PATHO FINAL TB complete test A+
graded 2023-2024
A 78-kg patient with septic shock has a pulse rate of 120 beats/min with low central
venous pressure and pulmonary artery wedge pressure. Urine output has been 30
mL/hr for the past 3 hours. Which order by the health care provider should the nurse
question?
a.
Administer furosemide (Lasix) 40 mg IV.
b.
Increase normal saline infusion to 250 mL/hr.
c.
Give hydrocortisone (Solu-Cortef) 100 mg IV.
d.
Titrate norepinephrine to keep systolic blood pressure (BP) above 90 mm Hg. - ans a.
Administer furosemide (Lasix) 40 mg IV.
A nurse is caring for a patient whose hemodynamic monitoring indicates a blood
pressure of 92/54 mm Hg, a pulse of 64 beats/min, and an elevated pulmonary artery
wedge pressure (PAWP). Which intervention ordered by the health care provider should
the nurse question?
a.
Elevate head of bed to 30 degrees.
b.
Infuse normal saline at 250 mL/hr.
c.
Hold nitroprusside if systolic BP is less than 90 mm Hg.
d.
Titrate dobutamine to keep systolic BP is greater than 90 mm Hg. - ans c. Hold
nitroprusside if systolic BP is less than 90 mm Hg.
The patient's elevated PAWP indicates volume excess in relation to cardiac pumping
ability, consistent with cardiogenic shock. A saline infusion at 250 mL/hr will exacerbate
,the volume excess. The other actions will help to improve cardiac output, which should
lower the PAWP and may raise the BP.
A patient with massive trauma and possible spinal cord injury is admitted to the
emergency department (ED). Which assessment finding by the nurse will help confirm a
diagnosis of neurogenic shock?
a.
Inspiratory crackles
b.
Heart rate 45 beats/min
c.
Cool, clammy extremities
d.
Temperature 101.2°F (38.4°C) - ans b. Heart rate 45 beats/min
Neurogenic shock is characterized by hypotension and bradycardia.
An older patient with cardiogenic shock is cool and clammy. Hemodynamic monitoring
indicates a high systemic vascular resistance (SVR). Which intervention should the
nurse anticipate?
a.
Increase the rate for the dopamine infusion.
b.
Decrease the rate for the nitroglycerin infusion.
c.
Increase the rate for the sodium nitroprusside infusion.
d.
Decrease the rate for the 5% dextrose in normal saline (D5/.9 NS) infusion. - ans c.
Increase the rate for the sodium nitroprusside infusion.
Nitroprusside is an arterial vasodilator and will decrease the SVR and afterload, which
will improve cardiac output
After receiving 2 L of normal saline, the central venous pressure for a patient who has
septic shock is 10 mm Hg, but the blood pressure is still 82/40 mm Hg. The nurse will
anticipate an order for
a.
furosemide .
b.
nitroglycerin
c.
norepinephrine .
d.
sodium nitroprusside - ans c. Norepinephrine
When fluid resuscitation is unsuccessful, vasopressor drugs are given to increase the
systemic vascular resistance (SVR) and blood pressure and improve tissue perfusion.
,A patient with cardiogenic shock has the following vital signs: BP 102/50, pulse 128,
respirations 28. The pulmonary artery wedge pressure (PAWP) is increased, and
cardiac output is low. The nurse will anticipate an order for which medication?
a.
5% albumin infusion
b.
furosemide (Lasix) IV
c.
epinephrine (Adrenalin) drip
d.
hydrocortisone (Solu-Cortef) - ans b. furosemide (Lasix) IV
The PAWP indicates that the patient's preload is elevated, and furosemide is indicated
to reduce the preload and improve cardiac output. Epinephrine would further increase
the heart rate and myocardial oxygen demand. 5% albumin would also increase the
PAWP. Hydrocortisone might be considered for septic or anaphylactic shock.
The emergency department (ED) nurse receives report that a seriously injured patient
involved in a motor vehicle crash is being transported to the facility with an estimated
arrival in 5 minutes. In preparation for the patient's arrival, the nurse will obtain
a.
a dopamine infusion.
c.
lactated Ringer's solution.
b.
a hypothermia blanket.
d.
two 16-gauge IV catheters. - ans d. two 16-gauge IV catheters.
