Shock can result from all of the following except:

decreased blood volume

decreased size of capillary bed

inadequate cardiac output

third spacing

Answer and Explanation

The Correct Answer is B

Rationale:
A. Decreased blood volume is a primary cause of hypovolemic shock. When the body loses blood or plasma, there is insufficient circulating volume to perfuse tissues, leading to cellular hypoxia and organ dysfunction. Causes include hemorrhage, severe dehydration, or fluid loss from burns, all of which reduce oxygen delivery to vital organs.

B. Decreased size of the capillary bed does not cause shock. Shock occurs due to inadequate oxygen delivery to tissues, which results from reduced circulating volume, pump failure, or abnormal distribution of blood (as in distributive shock). While local perfusion might be affected if capillary beds are altered, systemic shock is not triggered simply by a reduction in capillary size. Shock depends on the overall ability of the circulatory system to deliver oxygen to cells, not the anatomical size of capillary networks.

C. Inadequate cardiac output is the hallmark of cardiogenic shock. When the heart cannot pump effectively, perfusion to tissues declines, leading to cellular hypoxia, lactic acidosis, and organ dysfunction. Causes include myocardial infarction, severe heart failure, or arrhythmias that compromise stroke volume.

D. Third spacing occurs when fluid shifts from the intravascular space into interstitial or “third” spaces, as seen in burns, pancreatitis, or severe sepsis. This effectively decreases circulating blood volume, reduces tissue perfusion, and can precipitate hypovolemic-type shock, even though total body fluid may be normal or elevated.

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Free Nursing Study Resources

Correct Answer is A

Explanation

Rationale:
A. An escharotomy is a surgical procedure in which incisions are made through the eschar (the rigid, burned tissue) to relieve pressure, restore circulation, and prevent compartment syndrome. This is often necessary in circumferential burns of the extremities or chest where swelling under the inelastic eschar can compromise blood flow and tissue perfusion. The statement accurately explains the purpose and method of the procedure.

B. Placing the client in a shower and removing dead tissue describes hydrotherapy or debridement, not an escharotomy. While debridement is important in burn care, it does not address circulation issues caused by tight eschar.

C. Removing healthy skin and grafting it over burned areas describes a skin graft procedure, not an escharotomy. Skin grafting is typically performed after the wound is stabilized and infection risk is controlled.

D. Non-surgical removal of dead tissue also refers to conservative debridement, which is different from an escharotomy. Escharotomy is surgical and emergent when circulation is compromised.

A. Additional pain medication may be needed because of rapid body metabolism. B. Pain medication should be given before procedures such as debridement, dressing changes, and hydrotherapy. C. Patients with a history of drug and alcohol abuse may require higher doses of pain medication. D. The intramuscular route is preferred for pain medication administration.

Correct Answer is ["A","B","C"]

Explanation

Rationale:
A. Additional pain medication may be needed because of rapid body metabolism is correct. Burn patients often have a hypermetabolic state that accelerates drug metabolism, which can reduce the duration and effectiveness of analgesics, necessitating more frequent or higher doses.

B. Pain medication should be given before procedures is correct because procedures such as debridement, dressing changes, and hydrotherapy are extremely painful. Administering analgesics preemptively helps reduce procedural pain and anxiety.

C. Patients with a history of drug and alcohol abuse may require higher doses is correct because these patients often have tolerance to opioids or other analgesics, meaning standard doses may be insufficient to achieve adequate pain control.

D. The intramuscular route is preferred is incorrect because intramuscular absorption is unreliable in burn patients, particularly those with extensive burns or poor perfusion. The intravenous route is preferred for rapid, reliable pain control, especially during the acute and procedural phases.

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Shock can result from all of the following except:

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Naxlex Comprehensive Predictor Exams

A nurse in a burn treatment center is caring for a client who is admitted with severe burns to both lower extremities and is scheduled for an escharotomy. The client's spouse asks the nurse what the procedure entails. Which of the following nursing statements is appropriate?

Correct Answer is A

Explanation

Which of the following statements about the pain management of a burn victim are true (select all that apply)?

Correct Answer is ["A","B","C"]

Explanation

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The nurse in trauma unit has received report on a client who has multiple injuries following a motor vehicle crash. Which of the following actions should the nurse plan to take first?

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A nurse is monitoring the fluid replacement of a client who has sustained burns. The nurse should administer which of the following fluids in the first 24 hr following a burn injury?