COPY: NIH Final Exam Review

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Questions and Answers

What is a key characteristic common to all types of shock?

  • Increased heart rate
  • Increased blood pressure
  • Decreased blood pressure (correct)
  • Increased blood volume

Which type of shock is primarily caused by a significant decrease in circulating blood volume?

  • Cardiogenic shock
  • Hypovolemic shock (correct)
  • Distributive shock
  • Obstructive shock

What primarily causes cardiogenic shock?

  • Cardiac muscle failure (correct)
  • Infection leading to systemic inflammation
  • Excessive dilation of blood vessels
  • Blockage of blood flow outside the heart

What complication can arise from shock if the brain experiences anoxic conditions for over 4 minutes?

<p>Brain death (D)</p> Signup and view all the answers

Which of the following symptoms is most indicative of septic shock?

<p>Persistent fever and flushed skin (B)</p> Signup and view all the answers

What type of shock is characterized by excessive dilation of venules and arterioles?

<p>Distributive shock (B)</p> Signup and view all the answers

Which condition is a potential cause of neurogenic shock?

<p>Spinal cord injury (A)</p> Signup and view all the answers

What vital sign change is typically associated with shock conditions?

<p>Elevated respiratory rate (D)</p> Signup and view all the answers

What is a primary cause of hypovolemic shock?

<p>Decreased circulating blood volume (C)</p> Signup and view all the answers

Which treatment should be prioritized for a patient with septic shock?

<p>Obtain blood cultures before starting antibiotics (C)</p> Signup and view all the answers

What is a common misconception about anaphylactic shock management?

<p>Healthcare providers should wait to see if symptoms resolve. (A), Symptoms can be treated with antihistamines alone. (C), Patients don’t need to carry an autoinjector after one episode. (D)</p> Signup and view all the answers

What symptom is most indicative of septic shock?

<p>Hypotension despite fluid resuscitation (A)</p> Signup and view all the answers

Which factor is a common cause of neurogenic shock?

<p>Spinal cord injury (D)</p> Signup and view all the answers

Which of the following actions should a nurse take for a patient experiencing shock?

<p>Monitor blood pressure regularly (B), Maintain airway and oxygenation (C)</p> Signup and view all the answers

What is the role of fluids in treating hypovolemic shock?

<p>To expand intravascular volume (B)</p> Signup and view all the answers

Which statement about managing cardiogenic shock is inaccurate?

<p>Monitoring patient response is unnecessary. (C)</p> Signup and view all the answers

Which type of shock is characterized by cardiac failure where the heart fails to adequately pump blood to the body?

<p>Cardiogenic Shock (A)</p> Signup and view all the answers

What is a potential consequence of acute pulmonary hypertension that can lead to shock?

<p>Increased pulmonary artery pressure (A)</p> Signup and view all the answers

Which symptom is specifically associated with anaphylactic shock?

<p>Laryngeal edema (A)</p> Signup and view all the answers

In the early phase of septic shock, which of the following symptoms is typically observed?

<p>Warm/flushed skin (D)</p> Signup and view all the answers

Which of the following can be a cause of neurogenic shock?

<p>Brain contusions (B)</p> Signup and view all the answers

Which of the following signs is NOT typically associated with hypovolemic shock?

<p>Bradycardia (A)</p> Signup and view all the answers

What is the first action to take when managing anaphylactic shock?

<p>Maintain airway patency (D)</p> Signup and view all the answers

What is a key characteristic of obstructive shock?

<p>Blocked blood flow outside the heart (B)</p> Signup and view all the answers

Septic shock is commonly associated with which of the following?

<p>Systemic infection and inflammation (D)</p> Signup and view all the answers

Which symptom is indicative of the late stage of neurogenic shock?

<p>Tachycardia (A)</p> Signup and view all the answers

Which of the following best describes anaphylactic shock?

<p>Extreme hypersensitivity reaction (D)</p> Signup and view all the answers

Which of the following symptoms is common in both hypovolemic and septic shock?

<p>Altered mental status (A)</p> Signup and view all the answers

Which of the following best describes the later phase of septic shock symptoms?

<p>Cold clammy skin and decreased BP (B)</p> Signup and view all the answers

What is the main vascular change observed in distributive shock?