A patient with multiple trauma may require fluid resuscitation to prevent or treat
hypovolemic shock, so the nurse will anticipate the need for 2 large-bore IV lines to
administer normal saline.
Which finding is the best indicator that the fluid resuscitation for a 90-kg patient with
hypovolemic shock has been effective?
a.
Hemoglobin is within normal limits.
b.
Urine output is 65 mL over the past hour.
c.
Central venous pressure (CVP) is normal.
d.
Mean arterial pressure (MAP) is 72 mm Hg - ans b. Urine output is 65 mL over the
past hour.
, Assessment of end organ perfusion, such as an adequate urine output, is the best
indicator that fluid resuscitation has been successful. Urine output should be equal to or
more than 0.5 mL/kg/hr.
Which intervention will the nurse include in the plan of care for a patient who has
cardiogenic shock?
a.
Check temperature every 2 hours.
b.
Monitor breath sounds frequently.
c.
Maintain patient in supine position.
d.
Assess skin for flushing and itching. - ans b. Monitor breath sounds frequently.
Because pulmonary congestion and dyspnea are characteristics of cardiogenic shock,
the nurse should assess the breath sounds frequently. The head of the bed is usually
elevated to decrease dyspnea in patients with cardiogenic shock
A nurse is assessing a patient who is receiving a nitroprusside infusion to treat
cardiogenic shock. Which finding indicates that the drug is effective?
a.
No new heart murmurs
b.
Decreased troponin level
c.
Warm, pink, and dry skin
d.
Blood pressure of 92/40 mm Hg - ans c. Warm, pink, and dry skin
Warm, pink, and dry skin indicates that perfusion to tissues is improved. Because
nitroprusside is a vasodilator, the blood pressure may be low even if the drug is
effective. Absence of a heart murmur and a decrease in troponin level are not indicators
of improvement in shock
Which assessment information is most important for the nurse to obtain when
evaluating whether treatment of a patient with anaphylactic shock has been effective?
a.
Heart rate
c.
Blood pressure
b.
Orientation
d.
Oxygen saturation - ans d. Oxygen saturation
graded 2023-2024
A 78-kg patient with septic shock has a pulse rate of 120 beats/min with low central
venous pressure and pulmonary artery wedge pressure. Urine output has been 30
mL/hr for the past 3 hours. Which order by the health care provider should the nurse
question?
a.
Administer furosemide (Lasix) 40 mg IV.
b.
Increase normal saline infusion to 250 mL/hr.
c.
Give hydrocortisone (Solu-Cortef) 100 mg IV.
d.
Titrate norepinephrine to keep systolic blood pressure (BP) above 90 mm Hg. - ans a.
Administer furosemide (Lasix) 40 mg IV.
A nurse is caring for a patient whose hemodynamic monitoring indicates a blood
pressure of 92/54 mm Hg, a pulse of 64 beats/min, and an elevated pulmonary artery
wedge pressure (PAWP). Which intervention ordered by the health care provider should
the nurse question?
a.
Elevate head of bed to 30 degrees.
b.
Infuse normal saline at 250 mL/hr.
c.
Hold nitroprusside if systolic BP is less than 90 mm Hg.
d.
Titrate dobutamine to keep systolic BP is greater than 90 mm Hg. - ans c. Hold
nitroprusside if systolic BP is less than 90 mm Hg.
The patient's elevated PAWP indicates volume excess in relation to cardiac pumping
ability, consistent with cardiogenic shock. A saline infusion at 250 mL/hr will exacerbate
,the volume excess. The other actions will help to improve cardiac output, which should
lower the PAWP and may raise the BP.
A patient with massive trauma and possible spinal cord injury is admitted to the
emergency department (ED). Which assessment finding by the nurse will help confirm a
diagnosis of neurogenic shock?
a.
Inspiratory crackles
b.
Heart rate 45 beats/min
c.
Cool, clammy extremities
d.
Temperature 101.2°F (38.4°C) - ans b. Heart rate 45 beats/min
Neurogenic shock is characterized by hypotension and bradycardia.
An older patient with cardiogenic shock is cool and clammy. Hemodynamic monitoring
indicates a high systemic vascular resistance (SVR). Which intervention should the
nurse anticipate?
a.
