Chapter 48: Shock, Multiple Organ Dysfunction Syndrome, and Burns in Adults

Chapter 48: Shock, Multiple Organ Dysfunction Syndrome, and Burns in Adults

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE

1. What is the final outcome of impaired cellular metabolism?

ANS:  B

The common pathway in all types of shock is impairment of cellular metabolism as a result of decreased delivery of oxygen and nutrients, which are frequently coupled with an increased demand, the consumption of oxygen and nutrients, and a decreased removal of cellular waste products. Of the options available, this selection is the only accurate outcome.

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2. Which clinical manifestation of septic shock confirms an elevation in immune system response?

ANS:  B

Clinical manifestations common in septic shock are fever, high heart rate, high respiratory rate, or elevations in immune responses, such as increased white blood cells and circulating blood glucose.

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3. The release of catecholamine by the adrenal glands compensate for which initial effects of hypovolemic shock?

ANS:  C

Compensatory mechanisms (see Figure 48-3) initially offset hypovolemia. Heart rate and systemic vascular resistance increase as a result of catecholamine release by the adrenal glands, which boosts cardiac output and tissue perfusion pressures. Compelled by a decrease in capillary hydrostatic pressures, interstitial fluid moves into the vascular compartment. The liver and spleen add to blood volume by disgorging stored red blood cells and plasma. In the kidneys, renin (through several intermediaries) stimulates aldosterone release and the retention of sodium and therefore water, whereas antidiuretic hormone (ADH), or vasopressin, from the posterior pituitary gland increases water retention. Data on the compensation of ADH, however, show that as shock worsens, ADH in plasma decreases.

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4. Hypovolemic shock begins to develop when intravascular volume has decreased by what percentage?

ANS:  C

Hypovolemic shock begins to develop when intravascular volume has decreased by approximately 15%.

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5. What type of shock develops as a result of the overstimulation of the parasympathetic nervous system or the understimulation of the sympathetic nervous system?

ANS:  D

Only vasogenic shock refers to a widespread and massive vasodilation resulting from an imbalance between parasympathetic and sympathetic stimulation of vascular smooth muscle.

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