1. The nurse is assessing a client who has hypovolemic shock.

Which laboratory value indicates

that the client is at risk for acidosis?

a. Decreased serum creatinine

b. Increased serum lactic acid

c. Increased urine specific gravity

d. Decreased partial pressure of arterial carbon dioxide

____2. A client brought to the emergency department after a motor vehicle accident is suspected
of having internal bleeding. Which question does the nurse ask to determine whether the client is
in the early stages of hypovolemic shock?

a. “Are you more thirsty than normal?”

b. “When was the last time you urinated?”

c. “What is your normal heart rate?”

d. “Is your skin usually cool and pale?”

____3. A client who has acidosis resulting from hypovolemic shock has been prescribed
intravenous fluid replacement. Which fluid does the nurse prepare to administer?

a. Normal saline

b. Ringer’s lactate

c. 5% dextrose in water

d. 5% dextrose in 0.45% normal saline

____4. The nurse is monitoring a client in hypovolemic shock who has been placed on a dopamine
hydrochloride (Intropin) drip. Which manifestation is a desired response to this medication?

a. Decrease in blood pressure

b. Increase in heart rate

c. Increase in cardiac output

d. Decrease in mean arterial pressure

____5. The nurse is caring for a client who has hypovolemic shock. After administering oxygen,
what is the priority intervention for this client?
a. Administer an aminoglycoside.

b. Initiate a dopamine hydrochloride (Intropin) drip.

c. Administer crystalloid fluids.

d. Initiate an intravenous heparin drip.

____6. A client who has septic shock is admitted to the hospital. What priority intervention does
the nurse implement first?

a. Obtain two sets of blood cultures.

b. Administer the prescribed IV vancomycin (Vancocin).

c. Obtain central venous pressure (CVP) measurements

d. Administer the prescribed IV norepinephrine (Levophed)

____7. The nurse is assessing a client who was admitted for treatment of shock. Which
manifestation indicates that the client’s shock is caused by sepsis?

a. Hypotension

b. Pale clammy skin

c. Anxiety and confusion

d. Oozing of blood at the IV site

____8. A client was admitted 2 days ago with early stages of septic shock. Today the nurse notes
that the client’s systolic blood pressure, pulse pressure, and cardiac output are decreasing rapidly.
Which intervention does the nurse do first?

a. Insert a Foley catheter to monitor urine output closely.

b. Ask the client’s family to come to the hospital because death is near.

c. Initiate the prescribed dobutamine (Dobutrex) intravenous drip.

d. Obtain blood cultures before administering the next dose of antibiotics

9. The intensive care nurse is educating the spouse of a client who is being treated for shock. The
spouse states, “The doctor said she has shock. What is that?” What is the nurse’s best response?
a. “Shock occurs when oxygen to the body’s tissues and organs is impaired.”
b. “Shock is a serious condition, but it is not a life-threatening emergency.”
c. “Shock progresses slowly and can be stopped by the body’s normal compensation.”
d. “Shock is a condition that affects only specific body organs like the kidneys.”

10. The nurse is caring for multiple clients in the emergency department. The client with which
condition is at highest risk for distributive shock?
a. Severe head injury from a motor vehicle accident
b. Diabetes insipidus from polycystic kidney disease
c. Ischemic cardiomyopathy from severe coronary artery disease
d. Vomiting of blood from a gastrointestinal ulcer

11. THE NURSE IS ADMINISTERING PRESCRIBED SODIUM NITROPRUSSIDE (NIPRIDE)

INTRAVENOUSLY TO A CLIENT WHO HAS SHOCK . WHICH NURSING INTERVENTION IS A PRIORITY
WHEN ADMINISTERING THIS MEDICATION ?
A. ASK IF THE CLIENT HAS CHEST PAIN EVERY 30 MINUTES .
B. ASSESS THE CLIENT ’S BLOOD PRESSURE EVERY 15 MINUTES .
C. MONITOR THE CLIENT ’ S URINARY OUTPUT EVERY HOUR .
D. OBSERVE THE CLIENT ’ S EXTREMITIES EVERY 4 HOURS .

12. THE NURSE IS CARING FOR A CLIENT WHO HAS HAD AN ANAPHYLACTIC EVENT. WHICH
PRIORITY QUESTION DOES THE NURSE ASK TO DETERMINE WHETHER THE CLIENT IS
EXPERIENCING DISTRIBUTIVE SHOCK?
A. “ IS YOUR BLOOD PRESSURE HIGHER THAN USUAL ?”
B. “ARE YOU HAVING PAIN IN YOUR THROAT?”
C. “HAVE YOU BEEN VOMITING?”
D. “ARE YOU USUALLY THIS SWOLLEN ?”

13. The nurse is assessing clients in the emergency department. Which client is at highest risk for
developing septic shock?

a. 25-year-old man who has irritable bowel syndrome

b. 37-year-old woman who is 20% above ideal body weight

c. 68-year-old woman who is being treated with chemotherapy

d. 82-year-old man taking beta blockers for hypertension

14. The nurse is caring for a client in the hyperdynamic phase of septic shock. Which medication
does the nurse expect to be prescribed?

a. Heparin sodium
b. Vitamin K

c. Corticosteroids

d. Hetastarch (Hespan)

Answers: 1. B 2. C 3. B 4. C 5. C 6. A 7. D 8. C 9. A 10. A 11. B 12. D 13. C 14. A