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Chapter 12: SHOCK

Terms in this set (37)

Hypovolemic shock caused by severe burns is the result of a loss of:
Select one:
a. plasma.
b. platelets.
c. red blood cells.
d. whole blood.
a. plasma.
Neurogenic shock occurs when:
Select one:
a. massive vasoconstriction occurs distal to a spinal cord injury.
b. failure of the nervous system causes widespread vasodilation.
c. the spinal cord is severed and causes massive hemorrhaging.
d. there is too much blood to fill a smaller vascular container.
b. failure of the nervous system causes widespread vasodilation.
Pulmonary edema and impaired ventilation occur during:
Select one:
a. anaphylactic shock.
b. neurogenic shock.
c. cardiogenic shock.
d. septic shock.
c. cardiogenic shock.
A 70-year-old female was recently discharged from the hospital following a total hip replacement. Today, she presents with restlessness, tachycardia, and a blood pressure of 100/64 mm Hg. Her skin is hot and moist. You should be MOST suspicious that she is experiencing:
Select one:
a. decompensated shock.
b. septic shock.
c. pump failure.
d. a local infection.
b. septic shock.
Which of the following is the ONLY action that can prevent eventual death from a tension pneumothorax?
Select one:
a. Positive-pressure ventilation with a bag-valve mask
b. Early administration of high-flow oxygen
c. Rapid administration of intravenous fluids
d. Decompression of the injured side of the chest
d. Decompression of the injured side of the chest
Hypotension in a child with blunt or penetrating trauma is particularly significant because:
Select one:
a. the most likely cause of the hypotension is respiratory failure.
b. it typically develops earlier in children than it does in adults.
c. most children with hypotension die in the prehospital setting.
d. it often indicates the loss of half of his or her blood volume.
d. it often indicates the loss of half of his or her blood volume.
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 lungs.
b. the skin.
c. the heart.
d. the brain.
b. the skin.
One of the primary waste products of normal cellular metabolism that must be removed from the body by the lungs is:
Select one:
a. pyruvic acid.
b. carbon monoxide.
c. lactic acid.
d. carbon dioxide.
d. carbon dioxide.
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. apply a tourniquet proximal to the wrist.
b. apply pressure to the brachial artery.
c. wrap the towel with pressure bandages.
d. administer high-flow supplemental oxygen.
a. apply a tourniquet proximal to the wrist.
Which of the following would MOST likely result in hemorrhagic shock?
Select one:
a. Severe vomiting
b. Repeated diarrhea
c. Excessive sweating
d. Liver laceration
d. Liver laceration
A construction worker fell approximately 30 feet. He is semiconscious with rapid, shallow respirations. Further assessment reveals deformity to the thoracic region of his spine. His blood pressure is 70/50 mm Hg, his pulse is 66 beats/min and weak, and his skin is warm and dry. In addition to spinal immobilization and rapid transport, the MOST appropriate treatment for this patient includes:
Select one:
a. assisted ventilation, preventing hyperthermia, and elevating his lower extremities.
b. assisted ventilation, thermal management, and elevation of the lower extremities.
c. oxygen via nonrebreathing mask, blankets for warmth, and elevation of his head.
d. oxygen via nonrebreathing mask, thermal management, and elevation of his legs.
b. assisted ventilation, thermal management, and elevation of the lower extremities.
Patients develop septic shock secondary to:
Select one:
a. weak vessel tone caused by nervous system damage.
b. an infection that weakens cardiac contractions.
c. failure of the blood vessels to adequately dilate.
d. poor vessel function and severe volume loss.
d. poor vessel function and severe volume loss.
Cardiogenic shock may result from all of the following, EXCEPT:
Select one:
a. increased preload.
b. heart attack.
c. increased afterload.
d. poor contractility.
a. increased preload.

(this is input, not output)
You are transporting a 33-year-old male who was involved in a major motor vehicle crash. You have addressed all immediate and potentially life-threatening conditions and have stabilized his condition with the appropriate treatment. With an estimated time of arrival at the hospital of 20 minutes, you should:
Select one:
a. repeat your secondary assessment.
b. reassess his condition in 5 minutes.
c. take his vital signs in 15 minutes.
d. arrange for an ALS rendezvous.
b. reassess his condition in 5 minutes.
