Quiz 48: Shock, Multiple Organ Dysfunction Syndrome, and Burns in Adults

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Quiz 48: Shock, Multiple Organ Dysfunction Syndrome, and Burns in Adults

Questions 33
Instructor Verified Answers Included
WarofGrades Guaranteed A+ Graded Tutorial

MULTIPLE CHOICE

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 c. Low respiratory rate
b. Increased white blood cell count d. Hypothermia

3. The release of catecholamine by the adrenal glands compensate for which initial effects of 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 c. 15
b. 10 d. 20

5. What type of shock develops as a result of the overstimulation of the parasympathetic nervous system or the understimulation of the sympathetic nervous system?
a. Septic c. Anaphylactic
b. Cardiogenic d. Vasogenic

6. What is the clinical hallmark of neurogenic shock as a result of the overstimulation of the parasympathetic nervous system?
a. Vasoconstriction c. Increased metabolism
b. Vasodilation d. Respiratory distress

7. Which form of shock is often more severe than other forms because of its sudden, rapid systemic vasodilation?
a. Septic c. Anaphylactic
b. Hypovolemic d. Neurogenic

8. What type of shock is related to a decrease in systemic vascular resistance?
a. Septic c. Hypovolemic
b. Cardiogenic d. Heart failure

9. For which type of shock would antihistamines and corticosteroids be prescribed?
a. Septic c. Hypovolemic
b. Anaphylactic 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 c. Septicemia
b. Sepsis d. Septic shock

11. In septic shock, which mediators are antiinflammatory?
a. Interleukin (IL)–4 (IL-4), IL-10, and IL-13
b. Tumor necrosis factor–alpha (TNF-) and granulocyte cell-stimulating factor
c. IL-1, IL-2, and IL-6
d. Prostaglandin, leukotrienes, and bradykinin

12. What mechanism causes organ injury in primary multiple organ dysfunction syndrome (MODS)?
a. Impaired immune response c. Impaired perfusion
b. Impaired glucose use d. Impaired ventilation

13. In secondary multiple organ dysfunction syndrome (MODS), what stimulates the normal endothelial cells to change to a proinflammatory state?
a. Interleukin (IL)–4 (IL-4) and IL-13
b. IL-1, IL-6, and tumor necrosis factor (TNF)
c. Interferon gamma (IFN-) and granulocyte cell-stimulating factor
d. Prostaglandin, leukotrienes, histamine, and bradykinin

14. 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

15. In multiple organ dysfunction syndrome (MODS), the gut hypothesis attempts to explain which phenomena?
a. Paralytic ileus
b. Translocation of bacteria
c. Maldistribution of blood flow
d. Massive diarrhea accompanying septic shock

16. Blistering of the skin within minutes occurs in which type of burn injury?
a. First degree c. Deep second degree
b. Superficial second degree d. Third degree

17. Which form of shock occurs from an acute burn injury?
a. Hypovolemic c. Cardiogenic
b. Septic d. Vasogenic

18. Which fluid is most often used in fluid resuscitation after a major burn injury?
a. Saline c. Lactated Ringer solution
b. Albumin d. Dextrose in water

19. What is the most reliable criterion of adequate fluid resuscitation after a major burn injury?
a. Blood pressure c. Respiratory rate
b. Pulse rate d. Urine output

20. The endpoint of burn shock is defined as the time when the individual is able to do which of the following?
a. Maintain adequate blood pressure for 4 hours.
b. Maintain adequate urine output for 2 hours.
c. Manage pain without narcotics.
d. Manage pain during dressing changes.

21. Which condition does a burn injury create for an extended period?
a. Hypervolemia c. Hyponatremia
b. Hypermetabolism d. Hypotension

22. What effect does a fatal burn injury have on interleukins (ILs)?
a. Decreases levels of IL-2, which may decrease T helper 1 (Th1) lymphocytes.
b. Decreases levels of IL-4, which causes a shift in production from Th1 to Th2 lymphocytes.
c. Decreases levels of IL-6, which produces cytokines.
d. Decreases levels of IL-12, which stimulates the production of immunoglobulins.

23. Daily evaporative water loss after a burn injury is approximately how many times the normal?
a. 5 c. 15
b. 10 d. 20

24. 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. c. Urinary function is improved.
b. Antibiotic therapy is required. d. They are less at risk for death.

25. What is the purpose of monitoring procalcitonin (PCT) levels in a patient after a burn?
a. To help evaluate the potential risk for respiratory complications
b. To justify the initiation of antibiotic therapy
c. To determine when discontinuing antibiotic use is feasible
d. To help in the selection of appropriate antibiotic therapy agents

26. How many milliliters of fluid replacement per hour does a 70-kg adult with a 50% total body surface area burn and a body surface area of 2 m require?
a. 150 c. 350
b. 275 d. 500

MULTIPLE RESPONSE

27. A patient will be referred to the burn unit when which criteria are met? (Select all that apply.)
a. Patient is older than 5 years of age.
b. The burn involves the face or a major joint.
c. The source of the burn is electrical.
d. Partial thickness burns are on more than 10% of the total body surface area (TBSA).
e. Patient has a life-threatening trauma injury.

28. Which feedback loop will further impair oxygen in all types of shock? (Select all that apply.)
a. Activation of the fibrinolytic cascade
b. Increased circulating volume
c. Hypermetabolic state
d. Lysosomal enzyme release
e. Activation of the clotting cascade

MATCHING

Match the types of shock with the corresponding descriptions. Terms can be used more than once.
______ A. Cardiogenic
______ B. Hypovolemic
______ C. Neurogenic
______ D. Anaphylactic
______ E. Septic

29. Follows a systemic inflammatory response.

30. Follows widespread hypersensitivity reaction.

31. Follows myocardial infarction.

32. Follows major burns.

33. Follows parasympathetic stimulation.

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