Quiz 49: Shock, Multiple Organ Dysfunction Syndrome, and Burns in Children
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1. What is the most common type of shock in children?
a. Hypovolemic c. Neurogenic
b. Cardiogenic d. Septic
2. Hypotension is likely to occur when an infant or child is greater than _____ % dehydrated.
a. 2 c. 7
b. 5 d. 10
3. A prolonged capillary refill time in children is consistent with the development of what type of shock?
a. Hypovolemic c. Compensated
b. Septic d. Cardiogenic
4. Bradycardia in young children experiencing shock symptoms often suggests which result?
a. Onset of cardiac dysfunction
b. Effective management of cardiac dysfunction
c. Good management of anxiety
d. Cardiovascular collapse
5. What is the cause of appropriately 50% of the deaths in children who have experienced a burn injury?
a. Immunosuppression c. Inhalation injury
b. Hypermetabolism d. Hypertrophic scarring
6. In cardiogenic shock, what is the cause of hepatomegaly and periorbital edema?
a. Mass vasodilation as a result of chemical mediators released from the myocardium
b. Low cardiac output, causing a high central venous pressure
c. Tissue damage to the myocardium, causing increased capillary permeability
d. Low perfusion of the kidneys, stimulating the renin-angiotensin-aldosterone system to retain sodium and water
7. Approximately 80% of all hospital-acquired infections in children are a result of which type of organism?
a. Bacteria c. Fungi
b. Viruses d. Rickettsia
8. Which cytokines are antiinflammatory mediators?
a. Interleukin (IL)–1, IL-6, and tumor necrosis factor–alpha (TNF-)
b. IL-8, IL-12, and platelet-activating factor
c. IL-24, arachidonic acid metabolites, and nitric oxide
d. IL-4, IL-11, and colony-stimulating factor
9. What type of injury is associated with cellular injury caused by the restoration of blood flow and physiologic concentrations of oxygen to cells that have been exposed to injurious but nonlethal hypoxic conditions?
a. Hypoxic c. Reperfusion
b. Hyperoxygenation d. Ischemic
10. What are the primary goals for the treatment of shock?
a. Maximizing oxygen delivery and minimizing oxygen demand
b. Maintaining hydration and adequate urinary output
c. Supporting all facets to the cardiovascular system
d. Maintaining all vital signs within normal functioning ranges
11. To determine a child’s response to fluid therapy for shock, the nurse should monitor ______________________.
a. Hematocrit and hemoglobin levels c. Blood pressure and pulse
b. Urine output and specific gravity d. Arterial blood gases and heart rate
12. For children who are experiencing shock, crystalloids and colloids are generally administered in boluses of how many milliliters per kilogram (ml/kg)?
a. 5 c. 15
b. 10 d. 20
13. As the result of the inability to concentrate urine, children are at risk for dehydration before which age?
a. 2 years c. 6 years
b. 4 years d. 8 years
14. What causes renal failure after electrical burns in children?
a. Cytokines are released after the damaged tissue.
b. Immature kidneys are unable to compensate for the electrical burn.
c. Cardiac output is reduced.
d. Myoglobin is released from damaged muscles.
15. Compared with the ebb phase, characteristics of the catabolic flow phase in metabolism after a burn injury in a child include which process?
a. Reduced oxygen consumption c. Impaired circulation
b. Elevation of catecholamines d. Cellular shock
16. What advantage do impregnated silver dressings have for patients with burn injuries?
a. Impregnated silver dressings contain natural-occurring collagens.
b. They require only one dressing change every other day.
c. Removal is less painful.
d. Impregnated silver dressings are cost effective.
17. What is the most serious outcome resulting from limited glycogen stores in children who have been seriously burned?
a. Poor wound healing c. Decreased immunity
b. Increased morbidity d. Loss of adipose tissue stores
18. What is the normal range of respirations for an infant (in breaths per minute)?
a. 18 to 25 c. 27 to 37
b. 20 to 28 d. 30 to 53
19. While awake, what is the normal heart rate for toddlers (in beats per minute)?
a. 100 to 205 c. 98 to 140
b. 100 to 180 d. 80 to 120
20. Which statements are true regarding multiple organ dysfunction syndrome (MODS)? (Select all that apply.)
a. Diagnosis requires simultaneous failure of at least two organs.
b. Primary MODS occurs immediately after the attributing cause.
c. Secondary MODS occurs within 3 to 7 days of the initial insult.
d. Chronic illness increases a child’s risk for MODS.
e. Risk factors for MODS include severe or prolonged shock, sepsis, and trauma.
21. The child with septic shock has significant hypovolemia that typically responds to which interventions? (Select all that apply.)
a. Aggressive fluid administration
b. Antibiotic therapy
c. Titration of inotropes
e. High caloric nasogastric feedings
22. Which behaviors in newborns would support the possibility of shock? (Select all that apply.)
a. Decreased heart rate variability
b. Temperature instability
d. Increased muscle tone
23. Which assessment finding would be recognized as a late sign of shock in a child? (Select all that apply.)
a. Metabolic (lactic) acidosis
b. Cool skin
d. Prolonged capillary refill
24. Which statements are true regarding how a child’s body compensates for cardiogenic shock? (Select all that apply.)
a. Splanchnic arteries are constricted to divert blood from the skin, kidneys, and gut to the heart and brain.
b. Peripheral blood vessels are constricted to raise blood pressure.
c. Adrenergic responses produce tachycardia to increase cardiac output.
d. The renin-angiotensin-aldosterone system is stimulated when renal function decreases.
e. Compensation prevents the child from developing hepatic or mesenteric failure.
25. What considerations must the nurse take into account when assessing the severity of a burn injury? (Select all that apply.)
a. Amount of fluid lost over a 24-hour period
b. Circumference of the burn injury
c. Depth of the burn injury
d. Severity of the injury caused to other body systems
e. Percentage of total body surface area involved
Match the terms with the corresponding descriptions.
______ A. Scald burn
______ B. Contact burn
______ C. Flame burn
______ D. Electrical burn
______ E. Chemical burn
26. Involves flammable liquids such as gasoline.
27. Is caused by hot grease.
28. Is the result of direct contact with high- and low-voltage current.
29. Is caused by a corrosive agent.
30. Involves cigarette burns and curling irons.