. 3. renal, hypervolemic, and distributive shock. 4. hypovolemic, cardiogenic, and distributive shock. ANS: 4 The other three answers use terms that are associated with the shock syndrome. PTS: 1 DIF: Cognitive Level: Comprehension REF: 290 OBJ: 1 TOP: Types of Shock KEY: Nursing Process Step: Assessment MSC: NCLEX: Physiological Integrity 2. Several of the life-supporting systems of the body are involved in shock. However, shock it- self results from failure of the: 1. circulatory system. 2. endocrine system. 3. neurological system. 4. respiratory system. ANS: 1 When the heart fails as a pump, lack of tissue perfusion follows and deprives all the body’s cells of oxygen and removal of wastes. PTS: 1 DIF: Cognitive Level: Application REF: 290 OBJ: 2 TOP: Definition of Shock KEY: Nursing Process Step: N/A MSC: NCLEX: Physiological Integrity 3. The nurse is assessing a patient who has been in shock. One common sign that the nurse will find is: 1. skin that is cool and dry, with cyanotic nail beds. 2. skin that is cool and moist with cyanotic nail beds. 3. reddened nail beds and moist, warm skin. 4. redness of nail beds with warm, dry skin. ANS: 2 Lack of adequate perfusion of tissues pools venous blood in the extremities of the fingers and makes the skin cool and moist from lack of oxygen and waste exchanges. PTS: 1 DIF: Cognitive Level: Comprehension REF: 290 OBJ: 3 TOP: Common Signs of Shock KEY: Nursing Process Step: Assessment MSC: NCLEX: Health Promotion and Maintenance
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4. The nurse is evaluating the signs and symptoms of a patient in shock. Cardiovascular signs include: 1. bounding pulse, decreased respirations, and blood pressure. 2. bounding pulse and shallow respirations, with a greatly increased blood pressure. 3. thready pulse and shallow respirations, with a decreased blood pressure. 4. thready pulse and irregular respirations with an increased blood pressure. ANS: 3 When the heart as a pump fails, the pulse is weak, the respirations slow down to meet the needs and, with less volume being pumped, the blood pressure falls. PTS: 1 DIF: Cognitive Level: Comprehension REF: 291 OBJ: 3 TOP: Cardiac Signs of Shock KEY: Nursing Process Step: Assessment MSC: NCLEX: Physiological Integrity 5. Because of the falling blood pressure and movement of blood around the body during the compensatory stage, the nurse expects that the respirations will be: 1. rapid and deep. 2. rapid and shallow. 3. slow and deep. 4.
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chapter 19 - Chapter 19 Shock MULTIPLE CHOICE 1 A patient...

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