A 27-year-old male was stabbed in the chest during a disagreement at a poker game. As you approach him, you see that a knife is impaled in his chest. Before you make physical contact with the patient, it is MOST important to:
Select one:
a. form a general impression.
b. ask bystanders what happened.
c. follow standard precautions.
d. call for an ALS ambulance.
c. follow standard precautions.
Capillary sphincters are:
Select one:
a. under complete control of the voluntary portion of the nervous system.
b. capable of dilating in order to increase perfusion to crucial body organs.
c. circular muscular walls that regulate blood flow through the capillaries.
d. responsible for constricting to compensate for decreased cell perfusion.
c. circular muscular walls that regulate blood flow through the capillaries.
Your assessment of an unresponsive patient reveals that her breathing is inadequate. Your MOST immediate action should be to:
Select one:
a. ventilate her with a bag-valve mask.
b. move her to the ambulance stretcher.
c. check her airway for obstructions.
d. administer high-flow oxygen.
c. check her airway for obstructions.
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. High-flow oxygen administration
b. Full immobilization of her spine
c. Rapid transport to a trauma center
d. Intravenous fluid administration
c. Rapid transport to a trauma center
Distributive shock occurs when:
Select one:
a. widespread dilation of the blood vessels causes blood to pool in the vascular beds.
b. severe bleeding causes tachycardia in order to distribute blood to the organs faster.
c. an injury causes restriction of the heart muscle and impairs its pumping function.
d. temporary but severe vasodilation causes a decrease in blood supply to the brain.
a. widespread dilation of the blood vessels causes blood to pool in the vascular beds.
Which of the following patients is in decompensated shock?
Select one:
a. A 23-year-old restless male with cool, clammy skin and tachycardia
b. A 28-year-old female with pale skin and rapid, shallow respirations
c. A 20-year-old female with absent radial pulses and dilated pupils
d. A 32-year-old male with anxiety and a systolic blood pressure of 110 mm Hg
c. A 20-year-old female with absent radial pulses and dilated pupils
Which of the following clinical signs is unique to anaphylactic shock?
Select one:
a. Dizziness
b. Hypotension
c. Wheezing
d. Pallor
c. Wheezing
Which of the following MOST accurately describes septic shock?
Select one:
a. Bacterial damage to the vessel wall, leaking blood vessels, and vasodilation
b. Viral infection of the blood vessels, vascular damage, and vasoconstriction
c. Widespread vasoconstriction and plasma loss due to a severe viral infection
d. Bacterial infection of the nervous system with widespread vasodilation
a. Bacterial damage to the vessel wall, leaking blood vessels, and vasodilation
A 56-year-old male is found semiconscious by his wife. Your assessment reveals that his respirations are rapid and shallow, his pulse is rapid and irregular, and his blood pressure is low. The patient's wife states that he complained of left arm pain and nausea the day before, but would not allow her to call 9-1-1. The MOST likely cause of this patient's present condition is:
Select one:
a. acute myocardial infarction.
b. severe septic hypoperfusion.
c. a ruptured aortic aneurysm.
d. cardiogenic hypoperfusion.
d. cardiogenic hypoperfusion.
A 19-year-old male was stung multiple times by fire ants. He is experiencing obvious signs and symptoms of anaphylactic shock. You administer high-flow oxygen and give him epinephrine via intramuscular injection. Upon reassessment, you determine that his condition has not improved. You should:
Select one:
a. transport him immediately and provide supportive care while en route.
b. consider that he may actually be experiencing an acute asthma attack.
c. request a paramedic unit that is stationed approximately 15 miles away.
d. repeat the epinephrine injection after consulting with medical control.
d. repeat the epinephrine injection after consulting with medical control.
All of the following conditions should make you suspect shock, EXCEPT:
Select one:
a. severe infection.
b. spinal injury.
c. ischemic stroke.
d. anaphylaxis.
c. ischemic stroke.
