What is the final outcome of impaired cellular metabolism?

1.            What is the final outcome of impaired cellular metabolism?

 

a.            Cellular alterations in the heart and brain

 

b.            Buildup of cellular waste products

 

c.             Cellular alterations in the vasculature structures and kidneys

 

d.            Impairment of urine excretion

 

2.            Which clinical manifestation of septic shock confirms an elevation in immune system response?

 

a.            Tachycardia

 

b.            Increased white blood cell count

 

c.             Low respiratory rate

 

d.            Hypothermia

 

3.            The release of catecholamine by the adrenal glands provides which compensatory mechanism in hypovolemic shock?

 

a.            Interstitial fluid moves out of the vascular compartment.

 

b.            Systemic vascular resistance is decreased.

 

c.             Heart rate is increased.

 

d.            Water excretion is increased.

 

4.            Hypovolemic shock begins to develop when intravascular volume has decreased by what percentage?

 

a.            5

 

b.            10

 

c.             15

 

d.            20

 

5.            A student asks the professor to explain the basics of vasogenic shock. What statement by the professor is best?

 

a.            The outcome of widespread hypersensitivity to an allergen

 

b.            Bacteremia combined with systemic inflammatory response

 

c.             Inability to get adequate blood to tissues and end organs

 

d.            Vasodilation from an imbalance between the two nervous systems

 

6.            What is the clinical hallmark of neurogenic shock as a result of the overstimulation of the parasympathetic nervous system?

 

a.            Vasoconstriction

 

b.            Vasodilation

 

c.             Increased metabolism

 

d.            Respiratory distress

 

7.            Four patients are in the intensive care unit with different types of shock. Which patient would the healthcare professional assess as the priority?

 

a.            Septic

 

b.            Hypovolemic

 

 c.            Anaphylactic

 

d.            Neurogenic

 

8.            A patient is diagnosed with septic shock. What action by the healthcare professional will address the main underlying pathophysiologic mechanism of this disorder?

 

a.            Administer antibiotics as soon as possible.

 

b.            Provide high volumes of isotonic fluid.

 

c.             Place patient on an intra-aortic balloon pump.

 

d.            Give the patient antihistamines and steroids.

 

9.            For which type of shock would antihistamines and corticosteroids be prescribed?

 

a.            Septic

 

b.            Anaphylactic

 

c.             Hypovolemic

 

d.            Cardiogenic

 

10.          Which condition is best defined as a clinical syndrome involving a systemic response to infection, which is manifested by two or more of the systemic inflammatory response syndrome criteria?

 

a.            Bacteremia

 

b.            Sepsis

 

c.             Septicemia

 

d.            Septic shock

 

11.          The student learns that which mechanism causes organ injury in primary multiple organ dysfunction syndrome (MODS)?

 

a.            Impaired immune response

 

b.            Impaired glucose use

 

c.             Impaired perfusion

 

d.            Impaired ventilation

 

12.          A student has studied secondary multiple organ dysfunction syndrome (MODS). What substance does the student learn is least likely to stimulate the normal endothelial cells to change to a proinflammatory state?

 

a.            Interleukin (IL)-1

 

b.            IL-4

 

c.             IL 6

 

d.            Tumor necrosis factor

 

13.          What stimulates the respiratory burst and production of highly toxic free radicals in the multiple organ dysfunction syndrome (MODS)?

 

a.            Neutrophils adhering to the endothelium

 

b.            Activation of the complement cascade

 

c.             Release of prostaglandins, thromboxanes, and leukotrienes

 

d.            Activation of the fibrinolytic system

 

14.          A student is perplexed that in a patient with multiple organ dysfunction syndrome (MODS), no infectious source has been found. What statement by the healthcare professional best describes this phenomenon?

 

a.            Death of organs

 

b.            Translocation of bacteria

 

c.             Maldistribution of blood flow

 

d.            Massive inflammatory response

 

15.          Blistering of the skin within minutes occurs in which type of burn injury?

 

a.            First degree

 

b.            Superficial partial thickness

 

c.             Deep partial thickness

 

d.            Full thickness

 

16.          A patient has an acute burn injury. What type of treatment for shock will the healthcare professional anticipate for this patient?

 

a.            Intravenous fluids

 

b.            Antibiotics

 

c.             Intra-aortic balloon pump

 

d.            Antihistamines and steroids

 

 17.         What assessment finding would indicate to the healthcare professional that the patient is no longer in burn shock?

 

a.            Blood pressure 100/58 mmHg

 

b.            Pulse rate 98 beats/min

 

c.             Respiratory rate 24 breaths/min

 

d.            Urine output 35 mL/hour for 4 hours

 

18.          Which condition does a burn injury create for an extended period?

 

a.            Hypervolemia

 

b.            Hypermetabolism

 

c.             Hyponatremia

 

d.            Hypotension

 

19.          A student learns that a fatal burn injury has what effect on interleukins (ILs)?

 

a.            Decreases levels of IL-2

 

b.            Decreases levels of IL-4 lymphocytes

 

c.             Increases levels of IL-6

 

d.            Increases levels of IL-12

 

20.          Daily evaporative water loss after a burn injury is approximately how many times the normal?

 

 a.           5

 

b.            10

 

c.             15

 

d.            20

 

21.          What is the significance of a high level of interleukin 1 (IL-1) in a patient who has experienced severe burns?

 

a.            Prognosis is poor.

 

b.            Antibiotic therapy is required.

 

c.             Urinary function is improved.

 

d.            They are less at risk for death.

 

MULTIPLE RESPONSE

 

1.            A healthcare professional is determining the disposition of four burn patients in the Emergency department. Which patients will the professional refer to the burn center? (Select all that apply.)

 

a.            Partial thickness burn 20% TBSA

 

b.            Burn of the genitals

 

c.             Lightening injury

 

d.            Both arms burned

 

e.            Concomitant trauma

 

2.            In septic shock, which mediators are antiinflammatory? (Select all that apply.)

 

a.            Interleukin (IL)-4 (IL-4)

 

 b.           IL-10

 

c.             IL-13

 

d.            Tumor necrosis factor–alpha (TNF-?)

 

e.            Prostaglandin

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