Nclex Questions for Shock - Critical Care
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1. What will the nurse identi-
fy as symptoms of hypov-
olemic shock in a patient?
Note: Credit will be given
only if all correct choices
and no incorrect choices
are selected.
Standard Text: Select all
that apply.
1. Temperature of 97.6°F
(36.4°C)
2. Restlessness
3. Decrease in blood pres-
sure of 20 mm Hg when the
patient sits up
4. Capillary refill time
greater than 3 seconds
5. Sinus bradycardia of 55
beats per minute
2. Which laboratory finding
should cause the nurse
to suspect that a patient
is developing hypovolemic
shock?
1. Serum sodium of 130
mEq/L (130 mmol/L)
2. Metabolic acidosis vali-
dated by arterial blood gas-
es
3. Serum lactate of 3
mmol/L
4. SvO2 greater than 80%
Correct Answer: 2,3,4
Rationale 1: Fever will increase oxygen de-
mands but is unrelated to hypovolemic shock
unless prolonged fever has caused severe de-
hydration, reducing the circulating blood vol-
ume. Hypovolemic shock reduces tempera-
tures by peripheral shunting of blood away from
the extremities and reducing the core metabolic
rate.
Rationale 2: Due to decreased blood flow to
the brain and peripheral areas when blood is
shunted to maintain the vital organs, cerebral
hypoxia occurs, leading to a change in mental
status.
Rationale 3: Orthostatic hypotension is a man-
ifestation of hypovolemic shock.
Rationale 4: Due to decreased blood flow to
the brain and peripheral areas when blood is
shunted to maintain the vital organs, capillary
refill time will be reduced.
Rationale 5: Bradycardia is not present. The
compensatory response is to increase the
heart rate to circulate the blood faster to make
up for the fluids that are not present in hypov-
olemic shock.
Correct Answer: 2
Rationale 1: The sodium level in hypovolemic
shock is elevated above the normal values of
135 to 145 mEq/L, not reduced.
Rationale 2: Metabolic acidosis is present due
to an accumulation of carbonic acid, leaving a
bicarbonate deficit from decreased tissue per-
fusion.
Rationale 3: Serum lactate is greater than 4
mmol/L as a result of tissue ischemia, hypoxia,
and breakdown from decreased blood flow with
hypovolemic shock.
Rationale 4: SvO2 (mixed venous oxygen sat-
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 Nclex Questions for Shock - Critical Care
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3. The nurse recognizes that
which patient would be
most likely to develop hy-
povolemic shock? A patient
with:
1. Decreased cardiac out-
put
2. Severe constipation,
causing watery diarrhea
3. Ascites
4. Syndrome of inappropri-
ate ADH (SIADH)
4. Which finding indicates
that a patient is experienc-
ing increased peripheral re-
sistance and vasoconstric-
tion?
1. Strong bounding pulse
with deep red coloring
2. Pale, cool extremities
with decreased pulses
3. Increased venous en-
gorgement with strong
pulses
uration) would be less than 60% due to de-
creased circulating blood volume or decrease
in cells to carry the oxygen. Therefore, O2 is
carried less efficiently and decreased, not in-
creased.
Correct Answer: 3
Rationale 1: Although ECG changes reflect the
effectiveness of the heart's pumping when cir-
culating the blood, it is not a risk factor for
hypovolemic shock, which reflects a decreased
circulating volume from either blood or fluid
losses within the intravascular system.
Rationale 2: Severe constipation does not af-
fect the circulating blood volume.
Rationale 3: Third spacing shifts move the flu-
ids from the intravascular space into the in-
terstitial space, causing a drop in the circulat-
ing blood volume. Therefore, third spacing is a
risk factor for the development of hypovolemic
shock.
Rationale 4: Overhydration does not lead to
hypovolemic shock. It leads to fluid overload,
which might cause cardiogenic shock, conges-
tive heart failure, and pulmonary edema.
Correct Answer: 2
Rationale 1: An increased blood supply would
increase color and bounding pulses as seen
with vasodilation (blood engorgement) and is
not present with increased peripheral resis-
tance and vasoconstriction.
Rationale 2: Increased peripheral resistance
causes the blood supply to decrease and re-
sults in decreased blood to the tissues, which
causes pallor and decreased skin tempera-
tures. The pulses would decrease in intensity
with a decreased blood supply.
Rationale 3: Venous engorgement would not
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4. Faster than normal capil- result from vasoconstriction of the arteries.
lary refill time Strong pulses would not be present with vaso-
constriction from increased peripheral resis-
tance.
Rationale 4: Capillary refill times are delayed
or slowed due to decreased blood flow through
the vessels caused by the vasoconstriction
from increased peripheral resistance.

