Holland/Adams/Brice, Core Concepts in Pharmacology 5th Edition Test Bank
Chapter 22

Question 1

Type: MCSA

If the client is entering hypovolemic shock, the nurse anticipates which item to be a priority?

1. Maintenance of the airway
2. Maintenance of heart rate
3. Maintenance of brain tissue
4. Maintenance of volume

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 347

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 22-1 Compare and contrast the different types of shock.

Question 2

Type: MCMA

The nurse is providing care to a client who is experiencing an allergic reaction. What initial, usual responses of the body to an antigen does the nurse anticipate? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

1. Swelling of the larynx
2. Itching with development of hives
3. Release of histamine and mast cells
4. Inflammation production
5. Antibody production

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 353

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 22-1 Compare and contrast the different types of shock.

Question 3

Type: MCSA

A client presents with shock in the hospital, and has a history of a recent infection. What does the nurse suspect that this client is experiencing?

1. Septic shock
2. Hypovolemic shock
3. Cardiogenic shock
4. Neurogenic shock

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 347

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 22-1 Compare and contrast the different types of shock.

Question 4

Type: MCSA

What is the earliest sign of shock that the nurse would monitor for during a routine assessment?

1. Complaints of nausea
2. Complaints of thirst
3. Restlessness
4. Pale skin

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 347

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 22-1 Compare and contrast the different types of shock.

Question 5

Type: MCSA

The nurse is performing an assessment on a client who is experiencing shock. What metabolic findings would the nurse expect?

1. Rapid, shallow respiratory effort
2. Restlessness, anxiety, and confusion
3. Low temperature and thirst
4. Tachycardia and hypotension

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 348

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 22-1 Compare and contrast the different types of shock.

Question 6

Type: MCSA

The nurse is treating a client who has been diagnosed with shock. What is the first step in treating this client?

1. Medications to counteract the sequelae
2. Basic life support
3. Blood and/or blood products
4. Fluid replacement

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Page Number: 348

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 22-2 Explain the initial treatment of a patient with shock.

Question 7

Type: MCSA

The nurse is caring for a client who is experiencing anaphylaxis. The family asks the nurse why the client is having difficulty breathing. The nurse responds based on what knowledge?

1. Reflex tachycardia
2. Compensation for a rapid fall in blood pressure
3. Seizures are likely to occur
4. Bronchoconstriction in response to the allergen

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 353

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 22-2 Explain the initial treatment of a patient with shock.

Question 8

Type: MCMA

The nurse is caring for a client who is experiencing shock. Which fluid replacement agents does the nurse anticipate will be used when providing care? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

1. Crystalloids
2. Colloids
3. Water
4. Blood products
5. Oral electrolyte replacement solutions

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 349

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 22-3 Compare and contrast the use of blood products, colloids, and crystalloids in the pharmacotherapy of shock.

Question 9

Type: MCSA

The nurse is preparing to administer a crystalloid IV to a client. Which IV fluid is a crystalloid?

1. Dextran
2. Fresh frozen plasma
3. Hetastarch (Hespan)
4. Lactated Ringer’s

Cognitive Level: Understanding

Client Need: Physiological Integrity

Page Number: 350

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 22-3 Compare and contrast the use of blood products, colloids, and crystalloids in the pharmacotherapy of shock.

Question 10

Type: MCSA

A client has not responded to IV fluids to raise blood pressure for acute shock. Which medication does the nurse anticipate will be ordered?

1. Whole blood
2. Additional crystalloids
3. Vasodilators
4. Vasopressors

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 352

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 22-4 Identify the rationale for administering vasoconstrictors to patients experiencing shock.

Question 11

Type: MCSA

The nurse is administering norepinephrine (Levophed) to a client in shock. What is the most appropriate rationale for administering this medication?

1. To produce vasoconstriction
2. To cause bradycardia and reserve heart function
3. To increase urine output
4. To cause the heart’s conduction system to work more effectively

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 352

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 22-4 Identify the rationale for administering vasoconstrictors to patients experiencing shock.

