Chapter 26: Shock, Sepsis, and Multiple Organ Dysfunction Syndrome

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. The patient with hematological dysfunction is at risk of developing which of the following?

a.	Microcytic anemia
b.	Portal system encephalopathy
c.	Lymphedema
d.	Disseminated intravascular coagulation

 

ANS:   D

Hematological dysfunction occurs as a result of consumption of clotting factors, release of inflammatory cytokines, and dilutional thrombocytopenia. Disseminated intravascular coagulation may eventually develop.

 

DIF:    Cognitive Level: Comprehension       REF:    Table 26-17

OBJ:    Nursing Process: Analysis      TOP:    Multiple Organ Dysfunction Syndrome

MSC:   NCLEX: Physiological Integrity: Physiological Adaptation

 

2. The patient with spinal cord injury is at risk for disruption of the sympathetic nervous system. The nurse will be prepared to apply interventions for _____ shock.

a.	hypovolemic
b.	neurogenic
c.	toxic
d.	cardiogenic

 

ANS:   B

Neurogenic shock can be caused by anything that disrupts the sympathetic nervous system. The problem can occur as a result of interrupted impulse transmission or blockage of sympathetic outflow from the vasomotor center in the brain. The most common cause is spinal cord injury.

 

DIF:    Cognitive Level: Comprehension       REF:    554

OBJ:    Nursing Process: Analysis      TOP:    Multiple Organ Dysfunction Syndrome

MSC:   NCLEX: Physiological Integrity: Reduction of Risk Potential

 

3. Shock syndrome can best be described as a:

a.	physiological state resulting in hypotension and tachycardia.
b.	generalized systemic response to inadequate tissue perfusion.
c.	degenerative condition leading to death.
d.	condition occurring with hypovolemia that results in irreversible hypotension.

 

ANS:   B

Shock is an acute, widespread process of impaired tissue perfusion that results in cellular, metabolic, and hemodynamic alterations. Ineffective tissue perfusion occurs when an imbalance develops between cellular oxygen supply and cellular oxygen demand. This imbalance can occur for a variety of reasons and eventually results in cellular dysfunction and death.

 

DIF:    Cognitive Level: Comprehension       REF:    541

OBJ:    Nursing Process: Assessment TOP:    Shock

MSC:   NCLEX: Physiological Integrity: Physiological Adaptation

 

4. The initial priority action in managing the patient in shock is to:

a.	establish and maintain an airway.
b.	provide supplemental oxygen.
c.	monitor respiratory efforts.
d.	neutralize acidosis with bicarbonate.

 

ANS:   A

Management of the patient in shock focuses on supporting oxygen transport and oxygen utilization. Adequate pulmonary gas exchange is critical to oxygen transport. Establishing and maintaining an adequate airway are the first steps in ensuring adequate oxygenation.

 

DIF:    Cognitive Level: Application REF:    544

OBJ:    Nursing Process: Implementation       TOP:    Shock

MSC:   NCLEX: Physiological Integrity: Physiological Adaptation

 

5. The role of the gastrointestinal (GI) tract in the development of sepsis is related to which function?

a.	Waste elimination
b.	Fluid resorption
c.	Immunoregulation
d.	Nutrition

 

ANS:   C

The GI tract plays an important role in multiple organ dysfunction syndrome. GI organs normally have immunoregulatory functions. The GI tract contains about 70% to 80% of the immunological tissue of the entire body. Consequently, GI dysfunction amplifies systemic inflammatory response syndrome and gut damage, which may lead to bacterial translocation and endogenous endotoxemia.

 

DIF:    Cognitive Level: Comprehension       REF:    567

OBJ:    Nursing Process: N/A TOP:    Multiple Organ Dysfunction Syndrome

MSC:   NCLEX: Physiological Integrity: Reduction of Risk Potential