5. Which solution would be Correct Answer: 2

the most appropriate ini-
tial volume replacement for
a patient with severe GI
bleeding?
1. 200 mL of normal saline
(NS) per hour for 5 hours
2. A liter of Ringer's lactate
(RL) over 15 minutes
3. Two liters of D5W over
half an hour
4. 500 mL of 0.45% normal
saline (1/2 NS) over half an
hour
Rationale 1: This is not an adequate amount of
fluid replacement.
Rationale 2: The patient requires immediate
infusion of an adequate amount of fluid. Fluid
resuscitation begins with 500 to 1,000 mL of an
isotonic solution.
Rationale 3: This is a hypotonic solution and
would not help with fluid resuscitation.
Rationale 4: This is a hypotonic solution and
would not help with fluid resuscitation.

6. Which life-threatening com- Correct Answer: 2,3

plications would the nurse
anticipate developing in the
patient being treated for hy-
povolemic shock?
Note: Credit will be given
only if all correct choices
and no incorrect choices
are selected.
Standard Text: Select all
that apply.
1. Fluid volume overload
2. Renal insufficiency
3. Cerebral ischemia
Rationale 1: Fluid volume overload is not an
identified complication of hypovolemic shock.
Rationale 2: Renal insufficiency is a serious
complication because of the prerenal etiology
of hypovolemia.
Rationale 3: Early identification and correction
of the fluid volume deficit in hypovolemic shock
is necessary to prevent cerebral ischemia.
Rationale 4: Although physiologic stress can in-
crease the risk for the development of stress ul-
cers, it is not considered one of the common or
life-threatening complications of hypovolemic
shock.

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4. Gastric stress ulcer Rationale 5: Pulmonary edema is not an iden-
5. Pulmonary edema tified complication of hypovolemic shock.

7. The nurse, caring for a pa- Correct Answer: 3

tient in hypovolemic shock, Rationale 1: Hypotonic solutions do not cause
will not utilize a hypotonic third spacing.
solution for fluid resuscita- Rationale 2: Hypotonic solutions do not stay in
tion because hypotonic so- the intravascular space long enough to expand
lutions: the circulating blood volume.
1. Move quickly into the Rationale 3: Hypotonic solutions do not stay in
interstitial spaces and can the intravascular space long enough to expand
cause third spacing the circulating blood volume.
2. Stay longer to expand the Rationale 4: The bore size of the needle does
intravascular space but de- not affect the displacement or shifting of fluids.
plete intracellular fluid lev-
els
3. Do not stay in the
intravascular space long
enough to expand the cir-
culating blood volume
4. Need a smaller bore nee-
dle to run at a slower rate
to keep the intravascular
space low

8. The nurse should warm in- Correct Answer: 2

travenous fluids when a
rapid infuser is being uti-
lized to prevent which com-
plication?
1. Hemorrhagic shock
2. Hypothermia
3. Sepsis
4. Cardiogenic shock
Rationale 1: Hemorrhagic shock is caused by a
loss of cells or blood volume and is not a result
of infusing fluids too quickly.
Rationale 2: Hypothermia can result when pro-
viding room temperature fluids at a faster pace
than the body can warm them.
Rationale 3: Bacterial contamination can be
avoided by sterile technique, and sepsis is not
caused by the rate or temperature of the fluid
being administered.
Rationale 4: Cardiogenic shock results from
poor ventricular functioning, not from the tem-