<p>Excessive vasodilation (B)</p> Signup and view all the answers

Which of the following is the most appropriate action for a nurse to take for a patient with septic shock?

<p>Obtain blood cultures before starting antibiotics (C)</p> Signup and view all the answers

What critical intervention should a nurse implement for a patient experiencing shock?

<p>Maintain airway and ensure oxygenation (C)</p> Signup and view all the answers

Which statement regarding the causes of cardiogenic shock is correct?

<p>It is primarily caused by myocardial infarction (C)</p> Signup and view all the answers

Which symptom is commonly associated with hypovolemic shock?

<p>Weak pulses (D)</p> Signup and view all the answers

What is a key intervention to manage a patient diagnosed with allergic reactions?

<p>Elevate the head of the bed while sleeping (B)</p> Signup and view all the answers

What is the correct nursing action for a patient with newly diagnosed cardiogenic shock?

<p>Monitor IV fluid orders closely (A)</p> Signup and view all the answers

For a patient with hypotensive shock, which action is indicated?

<p>Relieve pain effectively (B)</p> Signup and view all the answers

Which of the following interventions is unnecessary for a patient in shock?

<p>Encourage walking exercises (B)</p> Signup and view all the answers

What is the expected initial treatment for a patient in septic shock?

<p>Initiate broad-spectrum antibiotics quickly (C)</p> Signup and view all the answers

Which condition may lead to obstructive shock due to blocked blood flow outside the heart?

<p>Tension pneumothorax (C)</p> Signup and view all the answers

In septic shock, what is a sign often observed during the early phase?

<p>Warm/flushed skin (B)</p> Signup and view all the answers

What is the first priority when managing anaphylactic shock?

<p>Maintain airway patency (D)</p> Signup and view all the answers

Which symptom is specifically associated with cardiogenic shock but not with hypovolemic shock?

<p>Pulmonary edema (D)</p> Signup and view all the answers

Which of the following can be a potential cause of neurogenic shock?

<p>Brain contusion (A)</p> Signup and view all the answers

What are common early signs of septic shock?

<p>Elevated white blood cells and fever (D)</p> Signup and view all the answers

Which symptom can occur in anaphylactic shock indicating an airway obstruction?

<p>Laryngeal edema (D)</p> Signup and view all the answers

In which type of shock is pallor and cool clammy skin particularly noted?

<p>Hypovolemic shock (D)</p> Signup and view all the answers

Which type of shock results from extreme hypersensitivity reaction?

<p>Anaphylactic shock (B)</p> Signup and view all the answers

What is a common consequence of significant fluid loss leading to hypovolemic shock?

<p>Decreased blood pressure (A)</p> Signup and view all the answers

What happens when the compensatory mechanisms in shock fail?

<p>Organ damage and death occur (B)</p> Signup and view all the answers

Which of the following is a common metabolic change observed in shock?

<p>Tachycardia (B)</p> Signup and view all the answers

Which type of shock is characterized by a blockage of blood flow outside the heart?

<p>Obstructive shock (D)</p> Signup and view all the answers

What is a potential complication of shock that may affect the lungs?

<p>Acute respiratory distress syndrome (ARDS) (C)</p> Signup and view all the answers

Which characteristic is common to all forms of shock?

<p>Decreased blood pressure (A)</p> Signup and view all the answers

What is the main cause of distributive shock?

<p>Excessive dilation of venules and arterioles (D)</p> Signup and view all the answers

What physiological response is NOT typically observed in shock?

<p>Increased urine output (C)</p> Signup and view all the answers

What is the effect of the sympathetic nervous system during shock?

<p>Promotion of tachycardia (B)</p> Signup and view all the answers

What is one effect on organ systems when tissue perfusion is inadequate?

<p>Ischemia and potential organ injury (A)</p> Signup and view all the answers

Which component is essential for maintaining tissue perfusion and blood pressure?

<p>Adequate blood volume (A)</p> Signup and view all the answers

What is the primary characteristic that distinguishes malignant neoplasms from benign neoplasms?

<p>Malignant neoplasms invade local tissues uncontrollably. (D)</p> Signup and view all the answers

What is a common method by which malignant cells spread throughout the body?

<p>Metastasis (B)</p> Signup and view all the answers

Which of the following processes contributes to the development of cancer after DNA alteration?

