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Medical-Surgical Nursing

Review Questions

Medical-Surgical NursingReview Questions

Review Questions

1 .
Shock is a state of a decrease in what?
  1. heart rate
  2. urine output
  3. blood pressure
  4. cell perfusion
2 .
What is a hallmark finding in the progressive stage of shock?
  1. significant increase in capillary permeability
  2. activation of the sympathetic nervous system
  3. stimulation of the carotid and aortic baroreceptors
  4. arousal of the renin-angiotensin-aldosterone system (RAAS)
3 .
In what stage of shock are the aortic and carotid baroreceptors stimulated to regulate blood pressure?
  1. initial stage
  2. compensatory stage
  3. progressive stage
  4. refractory stage
4 .
What response occurs when the renin-angiotensin-aldosterone system (RAAS) is activated?
  1. Water is excreted from the kidneys.
  2. Sodium from the kidneys decreases.
  3. Blood vessels constrict.
  4. Heart rate increases.
5 .
What is a hallmark finding of the refractory stage of shock?
  1. low urine output
  2. low blood pressure despite treatment
  3. low respiratory rate
  4. low heart rate
6 .
A nurse reviews laboratory results for a patient who has had uncontrolled vomiting and diarrhea for the past thirty-six hours. What clinical manifestation is an indication that the patient may be experiencing hypovolemia?
  1. high urine specific gravity
  2. lactate level of 2 mmol/L
  3. potassium of 4.0 mEq/L
  4. urine output of 40 mL/hour
7 .
A patient who experienced a burn injury is receiving fluid resuscitation therapy. To prevent complications from fluid resuscitation, what is most important for the nurse to assess?
  1. breath sounds
  2. burn wound dressings
  3. pain level
  4. urine output
8 .
What is an example of a patient whom the nurse would identify as most at risk for the development of hypovolemic shock?
  1. an eighteen-year-old patient who sustained a neck injury while diving into a pool
  2. a forty-year-old type I diabetic with a blood sugar of 422
  3. a fifty-two-year-old patient who sustained an anterolateral myocardial infarction eight hours ago
  4. a seventy-two-year-old patient with a urinary tract infection
9 .
The nurse is caring for a patient who received multiple blood transfusions for treatment of hemorrhagic hypovolemic shock. The nurse is especially concerned about the patient developing citrate toxicity. To prevent this, the nurse should assess for low levels of what electrolyte?
  1. phosphate
  2. potassium
  3. sodium
  4. calcium
10 .
The nurse is part of the medical team caring for a patient in hypovolemic shock. The team assesses the patient and ensures that the airway, breathing, and circulation is stabilized. What next step should the team take?
  1. start epinephrine to increase the patient’s heart rate
  2. start vasopressors to stabilize blood pressure
  3. start inotropes to increase the force of cardiac contraction
  4. identify the source of fluid loss
11 .
What laboratory finding is likely for patients who are experiencing hemoconcentration from the development of ascites?
  1. elevated hematocrit
  2. elevated BUN
  3. elevated potassium
  4. elevated lactate
12 .
A nurse receives orders from the provider for a post-op patient diagnosed with sepsis. What order should the nurse implement first?
  1. administer antibiotics
  2. change the surgical dressing
  3. insert a Foley catheter
  4. obtain a blood culture
13 .
A panel of blood work is drawn for a patient suspected of having septic shock. It is most important for the nurse to inform the provider of what result?
  1. lactate level: 4 mmol/L
  2. platelet count: 300,000 platelets per microliter of blood
  3. red blood cell count: 4.5 million
  4. white blood cell count: 9,000 per microliter
14 .
Laboratory results are reviewed by a nurse for a patient suspected of having sepsis. What value is most often associated with a diagnosis of sepsis?
  1. negative endotoxin
  2. high partial thromboplastin time (PTT)
  3. low C-reactive protein
  4. negative procalcitonin value
15 .
The nurse identifies what patient as being at highest risk for the development of septic shock?
  1. a twenty-year-old with a closed fractured femur
  2. a seventy-four-year-old who takes a diuretic for hypertension control
  3. a fifty-two-year-old who had a cerebral vascular aneurysm repaired
  4. a forty-year-old who had a total knee replacement
16 .
The nurse is caring for a patient in septic shock. What result would lead the nurse to conclude that the current treatment plan is effective?
  1. urine output of 28 mL/hour
  2. lactate level of 7 mmol/L
  3. blood glucose of 118 mg/dL
  4. mean arterial pressure of 60 mmHg
17 .
What is most accurate indicator of recovery from septic shock?
  1. negative blood culture
  2. urine output of 40 mL/hour
  3. blood pressure of 118/78 mmHg
  4. oral temperature of 37.2°C
18 .
What is a risk factor for the development of neurogenic shock?
  1. myocardial infarction
  2. pneumonia
  3. severe burns to the chest
  4. spinal cord injury
19 .
What drug is used in the treatment of bradycardia of neurogenic shock?
  1. atropine
  2. dobutamine
  3. epinephrine
  4. norepinephrine
20 .
When assessing a patient who sustained a spinal cord injury, what manifestation does the nurse identify as being most often associated with neurogenic shock?
  1. bradycardia
  2. hypotension
  3. flaccid muscles and loss of reflex activity below the level of the injury
  4. cool skin
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