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9. Which finding indicates
that rehydration is com-
plete and hypovolemic
shock has been success-
fully treated in a patient?
1. CVP = 8 mm Hg
2. MAP = 45 mm Hg
3. Urinary output of 0.1
mL/kg/hr
4. Hct = 54%
10. A patient is demonstrat-
ing pulmonary edema, hy-
potension, and delayed
capillary refill. The nurse
suspects the patient is ex-
periencing which type of
shock?
1. Hypovolemic
2. Cardiogenic
3. Anaphylactic
4. Obstructive
11.
perature of the intravenous fluids being admin-
istered too rapidly.
Correct Answer: 1
Rationale 1: A CVP reading of 8 mm Hg is
within normal range and rehydration has been
restored.
Rationale 2: The mean arterial pressure (MAP)
should be between 60 to 70 mm Hg as evi-
dence of positive fluid resuscitation efforts.
Rationale 3: Urinary output to reflect adequate
rehydration begins at 0.5 to 1 mL/kg/hr. There-
fore, 0.1 mL is too small and renal insufficiency
may be present due to inadequate circulating
blood volume.
Rationale 4: Hematocrit (Hct) is the percent-
age of the number of RBCs per fluid volume.
The normal range is 35% to 45% for an adult.
The higher percentage represents a decreased
fluid-to-cell ratio, which implies a fluid deficit
and rehydration is not complete. An Hct of
54% is critical and increases the risk of clots,
strokes, and other vessel obstruction from po-
tential hemolysis and sluggishness of cellular
movements.
Correct Answer: 2
Rationale 1: Pulmonary edema would not be
present in hypovolemic shock.
Rationale 2: In cardiogenic shock, there is a low
cardiac output, hypotension, and pulmonary
edema.
Rationale 3: Pulmonary edema would not be
present in anaphylactic shock.
Rationale 4: Pulmonary edema would not be
present in obstructive shock
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 Nclex Questions for Shock - Critical Care
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A patient, experiencing va-
sodilation, is diagnosed
with distributive shock. The
nurse will assess the pa-
tient for which etiologies?
Note: Credit will be given
only if all correct choices
and no incorrect choices
are selected.
Standard Text: Select all
that apply.
1. Sepsis
2. Spinal cord injury
3. Anaphylaxis
4. Hemorrhage
5. Pulmonary embolism
12. The nurse is concerned that
a patient is at risk for de-
veloping obstructive shock
because of which assess-
ment findings?
Note: Credit will be given
only if all correct choices
and no incorrect choices
are selected.
Standard Text: Select all
that apply.
1. Age 80
2. History of atrial fibrilla-
tion
3. Bacteremia
4. T3 spinal cord injury
5. Latex allergy
13. A patient is experiencing
an anaphylactic reaction to
a medication. The nurse
is concerned that the pa-
Correct Answer: 1,2,3
Rationale 1: One etiology of distributive shock
is sepsis.
Rationale 2: One etiology of distributive shock
is spinal cord injury.
Rationale 3: One etiology of distributive shock
is anaphylaxis.
Rationale 4: Hemorrhage is not an etiology of
distributive shock.
Rationale 5: Pulmonary embolism is not an
etiology of distributive shock.
Correct Answer: 1,2
Rationale 1: Advanced age increases the risk
for development of pulmonary emboli, which is
one cause of obstructive shock.
Rationale 2: Atrial fibrillation increases the risk
for developing pulmonary emboli, which is one
cause of obstructive shock.
Rationale 3: Bacteremia increases a patient's
risk of developing septic shock and not obstruc-
tive shock.
Rationale 4: A spinal cord injury increases the
risk for developing distributive shock and not
obstructive shock.
Rationale 5: A latex allergy increases the risk
for developing distributive shock and not ob-
structive shock.
Correct Answer: 1
Rationale 1: In an anaphylactic reaction leading
to distributive shock, the release of histamine
causes vasodilation with plasma leakage. Va-
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 Nclex Questions for Shock - Critical Care
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tient will develop distribu- sodilation leads to profound hypotension, hy-
tive shock because: povolemia from fluid extravasation, reduced re-
1. The release of histamine load, and reduced cardiac output.
causes vasodilation with Rationale 2: Sympathetic innervation is not in-
plasma leakage. terrupted in an anaphylactic reaction.
2. Sympathetic innervation Rationale 3: Microorganisms do not overwhelm
is interrupted. the vascular system in an anaphylactic reac-
3. Microorganisms over- tion.
whelm the vascular system. Rationale 4: Parasympathetic innervation func-
4. Parasympathetic inner- tioning unopposed is not a characteristic of an
vation functions are unop- anaphylactic reaction.
posed.

