The nurse is caring for a client in the emergency room who has been diagnosed with shock. The client has a history of an abscessed tooth that has not yet been removed. Which type of shock does the nurse suspect?
Septic
Obstructive
Cardiogenic
Hypovolemic
The Correct Answer is A
A. Septic is correct because an abscessed tooth is a localized bacterial infection. If untreated, bacteria can enter the bloodstream and lead to systemic infection and sepsis. Sepsis can progress to septic shock, which is characterized by widespread vasodilation, increased capillary permeability, hypotension, and poor tissue perfusion. A dental abscess is a known source of bacteremia and systemic infection.
B. Obstructive is incorrect because obstructive shock occurs when there is a physical obstruction to blood flow, such as in pulmonary embolism, cardiac tamponade, or tension pneumothorax. An abscessed tooth does not cause mechanical obstruction of circulation.
C. Cardiogenic is incorrect because cardiogenic shock results from the heart’s inability to pump effectively, often due to myocardial infarction or severe heart failure. There is no indication of cardiac pump failure related to a dental abscess.
D. Hypovolemic is incorrect because hypovolemic shock occurs due to significant blood or fluid loss, such as hemorrhage, vomiting, diarrhea, or burns. An abscess does not directly cause volume depletion.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. The Rapid Shallow Breathing Index (RSBI) is calculated as the ratio of respiratory rate to tidal volume (in liters). An RSBI <105 is generally considered favorable for weaning. A value of 85 indicates the patient is breathing efficientlyand may be ready to wean.
B. Negative inspiratory force measures inspiratory muscle strength. Values more negative than -20 to -30 cm H2O are considered adequate. A NIF of -28 cm H2O indicates sufficient inspiratory strengthfor spontaneous breathing.
C. A tidal volume ≥5 mL/kg is generally acceptable for weaning. A value of 6 mL/kg indicates adequate ventilationduring spontaneous breathing trials.
D. A FiO2 >40% to maintain adequate oxygen saturation indicates ongoing oxygenation impairment, suggesting the client may not yet be ready for weaning. Successful weaning usually requires an FiO2 ≤40% and PEEP ≤5 cm H2O to maintain SpO2 ≥90–92%, ensuring the lungs can sustain oxygenation without excessive support.
Correct Answer is A
Explanation
A. The primary goal of administering hydromorphone IVis to relieve severe pain. A decrease in the pain score from 8/10 to 3/10 indicates that the analgesic intervention has been effective, allowing improved comfort and potentially better respiratory effort.
B. While reduced anxiety may occur as a secondary effectof pain relief, it is not a direct measureof the effectiveness of the opioid analgesic. Anxiety reduction alone does not confirm pain control.
C. Although maintaining a normal respiratory rate is important, opioids can depress respirations. The rate of 16 may reflect adequate breathing, but it does not directly measure pain relief. The client could still be in pain despite a normal respiratory rate.
D. Improvement in oxygenation may occur as a result of better ventilation after pain control, but it is an indirect indicator. PaO2 can be influenced by factors other than pain, such as the pneumothorax or underlying lung injury, so it does not confirm analgesic effectiveness.
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