<p>Promotion (A)</p> Signup and view all the answers

Which factor is NOT considered a risk factor for cancer development?

<p>Frequent physical exercise (A)</p> Signup and view all the answers

What type of cancer is primarily associated with lymph tissue?

<p>Lymphoma (D)</p> Signup and view all the answers

Which cancer prevention method focuses on recognizing early signs of cancer?

<p>Early detection (A)</p> Signup and view all the answers

Which of the following is considered a carcinogen?

<p>Sunlight exposure (A)</p> Signup and view all the answers

Which statement best describes 'in situ' cancer?

<p>It remains localized and is hard to detect. (C)</p> Signup and view all the answers

What is the primary purpose of regular screenings such as mammograms and pap smears?

<p>To identify precursors or early stages of cancer (A)</p> Signup and view all the answers

Which dietary recommendation is made to promote cancer prevention?

<p>Consume 2 ½ cups of fruits and vegetables each day (A)</p> Signup and view all the answers

What type of test is considered the only accurate way to identify cancer?

<p>Biopsy (D)</p> Signup and view all the answers

What is the role of PET scans in cancer diagnosis?

<p>To detect abnormal cell growth and assess spread of cancer (D)</p> Signup and view all the answers

How does nuclear imaging assist in cancer diagnosis?

<p>It detects sites of abnormal cell growth (A)</p> Signup and view all the answers

What does Tis indicate in cancer staging?

<p>Carcinoma in situ with no spread (C)</p> Signup and view all the answers

Which of the following is NOT a common diagnostic test for cancer detection?

<p>Physical examination without imaging techniques (A)</p> Signup and view all the answers

Which side effect is commonly associated with radiation treatment?

<p>Xerostomia (dry mouth) (C)</p> Signup and view all the answers

What lifestyle change can significantly reduce the risk of developing cancer?

<p>Smoking cessation (A)</p> Signup and view all the answers

What is the significance of monitoring tumor markers in lab tests?

<p>They help confirm a diagnosis and monitor treatment effects (B)</p> Signup and view all the answers

What is indicated by the 'NX' designation in cancer staging?

<p>Regional lymph nodes cannot be evaluated (C)</p> Signup and view all the answers

Which of the following describes a well differentiated tumor?

<p>Resembles normal tissue (B)</p> Signup and view all the answers

During chemotherapy, what is the significant risk associated with vesicant drugs?

<p>Necrosis if infiltration occurs (B)</p> Signup and view all the answers

What is a common side effect of poorly differentiated tumors?

<p>They contain mostly abnormal cells (D)</p> Signup and view all the answers

Which of the following best describes the role of combinations in chemotherapy?

<p>Timing is crucial for drugs to obtain desired effects (B)</p> Signup and view all the answers

What does an increase in reticulocytes indicate?

<p>Increased levels of immature RBCs due to hypoxia or anemia (B)</p> Signup and view all the answers

Which type of white blood cells is primarily increased during viral infections?

<p>Lymphocytes (A)</p> Signup and view all the answers

When is it likely that eosinophils would be decreased?

<p>During bacterial infections (B)</p> Signup and view all the answers

What condition is associated with an increased level of basophils?

<p>Hyperthyroidism (D)</p> Signup and view all the answers

What happens to hemoglobin levels in cases of anemia or blood loss?

<p>They decrease (B)</p> Signup and view all the answers

Which of the following indicates a response to bacterial infections?

<p>Increased neutrophils (A)</p> Signup and view all the answers

What condition may result in decreased levels of reticulocytes?

<p>RBC maturation defects (D)</p> Signup and view all the answers

Which type of white blood cells is increased in allergic responses?

<p>Eosinophils (B)</p> Signup and view all the answers

What can be a potential cause of secondary polycythemia?

<p>Long-term hypoxia (D)</p> Signup and view all the answers

What is a significant sign of Disseminated Intravascular Coagulation (DIC)?

<p>Joint pain (D)</p> Signup and view all the answers

Which of the following conditions is associated with an acquired bleeding disorder?

<p>Von Willebrand disease (C)</p> Signup and view all the answers

What should be avoided to reduce the risk of decreased tissue perfusion?