14. A patient is diagnosed with Correct Answer: 1

cardiac tamponade. When Rationale 1: Cardiac tamponade can lead to
planning care, the nurse obstructive shock.
will include interventions Rationale 2: Cardiac tamponade will not lead to
to address which type of hypovolemic shock.
shock? Rationale 3: Cardiac tamponade will not lead to
1. Obstructive distributive shock.
2. Hypovolemic Rationale 4: Cardiac tamponade will not lead to
3. Distributive cardiogenic shock.
4. Cardiogenic

15. The nurse, caring for a pa- Correct Answer: 1

tient recovering from an
acute myocardial infarc-
tion, is planning interven-
tions to reduce the risk of
which type of shock?
1. Cardiogenic
2. Hypovolemic
3. Distributive
4. Obstructive
Rationale 1: One etiology of cardiogenic shock
is a myocardial infarction.
Rationale 2: Acute myocardial infarction does
not cause hypovolemic shock.
Rationale 3: Acute myocardial infarction does
not cause distributive shock.
Rationale 4: Acute myocardial infarction does
not cause obstructive shock.

16. A patient with cardiomy- Correct Answer: 1

opathy is demonstrating Rationale 1: In cardiogenic shock, cardiac out-
signs of cardiogenic shock. put is reduced, leading to poor tissue perfu-
The nurse realizes that this sion.

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type of shock is due to: Rationale 2: In cardiogenic shock, stroke vol-
1. Reduced cardiac output ume is decreased.
2. Increased stroke volume Rationale 3: There is not a reduction of blood
3. Reduced blood volume volume in cardiogenic shock.
4. Blood flow blocked in the Rationale 4: There is not a blockage of blood
pulmonary circulation flow through the pulmonary circulation in car-
diogenic shock.

17. The nurse is explaining the Correct Answer: 1,2,3,4,5,6

mechanism of a pulmonary Rationale 1: The obstruction caused by the
embolism to the family of a pulmonary embolism increases the afterload
patient diagnosed with the of the right ventricle, causing right ventricular
disorder. Place in order the failure.
steps the nurse will use Rationale 2: The embolus prevents adequate
to instruct the family about blood flow from the pulmonary circulation to the
this disease process. left ventricle.
Standard Text: Click and Rationale 3: Because blood flow from the pul-
drag the options below to monary circulation is blocked, left ventricular
move them up or down. preload drops.
Choice 1. Blood clot causes Rationale 4: Because left ventricular preload is
backup of blood in the right decreased, there is not enough blood in the
ventricle. heart to pump, causing decreased cardiac out-
Choice 2. Blood clot blocks put.
blood to the left ventricle. Rationale 5: A lack of blood circulating will lead
Choice 3. Left ventricle to hypotension.
does not get enough blood Rationale 6: When the blood is backed up and
to pump through the body. is not being pumped into the general circula-
Choice 4. Amount of blood tion, tissue perfusion is reduced.
the heart has to pump to the
body drops.
Choice 5. Blood pressure
drops.
Choice 6. Amount of blood
going to the body drops.

