Chapter 48 review question

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Chapter 48 Review Questions - 1. ID: 25066817398 Which type of shock is not related to low systemic vascular resistance? A. Septic B. Neurogenic C. Anaphylactic D. Cardiogenic Correct Cardiogenic shock has decreased cardiac output; therefore adequate oxygen is not delivered to the cells. Septic, neurogenic, and anaphylactic forms have low perfusion as a result of low systemic vascular resistance. Awarded 0.0 points out of 1.0 possible points. 2. 2. ID: 25066817803 Which is a true statement regarding cardiogenic shock? A. The most common cause of cardiogenic shock is infection. B. Cardiogenic shock responds well to multiple treatments. C. Mortality improves with revascularization strategies. Correct D. Compensatory adaptive responses result in hypotension. Mortality is improved with revascularization strategies. The most common cause of cardiogenic shock is myocardial infarction or surgery requiring bypass. Any form of heart failure may cause cardiogenic shock. Cardiogenic shock is often unresponsive to treatment, with in-hospital mortality ranging from 50% to 80%. Compensatory adaptive responses include the maintenance of blood pressure through vasoconstriction. Awarded 0.0 points out of 1.0 possible points. 3. 3. ID: 25066817808 At which level of fluid loss does hypovolemic shock develop? A. 5% B. 10% C. 15% Correct D. 20% Hypovolemic shock begins to develop when the intravascular volume has decreased by about 15%. Awarded 0.0 points out of 1.0 possible points. 4. 4. ID: 25066817813 What is the cause of neurogenic shock? A. Decreased volume B. Massive vasodilation Correct

C. Sympathetic overstimulation D. Increased systemic vascular resistance Neurogenic shock is due to massive vasodilation that may be caused by an overstimulation of the parasympathetic system or an understimulation of the sympathetic system. Decreased systemic vascular resistance occurs, as well as relative hypovolemia. The amount of blood has not changed, but the space that carries blood has increased. Awarded 0.0 points out of 1.0 possible points. 5. 5. ID: 25066817818 Which type of shock is most likely to occur after a bee sting? A. Anaphylactic Correct B. Neurogenic C. Cardiogenic D. Septic Anaphylactic shock begins as an allergic reaction, such as to bee venom. The allergen causes an extensive immune and inflammatory response. The vascular effects include vasodilation and increased vascular permeability. Awarded 0.0 points out of 1.0 possible points. 6. 6. ID: 25066817823 What is the appropriate first-line treatment for shock? A. Large amounts of fluid volume B. Medications to increase systemic vascular resistance C. Identification and treatment of the underlying cause Correct D. Enhancement of cardiac output The most important first-line treatment for shock is to identify and treat the underlying cause. After the underlying cause is detected, treatment is supportive. Awarded 0.0 points out of 1.0 possible points. 7. 7. ID: 25066817828 Which statement is true regarding multiple organ dysfunction syndrome (MODS)? A. MODS is the progressive dysfunction of one organ system. B. An uncontrolled inflammatory response can trigger MODS. Correct C. MODS is another term for sepsis. D. The mortality rate for MODS is generally low. MODS is the progressive dysfunction of two or more organ systems, resulting from uncontrolled inflammatory response, and may occur during sepsis. However, these two terms are not synonymous. The mortality rate for MODS is high.

Awarded 0.0 points out of 1.0 possible points. 8. 8. ID: 25066817833 Which classification of burn exhibits erythema with thin-walled, fluid- filled blisters and considerable pain? A. First-degree B. Superficial partial-thickness Correct C. Deep partial-thickness D. Third-degree Superficial partial-thickness burns include erythema, blisters, and pain. First-degree burns involve only the epidermis without injury to the underlying dermal or subcutaneous tissues. Deep partial- thickness burns involve the entire dermis, sparing skin appendages such as hair, follicles, and sweat glands. Third-degree burns are full- thickness burns that involve the destruction of the entire epidermis, dermis, and often the underlying tissue. Awarded 0.0 points out of 1.0 possible points. 9. 9. ID: 25066817838 What percentage of the total body surface area has been burned when the area is the size of the patient’s palm? A. 1% Correct B. 4% C. 9% D. 18% The surface area of the palm averages 1% of the body surface area over a wide range of ages. Awarded 0.0 points out of 1.0 possible points. 10.10. ID: 25066817843 What is the most reliable indicator of adequate fluid resuscitation in the treatment of burns? A. Blood pressure B. Heart rate C. Urine output Correct D. Skin turgor Urine output is the most reliable indicator of fluid resuscitation in the treatment of burns. Awarded 0.0 points out of 1.0 possible points. 11.11. ID: 25066817848 What triggers multiple organ dysfunction syndrome (MODS)? (Select all that apply.) A. Maldistribution of blood flow Correct B. Hypometabolism C. Myocardial depression Correct D. Supply-dependent oxygen consumption Correct

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E. Excessive inflammatory reaction Correct Primary MODS is associated with maldistribution of blood flow, hypermetabolism, myocardial depression, and supply-dependent oxygen consumption. The progressive organ dysfunction of secondary MODS is the result of an excessive inflammatory reaction. Awarded 0.0 points out of 1.0 possible points. 12.12. ID: 25066817854 Which elements are considered essential for the survival of a major burn injury? (Select all that apply.) A. Meticulous wound management Correct B. Adequate fluids Correct C. Early grafting Correct D. Early antibiotics E. Scar prevention The three essential elements of survival after a major burn are (1) meticulous wound management, (2) adequate fluids and nutrition, and (3) early surgical excision and grafting. Awarded 0.0 points out of 1.0 possible points. 13.13. ID: 25066817860 Which are results of gluconeogenesis in shock? (Select all that apply.) A. Increased lactic acid Correct B. Increased uric acid Correct C. Impairment of the immune system Correct D. Interstitial edema Correct E. Increased heart rate Gluconeogenesis causes proteins to be used for fuel. The breakdown of proteins can result in increased lactic acid, uric acid, interstitial edema, and ammonia, as well as impairment of the immune system. Tachycardia is a compensatory shock mechanism focused on oxygen delivery. Awarded 0.0 points out of 1.0 possible points.

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