Question 12

Type: MCMA

The nurse is preparing to administer dopamine (Dopastat) for a client who is experiencing cardiogenic and hypovolemic shock. Which effects does the nurse anticipate will occur? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

1. Vasoconstriction
2. Increased renal blood flow
3. Hypotension
4. Increased cardiac output
5. Decreased heart rate

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 353

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 22-5 Identify the rationale for administering inotropic drugs to patients experiencing shock.

Question 13

Type: MCSA

Which vasoconstrictor is usually associated with the treatment of anaphylaxis?

1. Norepinephrine (Levophed)
2. Epinephrine (Adrenalin)
3. Dopamine (Dopastat)
4. Dobutamine (Dobutrex)

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 354

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 22-6 Identify drugs used in the pharmacotherapy of anaphylaxis.

Question 14

Type: MCSA

The nurse is providing care to a client who is experiencing symptoms of life-threatening shock. Which drug does the nurse anticipate to administer to this client?

1. Corticosteroids
2. Epinephrine
3. Antihistamines
4. Calcium channel blockers

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 352

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 22-2 Explain the initial treatment of a patient with shock.

Question 15

Type: MCSA

A client is receiving norepinephrine (Levophed). The nurse knows vital signs must be continually monitored to watch for which effect?

1. Hypertension
2. Bradypnea
3. Oliguria
4. Tachycardia

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 352

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 22-4 Identify the rationale for administering vasoconstrictors to patients experiencing shock.

Question 16

Type: MCMA

A client presents with anaphylaxis. What treatment options are likely to be administered to this client? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

1. Oxygen
2. Albuterol (Ventolin)
3. Aspirin (ASA)
4. Diphenhydramine (Benadryl)
5. Acetaminophen (Tylenol)

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Numbers: 354–355

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 22-6 Identify drugs used in the pharmacotherapy of anaphylaxis.

Question 17

Type: MCSA

The nurse is treating a client who is experiencing cardiac symptoms of shock. Which medication does the nurse anticipate because of its ability to increase the force of myocardial contraction?

1. Crystalloids
2. Colloids
3. Inotropic drugs
4. Vasopressors

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 353

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 22-5 Identify the rationale for administering inotropic drugs to patients experiencing shock.

Question 18

Type: MCSA

At low doses, which inotropic medication selectively increases blood flow to the kidneys?

1. Dopamine (Dopastat)
2. Dobutamine (Dobutrex)
3. Digoxin (Lanoxin)
4. Norepinephrine (Levophed)

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 352

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 22-5 Identify the rationale for administering inotropic drugs to patients experiencing shock.

Question 19

Type: MCSA

The nurse is caring for a client who is receiving albumin (Albuminar). The nurse anticipates the need to monitor for an excess of what substance?

1. Protein
2. Sodium
3. Calcium
4. Potassium

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 350

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 22-3 Compare and contrast the use of blood products, colloids, and crystalloids in the pharmacotherapy of shock.

Question 20

Type: MCSA

The nurse is preparing to administer IV fluids to her client. The client has been ordered a colloid fluid. Which fluid order should the nurse question?

1. Plasma protein fraction (Plasmanate)
2. Dextran 40 (Gentran 40)
3. Platelets
4. Albumin (Albuminar)

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 350

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 22-3 Compare and contrast the use of blood products, colloids, and crystalloids in the pharmacotherapy of shock.

Question 21

Type: MCSA

Which of the following IV fluids is not a crystalloid?

1. Plasma protein fraction (Plasmanate)
2. Lactated Ringer’s
3. Normal saline (0.9% sodium chloride)
4. Hypertonic saline (3% sodium chloride)

Cognitive Level: Applying

Client Need: Physiological Integrity

Page Number: 350

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 22-3 Compare and contrast the use of blood products, colloids, and crystalloids in the pharmacotherapy of shock.