Which of the following statements best describes the pathophysiologic rationale for shock?

Circulating blood volume is decreased.

Cells lack an adequate blood supply and are deprived of oxygen and nutrients.

Hemorrhage occurs as a result of trauma.

Blood is shunted from vital organs to peripheral areas of the body.

Answer and Explanation

The Correct Answer is B

A. Circulating blood volume is decreased – This is true specifically in hypovolemic shock, but it does not apply to all types of shock (e.g., septic or cardiogenic shock).
B. Cells lack an adequate blood supply and are deprived of oxygen and nutrients – This is the most accurate and comprehensive description of the pathophysiology of shock. Shock is defined as a state of cellular and tissue hypoperfusion, regardless of the underlying cause.
C. Hemorrhage occurs as a result of trauma – While hemorrhage can cause hypovolemic shock, it is not the universal cause of all types of shock.
D. Blood is shunted from vital organs to peripheral areas of the body – The opposite is true in shock: blood is typically shunted away from peripheral tissues to preserve perfusion to vital organs like the brain and heart.

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Correct Answer is ["A","C","D"]

Explanation

A. Renal function – Requires follow-up: The client’s BUN is 28 mg/dL (high), and creatinine is 1.5 mg/dL (above normal range). This indicates possible renal hypoperfusion or early acute kidney injury due to decreased cardiac output from worsening heart failure. This needs immediate evaluation to prevent further decline in renal function.
B. Cardiac enzymes – Does NOT require follow-up: Troponin T = 0.06 ng/mL and Troponin I = 0.01 ng/mL, both of which are within normal limits. There is no evidence of acute myocardial infarction, so this finding does not require immediate follow-up.
C. BNP – Requires follow-up: BNP is 800 ng/mL (normal < 100 ng/mL), which is markedly elevated. This is a specific indicator of acute decompensated heart failure, requiring urgent treatment such as diuretics, oxygen, and possibly vasodilators.
D. ECG results – Requires follow-up: The client is in atrial fibrillation with rapid ventricular response (RVR) at a rate of 135/min. This rhythm can reduce cardiac output and increase risk for thromboembolic events. It requires rate control or rhythm conversion and anticoagulation evaluation.
E. Neurologic status – Does NOT require follow-up: The client is alert and oriented ×3, follows commands, and has no neurological deficits. This indicates no current neurologic impairment, so this finding is stable and does not need immediate intervention.

A. Sinus bradycardia B. Ventricular tachycardia C. Normal sinus rhythm D. Sinus tachycardia

Correct Answer is D

Explanation

A. Sinus bradycardia is characterized by a heart rate below 60 beats/min, which is inconsistent with this client’s elevated heart rate of 128.
B. Ventricular tachycardia is a potentially life-threatening rhythm with wide QRS complexes, usually not the immediate expected rhythm without other signs such as hypotension or loss of consciousness.
C. Normal sinus rhythm has a heart rate between 60–100 beats/min; this client’s rate of 128 exceeds that range.
D. Sinus tachycardia is the most likely rhythm, especially in a client who has used cocaine, a stimulant known to increase sympathetic nervous system activity, leading to increased heart rate and elevated blood pressure.

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Which of the following statements best describes the pathophysiologic rationale for shock?

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Naxlex Comprehensive Predictor Exams

A nurse is admitting a client who has a history of heart failure. Exhibits Check the 3 findings that require immediate follow-up.

Correct Answer is ["A","C","D"]

Explanation

Correct Answer is D

Explanation

The nurse notes that leads I, II, and III differ from one another on the cardiac rhythm strip because:

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