Ineffective Tissue Perfusion: Shock

Question 1

Which of the following is the most common type of shock?
A. Septic shock
B. Neurogenic shock
C. Cardiogenic shock
D. Hypovolemic shock

Answer 1

D. Hypovolemic shock

🧐 Rationale: Hypovolemic shock is the most common type and results from blood or fluid loss, leading to decreased venous return and cardiac output. Septic shock (A) occurs due to an immune response to infection, neurogenic shock (B) results from a loss of autonomic control, and cardiogenic shock (C) is due to left ventricular failure.

Question 2

What is the primary cause of metabolic acidosis in the progressive stage of shock?
A. Hyperventilation
B. Anaerobic metabolism and lactic acid accumulation
C. Increased renal excretion of bicarbonate
D. Hypoglycemia

Answer 2

B. Anaerobic metabolism and lactic acid accumulation

🧐 Rationale: In the progressive stage of shock, tissues receive insufficient oxygen, leading to anaerobic metabolism, which produces lactic acid and results in metabolic acidosis. Hyperventilation (A) can cause respiratory alkalosis, bicarbonate loss (C) is associated with diarrhea or kidney disease, and hypoglycemia (D) is not the primary cause of acidosis.

Question 3

Which of the following best describes cardiogenic shock?
A. Caused by severe blood or fluid loss
B. Triggered by widespread vasodilation
C. Occurs when the left ventricle fails to maintain cardiac output
D. Results from excessive allergic reactions

Answer 3

C. Occurs when the left ventricle fails to maintain cardiac output

🧐 Rationale: Cardiogenic shock results from a failure of the heart (usually the left ventricle) to pump blood effectively, leading to severe tissue hypoxia. Hypovolemic shock (A) is due to blood loss, distributive shock (B) includes neurogenic, septic, and anaphylactic shock, and anaphylactic shock (D) is caused by an excessive allergic reaction.

Question 4

A patient in shock presents with low blood pressure, tachycardia, and warm, flushed skin. Which type of shock is most likely?
A. Hypovolemic shock
B. Cardiogenic shock
C. Septic shock
D. Neurogenic shock

Answer 4

C. Septic shock

🧐 Rationale: Septic shock occurs due to bacterial endotoxins triggering an immune response, causing vasodilation and hypotension. Early signs include tachycardia and warm, flushed skin, unlike hypovolemic (A) and cardiogenic shock (B), which typically present with cool, pale skin. Neurogenic shock (D) also causes hypotension but is associated with bradycardia instead of tachycardia.

Question 5

A nurse is caring for a patient in anaphylactic shock. What is the priority intervention?
A. Administer IV fluids
B. Give epinephrine
C. Place the patient in Trendelenburg position
D. Monitor urine output

Answer 5

B. Give epinephrine

🧐 Rationale: Epinephrine is the first-line treatment for anaphylactic shock because it reverses airway constriction and vasodilation. While IV fluids (A) may be needed later, Trendelenburg positioning (C) is no longer recommended, and monitoring urine output (D) is important but not the priority.

Question 6

A patient with suspected shock has dry mucous membranes, tachycardia, and decreased urine output. What is the best initial treatment?
A. Vasopressors
B. Rapid fluid replacement
C. Diuretics
D. Beta-blockers

Answer 6

B. Rapid fluid replacement

🧐 Rationale: Hypovolemic shock (most likely in this case) requires immediate fluid resuscitation to restore circulating volume and perfusion. Vasopressors (A) may be needed later but are not first-line in hypovolemic shock. Diuretics (C) would worsen volume loss, and beta-blockers (D) could lower blood pressure further.