Shock is the result of:
Select one:
a. widespread constriction of the blood vessels.
b. temporary dysfunction of a major organ.
c. the body's maintenance of homeostasis.
d. hypoperfusion to the cells of the body.
d. hypoperfusion to the cells of the body.
Which of the following statements regarding anaphylactic shock is correct?
Select one:
a. Sensitized people will experience less severe reactions upon subsequent exposure.
b. Anaphylactic shock occurs immediately after a person is sensitized to an allergen.
c. Subsequent exposure after sensitization often produces a more severe reaction.
d. Anaphylactic shock is caused by immune system failure due to a toxic exposure.
c. Subsequent exposure after sensitization often produces a more severe reaction.
You are dispatched to a residence for a 40-year-old female who fainted. Upon your arrival, the patient is conscious and alert, and states that she is fine. Her husband tells you that she fainted after receiving news that her sister was killed in a car crash. You offer oxygen to the patient, but she refuses to accept it. At this point, your primary concern should be to:
Select one:
a. obtain baseline vital signs and a medical history.
b. determine if she was injured when she fainted.
c. provide emotional support regarding her sister.
d. advise her that she needs to go to the hospital.
b. determine if she was injured when she fainted.
In infants and children, a capillary refill time (CRT) that is greater than ______ second(s) is a sign of poor peripheral perfusion.
Select one:
a. 4
b. 2
c. 3
d. 1
b. 2
Temporary, widespread vasodilation and syncope caused by a sudden nervous system reaction MOST accurately describes:
Select one:
a. psychogenic shock.
b. neurogenic shock.
c. vasovagal shock.
d. neurologic shock.
a. psychogenic shock.
In an acute injury setting, neurogenic shock is commonly accompanied by:
Select one:
a. diaphoresis.
b. tachycardia.
c. hypothermia.
d. hypovolemia.
c. hypothermia.
When assessing a patient with signs and symptoms of shock, it is important to remember that:
Select one:
a. multiple fractures are the most common cause of hypovolemic shock.
b. the patient's respirations are deep during the early stages of shock.
c. irreversible shock often responds well to a prompt blood transfusion.
d. blood pressure may be the last measurable factor to change in shock.
d. blood pressure may be the last measurable factor to change in shock.
Which of the following injuries would MOST likely cause obstructive shock?
Select one:
a. Spinal cord injury
b. Cardiac tamponade
c. Liver laceration
d. Simple pneumothorax
b. Cardiac tamponade
You respond to a residence for a patient with a severe leg injury following an accident with a chainsaw. When you arrive, you find the patient, a 44-year-old male, lying supine in the backyard. He has a partial amputation of his right lower leg that is actively bleeding. The patient is conscious and breathing adequately; however, he is restless and his skin is diaphoretic. You should:
Select one:
a. immediately evaluate his airway.
b. administer 100% supplemental oxygen.
c. apply direct pressure to the wound.
d. assess the rate and quality of his pulse.
c. apply direct pressure to the wound.
Clinical signs of compensated shock include all of the following, EXCEPT:
Select one:
a. cool and clammy skin.
b. rapid, shallow breathing.
c. absent peripheral pulses.
d. restlessness or anxiety.
c. absent peripheral pulses.
When treating an 80-year-old patient who is in shock, it is important to remember that:
Select one:
a. compensation from the respiratory system usually manifests with increased tidal volume.
b. medications older patients take for hypertension often cause an unusually fast heart rate.
c. changes in gastric motility may delay gastric emptying, which increases the risk for vomiting.
d. he older patient's central nervous system usually reacts more briskly to compensate for shock.
c. changes in gastric motility may delay gastric emptying, which increases the risk for vomiting.
A 59-year-old male presents with severe vomiting and diarrhea of 3 days' duration. He is confused and diaphoretic, and his radial pulses are absent. His blood pressure is 78/50 mm Hg. After applying supplemental oxygen, you should:
Select one:
a. perform a head-to-toe exam.
b. prepare for immediate transport.
c. allow him to drink plain water.
d. obtain a repeat blood pressure in 5 minutes.
b. prepare for immediate transport.
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