Chapter 20: Shock

Chapter 20: Shock

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE

1. The progressive stage of hypovolemic shock is characterized by

ANS:  A

In the progressive stage of hypovolemic shock, the patient is anxious and confused, with decreased blood pressure and heart rate greater than 120 beats/minute. In this stage of shock, the blood pressure is decreased. Lactic acidosis does not occur in the progressive stage of hypovolemic shock. Cardiac failure is not likely to occur in the earlier stages of hemorrhagic shock.

REF:   Pg. 437

2. Cardiogenic shock is characterized by

ANS:  C

Cardiogenic shock occurs primarily as a result of severe dysfunction of the left or right ventricles, or both, that results in inadequate cardiac pumping. The low cardiac output state is associated with a high left ventricular diastolic filling pressure. Cardiogenic shock is not manifested by hypovolemia. Sympathetic activation leads to increases in heart rate, vasoconstriction, and a narrow pulse pressure. Low cardiac output leads to reduced SvO₂.

REF:   Pg. 437

3. Low cardiac output in association with high preload is characteristic of ________ shock.

ANS:  B

In cardiogenic shock, preload is high and cardiac output is low. In hypovolemic shock, preload and cardiac outputs are both low. In anaphylactic shock, blood volume may be normal. Septic shock is associated with infections.

REF:   Pg. 437

4. Administration of which therapy is most appropriate for hypovolemic shock?

ANS:  A

Crystalloids are solutions that contain electrolytes. Isotonic solutions, such as lactated ringers, are commonly used crystalloid solutions. These solutions are preferred for volume resuscitation, because they remain in the extracellular space and are more effective in increasing blood volume. Vasoconstrictor agents are contraindicated in hypovolemic shock. Isotonic crystalloids are the most appropriate fluid for volume resuscitation. Isotonic fluids are preferred over glucose or hypotonic electrolyte solutions.

REF:   Pg. 440