In neurogenic shock:

Vasoconstriction occurs as a result of a loss of balance between parasympathetic and sympathetic stimulation.

Vasodilation occurs as a result of a loss of balance between parasympathetic and sympathetic stimulation.

Caused by the sudden increase of signals from the sympathetic nervous system that maintain the normal muscle tone in blood vessel walls.

Caused by the sudden loss of signals from the parasympathetic nervous system

Answer and Explanation

The Correct Answer is B

Rationale:

A. In neurogenic shock, sympathetic input is lost, so blood vessels cannot constrict effectively, leading to vasodilation rather than vasoconstriction.

B. Neurogenic shock is a type of distributive shock caused by sudden loss of sympathetic tone. The parasympathetic nervous system remains unopposed, resulting in peripheral vasodilation, hypotension, and often bradycardia. Because the vessels are dilated, blood pools in the periphery, reducing venous return to the heart and causing decreased cardiac output. Common causes include spinal cord injury (typically above T6), severe traumatic brain injury, or spinal anesthesia.

C. Neurogenic shock is not due to increased sympathetic activity. In fact, it is the loss of sympathetic stimulation that leads to shock.

D. The parasympathetic nervous system is not lost; it remains active and unopposed, contributing to bradycardia and vasodilation.

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Correct Answer is D

Explanation

Rationale:
A. Prescription drugs, untreated pain is incorrect because certain medications (e.g., sedatives, opioids, anticholinergics) and untreated pain are well-known contributors to delirium. These factors can affect neurotransmitter balance and precipitate acute cognitive changes.

B. Dehydration, dementia, stress, infection is incorrect because fluid and electrolyte imbalances, pre-existing cognitive impairment, physiologic stress, and infections are all common triggers for delirium, particularly in older adults or critically ill patients.

C. Unfamiliar environment is incorrect because environmental changes, sensory overload or deprivation, and disorientation can precipitate delirium, especially in hospitalized or ICU patients.

D. Over-the-counter medications, stable environment, no change in health status is correct because in the absence of physiological or pharmacological stressors, delirium is unlikely to occur. A stable environment and no changes in health status do not contribute to delirium, and typical over-the-counter medications taken safely rarely induce acute cognitive changes.

A. Potassium 3.8 mEq/L B. Sodium 140 mEq/L C. Creatinine 1.0 mg/dl D. Lactate 6 mmol/L

Correct Answer is D

Explanation

Rationale:

A. Potassium 3.8 mEq/L is incorrect because this value is within the normal reference range of 3.5–5.0 mEq/L. While potassium should continue to be monitored—especially in critically ill patients due to risks of hypokalemia or hyperkalemia from fluid shifts or medications—this reading does not indicate an immediate complication or urgent need for intervention.

B. Sodium 140 mEq/L is incorrect because it falls within the normal serum sodium range of 135–145 mEq/L. This value suggests that the recent fluid administration has not caused significant electrolyte imbalance, and no immediate action is required.

C. Creatinine 1.0 mg/dl is incorrect because this is within the normal range (approximately 0.6–1.3 mg/dL) and does not indicate acute kidney injury at this time. While renal function must be monitored in septic patients due to the risk of acute kidney injury from hypoperfusion, this value alone is not alarming.

D. Lactate 6 mmol/L is correct because an elevated lactate level in a patient with severe sepsis is a critical indicator of tissue hypoperfusion, anaerobic metabolism, and possibly septic shock, even after aggressive fluid resuscitation. Normal lactate levels are <2 mmol/L, and levels >4 mmol/L are associated with high mortality risk.

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In neurogenic shock:

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Naxlex Comprehensive Predictor Exams

Causes of delirium include all of the following except:

Correct Answer is D

Explanation

The nurse has just completed an infusion of a 1000 ml bolus of 0.9% normal saline in a patient with severe sepsis. One hour later, which laboratory result requires immediate nursing action?

Correct Answer is D

Explanation

Which intervention about visitation in the critical care unit is consistent with current trends by professional organizations?

Which lab value does the nurse reassess related to a patient's nutritional care plan?

The patient is admitted with end-stage liver disease. Which of the following would the nurse NOT expect to find upon evaluation?

Which finding(s) would the nurse expect to assess on a patient with a diagnosis of diabetic ketoacidosis (DKA) recently admitted to the emergency department? (Select all that apply)

Which patient being cared for in the emergency department does the nurse identify as most at risk for developing hypovolemic shock?