Deck 29: Drugs for Shock

Question 1

A family member of a client receiving dobutamine intravenously asks the nurse how that will help their blood pressure. Which response should the nurse provide?

A) "The prescription is a vasopressor and helps the heart beat more effectively, which will increase blood pressure."
B) "Vasopressor drugs act on the renin-angiotensin system which will increase the blood pressure."
C) "The prescription is a vasopressor and will help stabilize blood pressure by making the blood vessels smaller."
D) "The prescription is a vasopressor which will help increase blood flow to peripheral muscles."

Answer 1

"The prescription is a vasopressor and will help stabilize blood pressure by making the blood vessels smaller."

Question 2

Which information should the nurse include when discussing cardiogenic shock with a client?

A) Cardiogenic shock occurs due to a presence of bacteria and toxins in the blood.
B) Cardiogenic shock occurs in relation to blood loss.
C) Cardiogenic shock occurs due to pump failure.
D) Cardiogenic shock occurs due to loss of sympathetic nerve activity.

Answer 2

Cardiogenic shock occurs due to pump failure.

Question 3

Which describes the mechanism of action of norepinephrine?

A) Increased blood flow
B) Increase heart rate
C) Decrease cardiac output
D) Vasoconstriction

Answer 3

Vasoconstriction

Question 4

Which is a contributing factor to hypovolemic shock?

A) Infectious process
B) Brain or spinal cord trauma
C) Inadequate cardiac output
D) Volume depletion

Question 5

Which effect should the nurse anticipate for a client receiving a low-dose dopamine (Intropin)?

A) Vasoconstriction and increased blood pressure
B) Stabilization of fluid loss
C) Urinary output of at least 50 mL/h
D) Increased cardiac output

Question 6

Which condition should the nurse review a client's records for prior to administering epinephrine (Adrenalin) for a client?

A) Type 1 diabetes mellitus
B) Narrow angle glaucoma
C) Hypothyroidism
D) Human immunodeficiency virus (HIV) infection

Question 7

Which assessment finding should the nurse associate with shock?

A) B/P: 140/90 mmHg, P: 46, weak and irregular, R: 24, and shallow
B) B/P: 50/0 mmHg, P: 126, weak and thready, R: 14, and shallow
C) B/P: 80/20 mmHg, P: 122, weak and thready, R: 28, and shallow
D) B/P: 130/88 mmHg, P: 90, bounding, R: 32, and shallow

Question 8

A client experiencing a severe allergic reaction to peanuts tells the nurse they have a known hypersensitivity to epinephrine (Adrenalin). Which response should the nurse provide the client?

A) "I will let the healthcare provider know about this immediately; we will need to choose an alternative prescription."
B) "Do you know what has been used before with this allergic response?"
C) "This is a life-threatening situation; a prior hypersensitivity is not an absolute contraindication."
D) "You most likely will be prescribed IV diphenhydramine (Benadryl)."

Question 9

Which is the nurse's priority action when monitoring a client receiving norepinephrine (Levophed) with a blood pressure of 230/120 mmHg?

A) Assess the patient for signs/symptoms of a stroke.
B) Notify the healthcare provider.
C) Slow the rate of the infusion
D) Discontinue the administration of the prescription.

Question 10

Which symptom should the nurse anticipate for a client experiencing cardiogenic shock?

A) Bradycardia
B) Low temperature
C) Restlessness and anxiety
D) Tachycardia and low blood pressure

Question 11

Which symptoms should the nurse anticipate to treat with epinephrine (EpiPen) for a child allergic to bee stings that has been stung? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) Cold clammy skin
B) Excessive thirst
C) Warm dry skin
D) Restlessness
E) Hyperactivity

Question 12

Which is the priority nursing assessment for the client receiving human serum albumin (Albuminar) as treatment for shock?

A) Auscultate breath sounds for hyper-resonance.
B) Auscultate for an absence of breath sounds in the lower lobes.
C) Auscultate breath sounds for inspiratory stridor.
D) Auscultate breath sounds for crackles.

Question 13

Which describes a characteristic of colloids?

A) Contain electrolytes
B) Readily leave the blood and enter cells
C) Too large to cross membranes
D) Promote urine output

Question 14

A client asks the nurse about the different types of shock. Which response should the nurse provide?