Increase the rate for the dopamine infusion.
b.
Decrease the rate for the nitroglycerin infusion.
c.
Increase the rate for the sodium nitroprusside infusion.
d.
Decrease the rate for the 5% dextrose in normal saline (D5/.9 NS) infusion. - ans c.
Increase the rate for the sodium nitroprusside infusion.
Nitroprusside is an arterial vasodilator and will decrease the SVR and afterload, which
will improve cardiac output
After receiving 2 L of normal saline, the central venous pressure for a patient who has
septic shock is 10 mm Hg, but the blood pressure is still 82/40 mm Hg. The nurse will
anticipate an order for
a.
furosemide .
b.
nitroglycerin
c.
norepinephrine .
d.
sodium nitroprusside - ans c. Norepinephrine
When fluid resuscitation is unsuccessful, vasopressor drugs are given to increase the
systemic vascular resistance (SVR) and blood pressure and improve tissue perfusion.
,A patient with cardiogenic shock has the following vital signs: BP 102/50, pulse 128,
respirations 28. The pulmonary artery wedge pressure (PAWP) is increased, and
cardiac output is low. The nurse will anticipate an order for which medication?
a.
5% albumin infusion
b.
furosemide (Lasix) IV
c.
epinephrine (Adrenalin) drip
d.
hydrocortisone (Solu-Cortef) - ans b. furosemide (Lasix) IV
The PAWP indicates that the patient's preload is elevated, and furosemide is indicated
to reduce the preload and improve cardiac output. Epinephrine would further increase
the heart rate and myocardial oxygen demand. 5% albumin would also increase the
PAWP. Hydrocortisone might be considered for septic or anaphylactic shock.
The emergency department (ED) nurse receives report that a seriously injured patient
involved in a motor vehicle crash is being transported to the facility with an estimated
arrival in 5 minutes. In preparation for the patient's arrival, the nurse will obtain
a.
a dopamine infusion.
c.
lactated Ringer's solution.
b.
a hypothermia blanket.
d.
two 16-gauge IV catheters. - ans d. two 16-gauge IV catheters.
A patient with multiple trauma may require fluid resuscitation to prevent or treat
hypovolemic shock, so the nurse will anticipate the need for 2 large-bore IV lines to
administer normal saline.
Which finding is the best indicator that the fluid resuscitation for a 90-kg patient with
hypovolemic shock has been effective?
a.
Hemoglobin is within normal limits.
b.
Urine output is 65 mL over the past hour.
c.
Central venous pressure (CVP) is normal.
d.
Mean arterial pressure (MAP) is 72 mm Hg - ans b. Urine output is 65 mL over the
past hour.
, Assessment of end organ perfusion, such as an adequate urine output, is the best
indicator that fluid resuscitation has been successful. Urine output should be equal to or
more than 0.5 mL/kg/hr.
Which intervention will the nurse include in the plan of care for a patient who has
cardiogenic shock?
a.
Check temperature every 2 hours.
b.
Monitor breath sounds frequently.
c.
Maintain patient in supine position.
d.
Assess skin for flushing and itching. - ans b. Monitor breath sounds frequently.
Because pulmonary congestion and dyspnea are characteristics of cardiogenic shock,
the nurse should assess the breath sounds frequently. The head of the bed is usually
elevated to decrease dyspnea in patients with cardiogenic shock
A nurse is assessing a patient who is receiving a nitroprusside infusion to treat
cardiogenic shock. Which finding indicates that the drug is effective?
a.
No new heart murmurs
b.
Decreased troponin level
c.
Warm, pink, and dry skin
d.
Blood pressure of 92/40 mm Hg - ans c. Warm, pink, and dry skin
Warm, pink, and dry skin indicates that perfusion to tissues is improved. Because
nitroprusside is a vasodilator, the blood pressure may be low even if the drug is
effective. Absence of a heart murmur and a decrease in troponin level are not indicators
of improvement in shock
Which assessment information is most important for the nurse to obtain when
evaluating whether treatment of a patient with anaphylactic shock has been effective?
a.
Heart rate
c.
Blood pressure
b.
Orientation
d.
Oxygen saturation - ans d. Oxygen saturation
