Deck 20: Shock

Question 1

Severe hypovolemic shock occurs when more than 40% of the total blood volume is lost.

Answer 1

True

Question 2

Vasopressor drugs to restore blood pressure are the primary therapy for hypovolemic shock.

Answer 2

False

Question 3

In cardiogenic shock, an increase in oxygen extraction (lower SvO₂) indicates an increase in cardiac output.

Answer 3

False

Question 4

Cardiogenic shock is characterized by low cardiac output, low blood pressure, and low cardiac preload.

Question 5

Hypotension associated with neurogenic and anaphylactic shock is due to

A) hypovolemia.
B) peripheral pooling of blood.
C) poor cardiac contractility.
D) high afterload.

Question 6

A patient presenting with fever, hypotension, and lactic acidosis is most likely to be experiencing what type of shock?

A) Cardiogenic
B) Septic
C) Anaphylactic
D) Neurogenic

Question 7

The early stage of hypovolemic shock is characterized by

A) tachycardia.
B) hypotension.
C) lactic acidosis.
D) cardiac failure.

Question 8

Excessive production of nitric oxide is a contributor to abnormal vasodilation seen in septic shock.

Question 9

In contrast to all other types of shock, the hyperdynamic phase of septic shock is associated with

A) high afterload.
B) low cardiac output.
C) high cardiac output.
D) reduced contractility.

Question 10

In septic shock, a decrease in venous oxygen saturation (SvO₂) may indicate an improvement in distribution of blood flow.

Question 11

All forms of shock are associated with inadequate tissue perfusion.

Question 12

Cardiogenic and hypovolemic shock can be differentiated based on differences in cardiac preload.

Question 13

Improvement in a patient with septic shock is indicated by an increase in

A) cardiac output.
B) SvO₂.
C) systemic vascular resistance.
D) serum lactate level.

Question 14

Cardiogenic shock is characterized by

A) hypovolemia.
B) reduced systemic vascular resistance.
C) reduced cardiac output.
D) elevated SvO₂.

Question 15

In which stage of shock is a patient who has lost 1200 ml of blood, has normal blood pressure when supine, but experiences orthostatic hypotension upon standing?

A) Compensated
B) Mild
C) Moderate
D) Severe

Question 16

Pulmonary edema is likely to occur when the left atrial or pulmonary capillary occlusion pressure reaches 12 mm Hg.

Question 17

In the early stages of circulatory shock, the blood pressure may not accurately reflect the impairment in cardiac output.

Question 18

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

A) hypovolemic
B) cardiogenic
C) anaphylactic
D) septic

Question 19

Administration of which of the following therapies would be most appropriate for hypovolemic shock?

A) Normal saline
B) Vasoconstrictor agents
C) Inotropic agents
D) 5% dextrose in water

Question 20

After surgery for a cardiac valve replacement, a patient becomes hypotensive and tachycardic. The heart sounds are muffled, and the central venous pressure and left atrial pressure are elevated and equal. This patient is experiencing _____ shock.

A) cardiogenic
B) obstructive
C) hypovolemic
D) distributive

Question 21

The effect of nitric oxide on systemic arterioles is

A) vasodilation.
B) vasoconstriction.
C) not significant.
D) opposed by nitrate drugs.

Question 22

A patient with cold extremities and low cardiac output is not likely to be experiencing _____ shock.

A) cardiogenic
B) hypovolemic
C) obstructive
D) septic

Question 23

Tumor necrosis factor $\alpha$ and interleukin-1 contribute to shock states because they induce production of

A) catecholamines.
B) clotting factors.
C) nitric oxide.
D) vasopressin.

Question 24

Tachycardia is an early sign of low cardiac output that occurs because of

A) tissue hypoxia.
B) anxiety.
C) baroreceptor activity.
D) acidosis.

Question 25

Administration of a pure $\alpha$ ₁-adrenergic agonist medication to a patient in shock would be expected to increase

A) cardiac output.
B) heart rate.
C) blood pressure.
D) stroke volume.

Question 26

Overproduction of nitric oxide is an important aspect of the pathophysiologic process of what type of shock?

A) Cardiogenic
B) Hypovolemic
C) Anaphylactic
D) Septic

Question 27

Massive release of histamine with consequent vasodilation and hypotension occurs with what type of shock?

A) Cardiogenic
B) Hypovolemic
C) Anaphylactic
D) Septic

Question 28

Sepsis is defined as

A) a systemic infection with viable organisms in the bloodstream.
B) a systemic inflammatory response to ischemia.
C) a systemic inflammatory response to infection.
D) severe hypotension in an infected patient.

Question 29

The majority of cases of anaphylactic shock occur when a sensitized individual comes in contact with

A) perfumes.
B) incompatible blood products.
C) animal proteins or dander.
D) antibiotics.

Question 30

Which of the following causes of shock is not considered to be obstructive?

A) Ventricular rupture
B) Pulmonary embolus
C) Cardiac tamponade
D) Tension pneumothorax