The development of MODS is confirmed in a patient who manifests

a urine output of 30 ml/hr, a BUN of 65 mg/dl, and a WBC of 1120.

upper GI bleeding and a Hct of 25%.

respiratory rate of 45/min, a PaCO2 of 60, and a chest x-ray with bilateral diffuse patchy infiltrates.

an elevated serum amylase and lipase, a serum creatinine of 3.8 mg/dl, and a platelet count of 15,000.

Answer and Explanation

The Correct Answer is D

Rationale:
A. A urine output of 30 mL/hr and an elevated BUN indicate renal impairment, and a WBC of 1120 suggests leukopenia. While concerning, this represents organ dysfunction in one system, not multiple organ systems. MODS requires failure of two or more organ systems.

B. Upper GI bleeding with a low hematocrit reflects gastrointestinal compromise and blood loss, but alone it does not constitute multi-organ dysfunction.

C. Respiratory rate of 45/min, elevated PaCO2, and bilateral infiltrates indicate acute respiratory failure or ARDS, which is dysfunction of the pulmonary system. This represents single-organ failure, not MODS.

D. Elevated serum amylase and lipase (pancreatic injury), a serum creatinine of 3.8 mg/dL (renal failure), and a platelet count of 15,000 (hematologic dysfunction) indicate failure of multiple organ systems. This combination confirms multi-organ dysfunction syndrome (MODS), which typically involves dysfunction of two or more organ systems and is often seen in severe sepsis, trauma, or shock.

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Free Nursing Study Resources

Correct Answer is B

Explanation

Rationale:
A. Anaphylactic shock is incorrect because it typically presents with hypotension, tachycardia, and warm, flushed skin, often accompanied by airway compromise, urticaria, or angioedema. The patient’s bradycardia and mechanism of injury do not support anaphylaxis.

B. Neurogenic shock is correct because the patient has a spinal cord injury (neck injury) with hypotension and bradycardia, and warm, dry skin. Neurogenic shock occurs due to loss of sympathetic tone, leading to vasodilation (causing hypotension) and unopposed parasympathetic activity (causing bradycardia). Skin is warm and dry because there is loss of vasoconstriction and inability to sweat below the injury level.

C. Septic shock is incorrect because septic shock usually presents with hypotension, tachycardia, and warm, flushed skin, often after infection. This patient’s scenario is acute trauma, not infection, and bradycardia is not typical in septic shock.

D. Hypovolemic shock is incorrect because hypovolemic shock is usually associated with tachycardia, hypotension, and cool, clammy skin due to peripheral vasoconstriction. The patient’s warm, dry skin and bradycardia are inconsistent with hypovolemic shock.

A. Age of the client B. Associated medical history C. Location of the burn D. Cause of the burn

Correct Answer is C

Explanation

Rationale:
A. Age of the client is an important consideration in overall prognosis and healing potential, as older adults and very young clients have higher morbidity and mortality from burns. However, age does not take priority over factors that immediately affect airway, breathing, and functional outcomes when determining burn severity.
B. Associated medical history, such as diabetes or cardiovascular disease, can influence healing and risk for complications, but it is a secondary consideration compared with the immediate threat posed by burns in critical areas.
C. Location of the burn is the priority factor when assessing burn severity. Burns involving the face and neck place the client at high risk for airway edema and obstruction, while burns to the upper extremities can significantly affect function. Burns in these critical areas are considered more severe regardless of total body surface area or cause, making location the most important priority.
D. Cause of the burn (thermal, chemical, electrical, or radiation) influences treatment decisions and potential complications, but it is not the primary factor when initially determining severity compared with burn location.

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The development of MODS is confirmed in a patient who manifests

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is B

Explanation

A nurse is assessing the depth and extent of injury on a client who has severe burns to the face, neck, and upper extremities. Which of the following factors is the nurse's priority when assessing the severity of the client's burns?

Correct Answer is C

Explanation

Administering Dopamine (Inotropin) at 2 mcg/kg/minute results in:

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