What is the earliest sign of shock that the nurse would monitor for during a routine assessment?

Restlessness

Pale skin

Complaints of thirst

Complaints of nausea

Answer and Explanation

The Correct Answer is A

A) Restlessness.
Restlessness is often one of the earliest signs of shock. It reflects the body's attempt to compensate for decreased tissue perfusion and oxygen delivery by increasing sympathetic nervous system activity. Restlessness may manifest as agitation, fidgeting, or an inability to sit still. It is an important clinical indicator that suggests impending hemodynamic instability and warrants prompt assessment and intervention.

B) Pale skin:
Pale skin is a common sign of shock, but it may not always be the earliest manifestation. Pale skin typically occurs later in the progression of shock as vasoconstriction occurs, redirecting blood flow away from the skin to vital organs in an attempt to maintain perfusion.

C) Complaints of thirst:
While complaints of thirst may indicate dehydration or fluid loss, they are not typically considered the earliest sign of shock. Thirst usually occurs after the body has already begun to experience fluid deficit and may not be apparent until shock is more advanced.

D) Complaints of nausea:
Nausea may occur in shock due to decreased perfusion to the gastrointestinal tract, but it is not usually the earliest sign. Nausea may develop as shock progresses and metabolic disturbances worsen, but it is often preceded by other symptoms such as restlessness or altered mental status.

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Correct Answer is C

Explanation

A) Theophylline:
Theophylline is a bronchodilator medication that is used for the long-term management of asthma and chronic obstructive pulmonary disease (COPD). It has a slower onset of action compared to short-acting beta-agonists like albuterol and is not typically used as the initial treatment for acute asthma exacerbations.

B) Montelukast:
Montelukast is a leukotriene receptor antagonist used for the long-term control and prevention of asthma symptoms, but it is not typically used as the initial treatment for acute asthma exacerbations. Its onset of action is slower compared to short-acting beta-agonists like albuterol.

C) Albuterol.
Albuterol is a short-acting beta agonist bronchodilator commonly used as a first-line treatment for acute asthma exacerbations. It works by quickly relaxing the smooth muscles of the airways, leading to rapid bronchodilation and improvement of airflow. This can help alleviate the patient's symptoms of shortness of breath and wheezing.

D) Salmeterol:
Salmeterol is a long-acting beta-agonist bronchodilator used for the maintenance treatment of asthma and COPD, but it is not typically used as the initial treatment for acute asthma exacerbations. Its onset of action is slower compared to short-acting beta-agonists like albuterol, and it is not recommended for rapid relief of acute symptoms.

Correct Answer is ["5"]

Explanation

To determine how many hours it will take for the IV pump to infuse the 1000 mL bag of 0.9% sodium chloride at a rate of 200 mL/hr, we can use the following formula:

Time (hr) = Volume (mL)/Rate (mL/hr)

Given:

Volume = 1000 mL

Rate = 200 mL/hr

Substitute the given values into the formula:

Time (hr)=1000 mL/200 mL/hr

Time (hr)=5hours

Rounding to the nearest whole number, the IV pump will infuse over 5 hours.

Therefore, the nurse should expect the IV pump to infuse over 5 hours.

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What is the earliest sign of shock that the nurse would monitor for during a routine assessment?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is C

Explanation

Correct Answer is ["5"]

Explanation

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