18. A patient is being treated Correct Answer: 1

for pericarditis. The nurse Rationale 1: Acute pericarditis and the devel-
will plan interventions to opment of fluid accumulation in the pericardial
prevent the onset of which space can lead to the development of obstruc-

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 Nclex Questions for Shock - Critical Care
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type of shock?
1. Obstructive
2. Hypovolemic
3. Distributive
4. Cardiogenic
19. A patient is brought to
the emergency department
with manifestations of ana-
phylactic shock. What will
the nurse assess as pos-
sible causes for this disor-
der?
Note: Credit will be given
only if all correct choices
and no incorrect choices
are selected.
Standard Text: Select all
that apply.
1. Recent bee sting
2. Ingestion of drugs
3. History of latex allergy
4. Recent diagnostic imag-
ing tests
5. Recent myocardial infarc-
tion
20. During an assessment the
nurse is concerned that a
patient is developing car-
diogenic shock. What did
the nurse assess in this pa-
tient?
Note: Credit will be given
only if all correct choices
and no incorrect choices
are selected.
tive shock.
Rationale 2: Pericarditis is not a risk factor for
the development of hypovolemic shock.
Rationale 3: Pericarditis is not a risk factor for
the development of distributive shock.
Rationale 4: Pericarditis is not a risk factor for
the development of cardiogenic shock.
Correct Answer: 1,2,3,4
Rationale 1: Venoms such as bee stings can
trigger anaphylactic shock.
Rationale 2: Drugs can trigger anaphylactic
shock.
Rationale 3: Latex can trigger anaphylactic
shock.
Rationale 4: Contrast media for diagnostic tests
can trigger anaphylactic shock.
Rationale 5: Myocardial infarction is not a trig-
ger for anaphylactic shock.
Correct Answer: 1,2,3
Rationale 1: Hypotension is a manifestation of
cardiogenic shock.
Rationale 2: Delayed capillary refill is a mani-
festation of cardiogenic shock.
Rationale 3: Crackles are a manifestation of
cardiogenic shock.
Rationale 4: Bradycardia is not a manifestation
of cardiogenic shock.
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Standard Text: Select all Rationale 5: Warm dry skin is not a manifesta-
that apply. tion of cardiogenic shock.
1. Systolic blood pressure
82 mm Hg
2. Capillary refill 10 sec-
onds
3. Crackles bilateral lung
bases
4. Heart rate 55 and regular
5. Warm dry skin

21. A patient is brought to Correct Answer: 1

the emergency department
with hypotension, tachycar-
dia, reduced capillary refill,
and oliguria. During the as-
sessment, the nurse deter-
mines the patient is expe-
riencing cardiogenic shock
because of which addition-
al finding?
1. Jugular vein distention
2. Dry mucous membranes
3. Poor skin turgor
4. Thirst
Rationale 1: Jugular vein distention is a mani-
festation of cardiogenic shock.
Rationale 2: The mucous membranes are not
dry in cardiogenic shock.
Rationale 3: The skin turgor is not poor in car-
diogenic shock.
Rationale 4: Thirst is not a manifestation of
cardiogenic shock.

22. A patient being treated for Correct Answer: 1,2,3

cardiogenic shock is be-
ing hemodynamically mon-
itored. Which findings are
consistent with the pa-
tient's diagnosis?
Note: Credit will be given
only if all correct choices
and no incorrect choices
are selected.
Standard Text: Select all
that apply.
1. Elevated pulmonary arte-
Rationale 1: This finding is consistent with pul-
monary vascular congestion.
Rationale 2: This finding is consistent with fluid
volume overload.
Rationale 3: This finding is consistent with pul-
monary vascular congestion.
Rationale 4: This finding is not consistent with
cardiogenic shock.
Rationale 5: This finding is not consistent with
cardiogenic shock.

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 Nclex Questions for Shock - Critical Care
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rial wedge pressure
2. Elevated central venous
pressure
3. Elevated systemic vascu-
lar resistance index
4. Elevated mean arterial
pressure
5. Elevated stroke volume

23. The nurse is caring for Correct Answer: 1,2,3

a patient recovering from
a spinal cord injury sus-
tained during a motor vehi-
cle crash. What assessment
findings indicate that the
patient is developing neu-
rogenic shock?
Note: Credit will be given
only if all correct choices
and no incorrect choices
are selected.
Standard Text: Select all
that apply.
1. Hypotension
2. Bradycardia
3. Warm dry skin
4. Abdominal cramps
5. Palpitations
Rationale 1: Hypotension is a manifestation of
neurogenic shock because of the loss of auto-
nomic reflexes.
Rationale 2: Bradycardia occurs because of the
loss of sympathetic innervation.
Rationale 3: Warm dry skin occurs because of
a loss of cutaneous control of sweat glands.
Rationale 4: Abdominal cramping is not a man-
ifestation of neurogenic shock.
Rationale 5: Palpitations are not seen in neuro-
genic shock.