<p>Strenuous exercise (D)</p> Signup and view all the answers

What is the primary treatment for managing polycythemia?

<p>Phlebotomy (B)</p> Signup and view all the answers

Which intervention is critical for a patient with Idiopathic Thrombocytopenic Purpura (ITP)?

<p>Monitoring blood platelet levels (D)</p> Signup and view all the answers

What symptom is commonly associated with acute polycythemia?

<p>Itching due to excess mast cells (A)</p> Signup and view all the answers

What is the pathophysiological consequence of Disseminated Intravascular Coagulation (DIC)?

<p>Excessive bleeding due to clotting factor depletion (C)</p> Signup and view all the answers

Which dietary change is recommended to help manage iron deficiency anemia?

<p>Choose foods with high iron content (A)</p> Signup and view all the answers

What is the primary cause of aplastic anemia?

<p>Bone marrow fatty tissue (B)</p> Signup and view all the answers

Which of the following is a common symptom of sickle cell anemia?

<p>Gallstones (C)</p> Signup and view all the answers

What intervention is crucial for managing a patient with aplastic anemia?

<p>Minimize exposure to infections (C)</p> Signup and view all the answers

Which test helps in diagnosing sickle cell anemia?

<p>Sickle Dex test (B)</p> Signup and view all the answers

What symptom is most likely associated with a crisis in sickle cell anemia?

<p>Severe chest pain (D)</p> Signup and view all the answers

What is a potential consequence of untreated aplastic anemia?

<p>Multiple organ failure (C)</p> Signup and view all the answers

Which intervention should be avoided in a patient with aplastic anemia?

<p>Exposure to infections (D)</p> Signup and view all the answers

What is the highest priority action for a nurse managing a patient experiencing anaphylactic shock?

<p>Maintain patient's airway (B)</p> Signup and view all the answers

Which of the following symptoms is typically observed in the later phase of septic shock?

<p>Cold and clammy skin (C)</p> Signup and view all the answers

What is a common precursor condition that may lead to septic shock?

<p>Corticosteroid therapy (A)</p> Signup and view all the answers

Which class of drugs is typically administered in anaphylactic shock to counteract severe allergic reactions?

<p>Epinephrine (A)</p> Signup and view all the answers

In neurogenic shock, which of the following symptoms might be present?

<p>Bradycardia (A)</p> Signup and view all the answers

Which type of shock is a leading cause of death in critically ill patients due to its severe effects on the body?

<p>Septic shock (D)</p> Signup and view all the answers

Regarding therapeutic measures for shock, which intervention is not commonly performed?

<p>Administer sedatives to calm the patient (C)</p> Signup and view all the answers

What describes the typical skin characteristics observed in a patient experiencing early septic shock?

<p>Warm and flushed skin (D)</p> Signup and view all the answers

What is the recommended position for a patient using an incentive spirometer?

<p>Sitting upright at 45 degrees (D)</p> Signup and view all the answers

How often should the patient perform deep breathing exercises post-operation?

<p>Every hour while awake (A)</p> Signup and view all the answers

What is the primary purpose of coughing and splinting the incision with a pillow post-operatively?

<p>To prevent pneumonia (B)</p> Signup and view all the answers

What is a critical component of pre-operative patient care regarding consent?

<p>Ensuring no coercion occurs during consent (B)</p> Signup and view all the answers

What should a nurse do if a patient expresses extreme anxiety before surgery?

<p>Involve the surgeon to address their fears (B)</p> Signup and view all the answers

Which items should be removed from a patient before surgery as part of the pre-operative checklist?

<p>Denture, contact lenses, and metal items (B)</p> Signup and view all the answers

What best describes the nurse's role when witnessing the signing of a consent form?

<p>Ensuring the patient or authorized person understands the consent (C)</p> Signup and view all the answers

Which statement accurately reflects the use of pain medication in relation to coughing post-operatively?

<p>Pain medication should be provided before coughing (D)</p> Signup and view all the answers

What is the role of the circulating nurse during a surgical procedure?

<p>Maintains a sterile environment and oversees the scrub person (C)</p> Signup and view all the answers

What is a primary complication associated with malignant hyperthermia?

<p>Muscle rigidity (C)</p> Signup and view all the answers

Which nursing action is crucial for airway management in the post-operative phase?

