Saudi Prometric Nursing Critical Care Nursing 2

Question 1

A patient develops hypotension, tachycardia, warm flushed skin, and a widened pulse pressure following a severe anaphylactic reaction. This presentation is most characteristic of:

Accepted Answer

Distributive shock

Answer

Distributive shock, as seen in anaphylaxis, is caused by massive vasodilation leading to a relative hypovolemia with warm skin and widened pulse pressure.

Question 2

According to current Surviving Sepsis Campaign guidelines, which fluid is recommended as first-line resuscitation for a patient in septic shock?

Accepted Answer

Crystalloid solution at 30 mL/kg

Answer

Current guidelines recommend 30 mL/kg of crystalloid (normal saline or lactated Ringer's) within the first 3 hours of sepsis recognition as the first-line resuscitation fluid.

Question 3

A patient remains hypotensive despite receiving 30 mL/kg of IV fluid resuscitation for septic shock. Which vasopressor is the recommended first-line agent?

Accepted Answer

Norepinephrine

Answer

Norepinephrine is the first-line vasopressor for septic shock because its potent alpha-adrenergic activity effectively counteracts the vasodilation characteristic of septic shock.

Question 4

A patient post-cardiac surgery develops hypotension, tachycardia, cool extremities, decreased urine output, and an elevated pulmonary capillary wedge pressure (PCWP) of 22 mmHg. These findings are consistent with:

Accepted Answer

Cardiogenic shock

Answer

Cardiogenic shock is characterized by decreased cardiac output (poor peripheral perfusion) and elevated filling pressures (high PCWP) due to failure of the heart as a pump.

Question 5

A critically ill patient's serum lactate measures 6 mmol/L. The nurse interprets this finding as indicating:

Accepted Answer

Tissue hypoperfusion with anaerobic metabolism

Answer

A serum lactate above 4 mmol/L indicates anaerobic metabolism resulting from inadequate tissue oxygen delivery, which is commonly seen in shock states.

Saudi Prometric Nursing Practice Test

Saudi Prometric Nursing Practice Test

Saudi Prometric Nursing Critical Care Nursing 2