24. A patient is demonstrating Correct Answer: 1

signs of obstructive shock
but the cause has yet to
be determined. Which find-
ing indicates the patient is
experiencing a pulmonary
embolism as the cause for
obstructive shock?
1. Chest pain
2. Hypotension
Rationale 1: Chest pain is a symptom associat-
ed with a massive pulmonary embolus.
Rationale 2: Hypotension is seen in other caus-
es of obstructive shock and is not a symptom
that differentiates the cause as being from a
pulmonary embolus.
Rationale 3: Tachycardia is seen in other caus-
es of obstructive shock and is not a symptom
that differentiates the cause as being from a

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3. Tachycardia
4. Oliguria
25. The nurse is preparing
medications for a patient
being treated for cardio-
genic shock. Which med-
ications will the nurse most
likely provide to this pa-
tient?
Note: Credit will be given
only if all correct choices
and no incorrect choices
are selected.
Standard Text: Select all
that apply.
1. Dopamine
2. Norepinephrine
3. Dobutamine
4. Epinephrine
5. Phenylephrine
26. A patient with neurogenic
shock is demonstrating
bradycardia. What action
will the nurse take at this
time?
1. Limit patient movement.
2. Prepare to administer
crystalloids.
3. Administer phenyle-
phrine as prescribed.
4. Administer atropine as
prescribed.
pulmonary embolus.
Rationale 4: Oliguria is seen in other causes
of obstructive shock and is not a symptom that
differentiates the cause as being from a pul-
monary embolus.
Correct Answer: 1,2,3,5
Rationale 1: Dopamine is commonly used in
the treatment of cardiogenic shock.
Rationale 2: Norepinephrine is commonly used
in the treatment of cardiogenic shock.
Rationale 3: Dobutamine may be used in the
patient with cardiogenic shock who has an ad-
equate blood pressure.
Rationale 4: Epinephrine is not used in the
treatment of cardiogenic shock.
Rationale 5: Phenylephrine is a vasopressor
and may be used in the patient with cardiogenic
shock who is receiving dobutamine.
Correct Answer: 4
Rationale 1: Limiting movement will not cor-
rect bradycardia in the patient with neurogenic
shock.
Rationale 2: Crystalloids are used to correct
vasodilation.
Rationale 3: Phenylephrine is used in the pa-
tient with neurogenic shock to correct hypoten-
sion.
Rationale 4: Bradycardia in neurogenic shock
is corrected by the administration of atropine at
the dose of 0.5 to 1.0 mg intravenous every 5
minutes to a total dose of 3 mg.
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27. A patient is experiencing Correct Answer: 1,2,3
acute respiratory distress Rationale 1: Epinephrine produces bronchodi-
after eating an item of a lation, improving the respiratory status. The
known food allergy. What route of administration is initially intramuscular.
interventions will the nurse Rationale 2: Supplemental oxygen is used in
implement when providing the treatment of anaphylactic shock.
emergency care to this pa- Rationale 3: Hydrogen ion blockers such as
tient? diphenhydramine may be administered to block
Note: Credit will be given the histamine effects.
only if all correct choices Rationale 4: Vasopressin is not used in the
and no incorrect choices treatment of anaphylactic shock.
are selected. Rationale 5: Antithrombolytic agents are not
Standard Text: Select all used in the treatment of anaphylactic shock.
that apply.
1. Administer epinephrine
1:1000 intramuscularly.
2. Apply oxygen via face
mask as prescribed.
3. Provide diphenhy-
dramine 25 mg intra-
venous.
4. Administer vasopressin.
5. Prepare to administer
antithrombolytic agents as
prescribed.