<p>Position the patient on their side or with head turned (C)</p> Signup and view all the answers

Which significant sign indicates the possibility of malignant hyperthermia during surgery?

<p>High fever (C)</p> Signup and view all the answers

What is the primary focus of a nurse caring for a patient who has received IV conscious sedation?

<p>Maintain constant monitoring and have emergency equipment available (B)</p> Signup and view all the answers

What should be the immediate action when a patient displays symptoms of malignant hyperthermia?

<p>Stop surgery and discontinue anesthesia (C)</p> Signup and view all the answers

Which statement best describes the duties of the scrub nurse in the intra-operative phase?

<p>Maintains sterile technique and manages surgical instruments (A)</p> Signup and view all the answers

What complication might a patient experience if they have low respiratory function post-surgery?

<p>Hypoventilation (C)</p> Signup and view all the answers

What is the primary goal of nurses in the context of surgical procedures?

<p>To identify and implement actions that reduce surgical risk factors (A)</p> Signup and view all the answers

Which factor is NOT considered when assessing surgical outcomes?

<p>Patient's favorite food (D)</p> Signup and view all the answers

What is the purpose of preoperative education for surgical patients?

<p>To teach patients about post-op care and special preparations (D)</p> Signup and view all the answers

Which is an essential consideration for a patient with a lung disorder prior to surgery?

<p>To avoid smoking 24 hours before surgery (B)</p> Signup and view all the answers

What is the key aspect of postoperative care that nurses should focus on?

<p>Monitoring respiratory function and pain control (C)</p> Signup and view all the answers

What is the significance of the pre-admission surgical patient assessment?

<p>To gather health history and risk factors for surgical procedures (C)</p> Signup and view all the answers

What should a patient be instructed to do regarding medication on the day of surgery?

<p>Only take medications specified by the surgical team with a small amount of water (C)</p> Signup and view all the answers

What is one of the perioperative phases that occurs directly before the patient goes to surgery?

<p>Pre-operative phase (C)</p> Signup and view all the answers

Which nursing action helps promote circulation in a post-operative patient?

<p>Administer anti-embolus stockings (A)</p> Signup and view all the answers

What is a key assessment for detecting complications following surgery?

<p>Monitoring skin color and temperature (B)</p> Signup and view all the answers

Which of the following interventions can help manage post-operative nausea and vomiting?

<p>Administering antiemetics and providing mouth care (D)</p> Signup and view all the answers

What vital sign changes should a nurse closely monitor in a post-operative patient?

<p>Increased pulse and decreased urinary output (B)</p> Signup and view all the answers

When promoting comfort for a post-operative patient, which nursing action is most effective?

<p>Grouping treatments and using music for distraction (A)</p> Signup and view all the answers

What should be the primary focus during the initial post-operative assessment?

<p>Checking the airway and respiratory status (B)</p> Signup and view all the answers

Which nursing action is appropriate for a patient at risk of hypovolemic shock?

<p>Monitor strict intake and output of fluids (B)</p> Signup and view all the answers

Which factor is critical in assessing the neurological function of a post-operative patient?

<p>Level of consciousness and orientation (A)</p> Signup and view all the answers

What is the most common problem after surgery regarding urinary function?

<p>Urinary retention (B)</p> Signup and view all the answers

Which intervention can help shorten the duration of paralytic ileus post-surgery?

<p>Early ambulation (D)</p> Signup and view all the answers

What distinguishes second intention wound healing from first intention?

<p>Delayed closure due to tissue necrosis (D)</p> Signup and view all the answers

In which scenario would a healthcare provider most likely need to contact a physician regarding urinary output?

<p>If the patient has not voided for 10 hours (B)</p> Signup and view all the answers

What should be done if a surgical wound exhibits signs of dehiscence?

<p>Contact the physician (C)</p> Signup and view all the answers

Which condition is NOT typically an interference with wound healing?

<p>Increased fluid intake (B)</p> Signup and view all the answers

What is one of the risks associated with administering Alvimopan for post-operative recovery?

<p>Myocardial infarction (B)</p> Signup and view all the answers

How should a nurse proceed with the removal of sutures from a long incision?

<p>Remove every other suture starting with the second (D)</p> Signup and view all the answers

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