A) "There are many kinds of shock: heart failure, nervous system damage, loss of blood, and respiratory failure."
B) "Allergic response is the most fatal type of shock; other types involve loss of blood, heart failure, and liver failure."
C) "There are many kinds of shock that also include infection, nervous system damage, and loss of blood."
D) "Heart failure is the most serious kind of shock; others include infection, kidney failure, and a significant loss of blood."

Question 15

A client is to receive intravenous (IV) dopamine (Intropin). Which should the nurse have immediately available prior to initiating the dopamine?

A) Phentolamine (Regitine)
B) Naltrexone (Revia)
C) Epinephrine (Adrenalin)
D) Flumazenil (Romazicon)

Question 16

Which is the expected priority outcome for a client receiving normal serum albumin (Albuminar)?

A) Afebrile
B) Free of a rash
C) Normal breathing pattern
D) Alert and oriented

Question 17

Which initial intervention should the nurse be prepared for in the treatment of shock?

A) Initiate an intravenous line
B) Assess the level of consciousness
C) Assess the blood pressure and pulse
D) Connect the client to a cardiac monitor

Question 18

Which equipment should the nurse secure for use when administering dopamine (Intropin)?

A) Oxygen cannula
B) Intravenous (IV) pump
C) Pulse oximeter
D) Sequential compression devices

Question 19

The nurse has reinforced the treatment plan for the administration of normal human serum albumin (Albutein) for a client recovering from hypovolemic shock. Which statement made by the client indicates an understanding of the information?

A) "The prescription is a protein that pulls water into my blood vessels."
B) "The prescription is a protein that causes my kidneys to conserve fluid."
C) "The prescription is a super-concentrated salt solution that helps my body conserve fluid."
D) "The prescription is a liquid that has electrolytes in it to pull water into my blood vessels."

Question 20

The nurse notes that the intravenous (IV) norepinephrine (Levophed) has been accidentally abruptly discontinued. Which is the nurse's priority action?

A) Obtain an oxygen saturation reading.
B) Notify the healthcare provider.
C) Assess the client's blood pressure.
D) Administer oxygen via a rebreather mask.

Question 21

Which should the nurse prepare for the client experiencing shock? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) Cardiac monitor
B) Pulse oximeter
C) Oxygen
D) Whole blood
E) Dextran 40

Question 22

Which statements by a client treated with epinephrine should the nurse be concerned about? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) "I feel jittery."
B) "My heart is skipping beats."
C) "I have a pounding headache."
D) "I am so dizzy."
E) "That really hurt when you gave me that med."

Question 23

Which immediate goals should the nurse focus on for a client experiencing an anaphylactic reaction to penicillin? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) Normalization of blood pressure
B) Reduction of blood volume
C) Identification of other allergies
D) Reduction of inflammatory response
E) Provision of basic life support

Question 24

Which current prescriptions should the nurse be concerned with for a client requiring dopamine? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) MAO inhibitor
B) Phenytoin
C) Beta blocker
D) Digoxin
E) Aspirin

Question 25

For which conditions should the nurse anticipate norepinephrine to be prescribed? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) Acute shock
B) Cardiac arrest
C) Septic shock
D) Hypovolemic shock
E) Cardiogenic shock

Question 26

Which laboratory results should the nurse understand are associated with the treatment of epinephrine? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) Elevated digoxin
B) Decreased potassium
C) Increased calcium
D) Decreased sodium
E) Elevated blood glucose

Question 27

Which prescription should the nurse anticipate administering to a client treated for an anaphylactic reaction with epinephrine? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) Antibiotics
B) Antihistamines
C) Corticosteroids
D) Vasopressors
E) Vasodilators

Question 28

Which conditions should the nurse be concerned about prior to administering epinephrine for anaphylaxis? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) Premature ventricular contractions
B) Hypertension
C) Hyperthyroidism
D) Pheochromocytoma
E) Hypotension

Question 29

Which assessment findings indicate a client receiving dobutamine (Dobutrex) is experiencing an adverse effect? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) Palpitations
B) Drop in blood pressure
C) Cold extremities
D) Headache
E) Blurred vision

Question 30

A client treated previously for a fractured leg and multiple abrasions returns to the emergency department experiencing anaphylactic shock. Which prescriptions should the nurse suspect have caused the reaction? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) Cephalosporin antibiotic
B) Topical antibiotic for use on abrasions
C) NSAIDs
D) Opioid analgesic
E) Normal saline wash for abrasions