28. A patient is receiving Correct Answer: 1

phenylephrine 50 mcg/min
as treatment for shock.
Which assessment finding
indicates this medication is
effective?
1. Blood pressure 110/68
mm Hg
2. Heart rate 110
3. Respiratory rate 12 and
regular
4. Decreased peripheral
pulses
Rationale 1: The expected effect of this med-
ication is an increase in blood pressure.
Rationale 2: Phenylephrine does not increase
the heart rate.
Rationale 3: Phenylephrine does not affect the
respiratory rate.
Rationale 4: Decreased peripheral pulses is a
side/toxic effect of this medication.
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29. A patient weighing 220
lbs is prescribed 10
mcg/kg/min of dopamine
to improve cardiac output
from cardiogenic shock.
How many milligrams of
dopamine will the patient
receive in an hour?
30. Which assessment finding
indicates that an infusion of
intravenous epinephrine 4
mcg/min is effective in the
treatment of a patient with
anaphylactic shock?
1. Reduced wheezing
2. Heart rate 55 and regular
3. Blood pressure 98/50 mm
Hg
4. Respiratory rate 28
31. A patient is receiving nor-
epinephrine 30 mcg/min
for treatment of refractory
shock. Which assessment
findings suggest the pa-
tient is experiencing pe-
ripheral vasoconstriction
from the medication?
Note: Credit will be given
only if all correct choices
and no incorrect choices
are selected.
Standard Text: Select all
Correct Answer: 60
Rationale : Determine the patient's weight in
kg by dividing 220 lbs by 2.2 or 100 kg. Then
multiply the number of mcg of medication the
patient is to receive per minute by 100 kg or
10 mcg × 100 kg = 1,000 mcg. This is the
dosage the patient will receive in 1 minute.
To determine the amount of medication in 1
hour, multiply 1,000 mcg × 60 = 60,000 mcg.
Using the conversion 1 mg = 1,000 mcg, divide
60,000 mcg by 1,000 mcg to determine that
the patient will receive 60 mg of dopamine in
1 hour.
Correct Answer: 1
Rationale 1: An expected action for epinephrine
is bronchodilation as evidenced by less wheez-
ing.
Rationale 2: Epinephrine increases heart rate.
Rationale 3: Epinephrine increases blood pres-
sure.
Rationale 4: Epinephrine lowers the respiratory
rate. This respiratory rate indicates that epi-
nephrine has not been effective.
Correct Answer: 1,2,3
Rationale 1: At high doses of norepinephrine,
decreased peripheral pulses indicates signifi-
cant vasoconstriction.
Rationale 2: At high doses of norepinephrine, a
drop in body temperature indicates significant
vasoconstriction.
Rationale 3: At high doses of norepinephrine,
paresthesias indicate significant vasoconstric-
tion.
Rationale 4: This medication does not cause a
drop in blood pressure.
Rationale 5: An increase in cardiac output is an
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 Nclex Questions for Shock - Critical Care
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that apply. expected effect of this medication and does not
1. Decreased peripheral indicate significant vasoconstriction.
pulses
2. Drop in body temperature
3. Onset of paresthesias
4. Drop in blood pressure
5. Increased cardiac output

32. A patient is pre- Correct Answer: 1

scribed vasopressin 0.03
units/minute as treatment
for septic shock. What ac-
tion will the nurse take
when providing this med-
ication?
1. Provide the vasopressin
infusion in addition to a
norepinephrine infusion.
2. Infuse through a periph-
eral line.
3. Utilize a rapid infuser.
4. Administer with 0.9%
normal saline.
Rationale 1: The dose of 0.03 units/min is usu-
ally added to a norepinephrine infusion.
Rationale 2: This medication should always be
administered via an infusion pump.
Rationale 3: A rapid infuser is used to deliver
large amounts of warmed crystalloid or blood
to a patient over a short period of time. It is not
used for medication administration.
Rationale 4: This medication does not need to
be administered with 0.9% normal saline.

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