Chapter 13 - Shock

Question 1

A 20-year-old male has a large laceration to his wrist. He is holding a blood-soaked towel over the wound, but it continues to bleed rapidly. You should:

Select one:

A. wrap the towel with pressure bandages.
B. apply a tourniquet proximal to the wrist.
C. administer high-flow supplemental oxygen.
D. apply pressure to the brachial artery.

Answer 1

B. apply a tourniquet proximal to the wrist.

Question 2

A 25-year-old unrestrained female struck the steering wheel with her chest when her car hit a tree while traveling at a high rate of speed. She has signs and symptoms of shock, which you suspect are the result of intrathoracic bleeding. Which of the following interventions will provide this patient with the greatest chance for survival?

Select one:

A. Intravenous fluid administration
B. High-flow oxygen administration
C. Rapid transport to a trauma center
D. Full immobilization of her spine

Answer 2

C. Rapid transport to a trauma center

Question 3

As you approach a patient lying at the side of the roadway, you observe severe bleeding from the leg. What should your first action be?

Select one:

A. Check for a pulse.
B. Control the bleeding.
C. Open the airway.
D. Administer oxygen.

Answer 3

B. Control the bleeding

Question 4

Distributive shock occurs when:

Select one:

A. severe bleeding causes tachycardia in order to distribute blood to the organs faster.

B. temporary but severe vasodilation causes a decrease in blood supply to the brain.

C. an injury causes restriction of the heart muscle and impairs its pumping function.

D. widespread dilation of the blood vessels causes blood to pool in the vascular beds.

Answer 4

D. widespread dilation of the blood vessels causes blood to pool in the vascular beds.

Question 5

Foods, medications, and insects are common causes of ________.

Select one:

A. septic shock
B. anaphylactic shock
C. psychogenic shock
D. neurogenic shock

Answer 5

B. anaphylactic shock

Question 6

Hypovolemic shock caused by severe burns is the result of a loss of:

Select one:

A. platelets.
B. plasma.
C. red blood cells.
D. whole blood.

Answer 6

B. plasma.

Question 7

In an acute injury setting, neurogenic shock is commonly accompanied by:

Select one:

A. hypothermia.
B. diaphoresis.
C. tachycardia.
D. hypovolemia.

Answer 7

A. hypothermia.

Question 8

Inadequate circulation of blood throughout the body is called ________.

Select one:

A. hypotension
B. shock
C. hypoxia
D. perfusion

Answer 8

B. shock

Question 9

Pulmonary edema and impaired ventilation occur during:

Select one:

A. neurogenic shock.
B. anaphylactic shock.
C. septic shock.
D. cardiogenic shock.

Answer 9

D. cardiogenic shock.

Question 10

Shock due to severe infection is called ________.

Select one:

A. neurogenic shock
B. septic shock
C. hypovolemic shock
D. anaphylactic shock

Answer 10

B. septic shock

Question 11

To protect vital organs, the body compensates by directing blood flow away from organs that are more tolerant of low flow, such as:

Select one:

A. the heart.
B. the skin.
C. the lungs.
D. the brain.

Answer 11

B. the skin.

Question 12

What are the three components of the “perfusion triangle”?

Select one:

A. Heart, brain, lungs
B. Heart, blood vessels, blood
C. Arteries, veins, capillaries
D. Plasma, red blood cells, platelets

Answer 12

B. Heart, blood vessels, blood

Question 13

When assessing a patient with signs and symptoms of shock, it is important to remember that:

Select one:

A. irreversible shock often responds well to a prompt blood transfusion.

B. multiple fractures are the most common cause of hypovolemic shock.

C. the patient’s respirations are deep during the early stages of shock.

D. blood pressure may be the last measurable factor to change in shock.

Answer 13

D. blood pressure may be the last measurable factor to change in shock.

Question 14

When should non-lifesaving interventions be performed for your multisystem trauma patient?

Select one:

A. Prior to transport
B. During the primary assessment
C. En route to the hospital
D. Immediately after the injuries are discovered

Answer 14

C. En route to the hospital

Question 15

When treating an 80-year-old patient who is in shock, it is important to remember that:

Select one:

A. medications older patients take for hypertension often cause an unusually fast heart rate.

B. changes in gastric motility may delay gastric emptying, which increases the risk of vomiting.

C. the older patient’s central nervous system usually reacts more briskly to compensate for shock.

D. compensation from the respiratory system usually manifests with increased tidal volume.

Answer 15

B. changes in gastric motility may delay gastric emptying, which increases the risk of vomiting.

Question 16

Which of the following injuries would MOST likely cause obstructive shock?

Select one:

A. Cardiac tamponade
B. Spinal cord injury
C. Liver laceration
D. Simple pneumothorax

Answer 16

A. Cardiac tamponade

Question 17

Which of the following is the ONLY action that can prevent eventual death from a tension pneumothorax?

Select one:

A. Rapid administration of intravenous fluids
B. Decompression of the injured side of the chest
C. Early administration of high-flow oxygen
D. Positive-pressure ventilation with a bag-valve-mask

Answer 17

B. Decompression of the injured side of the chest

Question 18

You suspect your patient is in shock. You note the patient’s skin is pale. This is likely due to ___________.

Select one:

A. peripheral vasodilation
B. an increased heart rate
C. hypothermia
D. peripheral vasoconstriction

Answer 18

D. peripheral vasoconstriction

Question 19

Your patient has a decreased cardiac output and poor myocardial contractility. This will likely lead to ___________.

Select one:

A. cardiogenic shock
B. hypovolemic shock
C. septic shock
D. neurogenic shock

Answer 19

A. cardiogenic shock

Question 20

Your patient is in shock, but the body’s defense mechanisms are currently able to maintain adequate circulation. This is called ___________.

Select one:

A. irreversible shock
B. compensated shock
C. decompensated shock
D. late shock

Answer 20

B. compensated shock

Question 21

Neurogenic shock occurs when:

Select one:

A. failure of the nervous system causes widespread vasodilation.

B. the spinal cord is severed and causes massive hemorrhaging.

C. there is too much blood to fill a smaller vascular container.

D. massive vasoconstriction occurs distal to a spinal cord injury.

Answer 21

A. failure of the nervous system causes widespread vasodilation.

Question 22

Perfusion is MOST accurately defined as the:

Select one:

A. effective transfer of oxygen from the venules across the systemic capillary membrane walls.

B. ability of the systemic arteries to constrict as needed to maintain an adequate blood pressure.

C. effective removal of carbon dioxide and other metabolic waste products from the body’s cells.

D. circulation of blood within an organ in adequate amounts to meet the body’s metabolic needs.

Answer 22

D. circulation of blood within an organ in adequate amounts to meet the body’s metabolic needs.