A nurse who is mentoring a graduate nurse explains the correlation between severe blood loss and the effect on the client's mean arterial pressure (MAI The graduate nurse demonstrates correct understanding when he states which of the following:

It raises cardiac output and MAP.

It causes vasoconstriction and increased MAP.

There is no direct correlation to MAP.

Lower blood volume lowers MAP.

Answer and Explanation

The Correct Answer is D

A.   Severe blood loss actually decreases blood volume, which leads to decreased cardiac output and ultimately lower MAP.
B.   While it's true that the body initially responds to blood loss by vasoconstricting to maintain blood pressure, this compensatory mechanism can only last for so long. As blood loss continues, MAP will decrease.
C.   There is no direct correlation to MAP. MAP is directly influenced by cardiac output and systemic vascular resistance (SVR). Blood volume is a major determinant of both.
D.   A decrease in blood volume leads to decreased preload, which reduces cardiac output. This, in turn, lowers MAP.

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Correct Answer is D

Explanation

A. Spinal cord degeneration is a general term for the deterioration of the spinal cord and doesn't specifically describe the patient's posture.
B. Decorticate posturing is characterized by the arms flexed and adducted, with the wrists and fingers flexed. The legs are extended and adducted, with the feet plantar flexed.
C. Atypical hyperreflexia refers to exaggerated reflexes, not a specific posture.

D. Decerebrate posturing is characterized by the arms extended and pronated, with the wrists and fingers flexed. The legs are stiffly extended with plantar flexion.

A. The client who has chronic kidney disease B. The client experiencing an asthma attack C. The client who has Guillain-Barré syndrome D. The client who has a severe burn injury

Correct Answer is C

Explanation

A. This client is at risk for other complications such as electrolyte imbalances or heart failure, but not specifically neurogenic shock.
B. This client is experiencing respiratory distress, which is a different type of shock (anaphylactic or septic shock might be considered, but not neurogenic).

C. Guillain-Barré syndrome is an autoimmune disorder that affects the nervous system, often leading to paralysis. It can cause a rapid loss of muscle function, which can result in neurogenic shock due to loss of sympathetic nervous system tone.
D. This client is at risk for hypovolemic shock due to fluid loss, not neurogenic shock.

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A nurse who is mentoring a graduate nurse explains the correlation between severe blood loss and the effect on the client's mean arterial pressure (MAI The graduate nurse demonstrates correct understanding when he states which of the following:

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Naxlex Comprehensive Predictor Exams

A nurse is doing rounds and notes a patient in the following position: How would the nurse document this finding?

Correct Answer is D

Explanation

A nurse is providing care for a group of clients in the emergency department. Which of the following clients is at risk for developing neurogenic shock?

Correct Answer is C

Explanation

A nurse who is mentoring a graduate nurse explains the correlation between severe blood loss and the effect on the client's mean arterial pressure (MAI The graduate nurse demonstrates correct understanding when he states which of the following:

A nurse is caring for a client who returns to the nursing unit from the recovery room after a sigmoid colon resection for adenocarcinoma. The client had an episode of intraoperative bleeding. Which finding indicates to the nurse that the client may be developing hypovolemic shock?

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A nurse is monitoring a client who is on telemetry. Which of the following findings on the ECG strip should the nurse recognize as normal sinus rhythm?

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