During the refractory stage of shock in hypovolemia, which of the following responses accurately describes the physiological changes that occur?

Increased cardiac output and improved tissue perfusion

Restored fluid balance and resolution of hypovolemia

Worsening organ dysfunction and failure

Decreased heart rate and improved blood pressure

Answer and Explanation

The Correct Answer is C

A. In the refractory stage, cardiac output is decreased and tissue perfusion is severely impaired, not improved.
B. Fluid balance is not restored during the refractory stage; instead, hypovolemia worsens.
C. The refractory stage is characterized by irreversible damage with worsening organ dysfunction and failure despite interventions.
D. Heart rate usually increases initially, and blood pressure typically decreases; decreased heart rate and improved blood pressure are not features of this stage.

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Correct Answer is B

Explanation

A. Ongoing cardiac care is still necessary after valvuloplasty to monitor valve function and complications.
B. Mechanical valve replacements require lifelong anticoagulant therapy to prevent thromboembolism, which is an important consideration when comparing with valvuloplasty.
C. Biologic valves do not require immunosuppressive drugs because they are derived from animal tissue.
D. Mechanical valves are durable and often last longer than 5 years, usually 10-20 years or more before replacement might be needed.

A. Client with infective endocarditis who has a murmur and splinter hemorrhages B. Client with rheumatic fever who has sharp chest pain with a deep breath C. Client with dilated cardiomyopathy who has bilateral crackles at the lung bases D. Client with acute aortic regurgitation whose blood pressure is 86/54 mm Hg

Correct Answer is D

Explanation

A. A murmur and splinter hemorrhages are expected findings in infective endocarditis and do not indicate an immediate life-threatening condition.
B. Sharp chest pain with inspiration in rheumatic fever may indicate pericarditis, which needs monitoring but is not immediately unstable.
C. Bilateral crackles suggest fluid overload in dilated cardiomyopathy, requiring attention, but not as urgent as hypotension in acute valve failure.
D. Acute aortic regurgitation with hypotension (BP 86/54 mm Hg) indicates a possible hemodynamic collapse and cardiogenic shock, making this client the highest priority for immediate assessment and intervention.

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During the refractory stage of shock in hypovolemia, which of the following responses accurately describes the physiological changes that occur?

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Naxlex Comprehensive Predictor Exams

A client is scheduled for percutaneous balloon valvuloplasty to treat mitral stenosis. When explaining the advantage of valvuloplasty instead of valve replacement to the client, which information will the nurse include?

Correct Answer is B

Explanation

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Correct Answer is D

Explanation

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