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A nurse is providing postoperative care to a client who lost 800 mL of blood during surgery. The client’s blood pressure has been steadily decreasing over the past 2 hours.

 

Which of the following categories of shock should the nurse recognize is occurring?

A.

Hypovolemic shock.

B.

Septic shock.

C.

Neurogenic shock.

D.

Obstructive shock.

Answer and Explanation

The Correct Answer is C

Choice A rationale

 

Hypovolemic shock occurs due to a significant decrease in circulating blood volume, leading to inadequate tissue perfusion. Blood loss, such as the 800 mL lost during surgery, is a common cause of hypovolemic shock. The steadily decreasing blood pressure is consistent with this type of shock.

 

Choice B rationale

 

Septic shock results from a systemic inflammatory response to infection, leading to vasodilation and maldistribution of blood flow. There is no indication of infection in this scenario.

 

Choice C rationale

 

Neurogenic shock results from a loss of sympathetic tone, leading to vasodilation and relative hypovolemia. It is often associated with spinal cord or severe head injury, which is not indicated in this scenario.

 

Choice D rationale

 

Obstructive shock occurs when there is an obstruction to blood flow within the cardiovascular system, such as a pulmonary embolism or cardiac tamponade. There is no evidence of such an obstruction in this scenario.


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View Related questions

Correct Answer is A

Explanation

Choice A rationale

Prostate cancer mortality is more than double for Black American males than for other groups. This is a significant consideration when creating a plan of care for prostate screening in high- risk populations. Black American males have a higher incidence and mortality rate of prostate cancer compared to other racial and ethnic groups. This disparity is attributed to a combination of genetic, socioeconomic, and healthcare access factors. Therefore, targeted screening and early detection efforts are crucial for this high-risk population to improve outcomes and reduce mortality rates.

Choice B rationale

Occupational toxic exposure among factory workers can increase the risk of various cancers, including prostate cancer. However, this is not the most important consideration when creating a plan of care for prostate screening in high-risk populations. While occupational exposure is a risk factor, it does not have the same level of impact on prostate cancer incidence and mortality as race and family history. Screening efforts should prioritize those with the highest risk, such as Black American males and individuals with a family history of prostate cancer.

Choice C rationale

Dietary factors can influence the risk of prostate cancer, but the impact is not as significant as other risk factors such as race and family history. While a healthy diet is important for overall health and may help reduce cancer risk, it is not the primary consideration for prostate screening in high-risk populations. Screening efforts should focus on those with the highest risk based on genetic and demographic factors, rather than dietary habits alone.

Choice D rationale

A computed tomography (CT) scan is not the best way to determine prostate cancer risk. The primary screening method for prostate cancer is the prostate-specific antigen (PSA) blood test, often combined with a digital rectal exam (DRE). CT scans are not typically used for initial screening but may be employed for further evaluation if there are abnormal findings on PSA or DRE. The focus should be on using established screening methods to identify high-risk individuals and provide early detection and intervention.

Correct Answer is C

Explanation

Choice A rationale

Maintaining a semi-Fowler’s position can help improve lung expansion and ease breathing in clients with chronic obstructive pulmonary disease (COPD). However, it does not directly address the issue of mucus congestion and difficulty in expectorating (bringing up) mucus.

While positioning can aid in overall respiratory comfort, it is not the most effective intervention for managing mucus congestion in COPD clients.

Choice B rationale

A low-salt diet is beneficial for overall health and can help manage conditions such as hypertension and heart disease. However, it does not have a direct impact on mucus congestion in clients with COPD. Dietary modifications are important for managing comorbidities, but they do not address the primary concern of mucus clearance in this scenario.

Choice C rationale

Encouraging the client to drink 2 to 3 liters of water daily is an effective intervention for managing mucus congestion in clients with COPD. Adequate hydration helps thin the mucus, making it easier to cough up and clear from the airways. This intervention directly addresses the client’s complaint of difficulty in expectorating mucus and can improve respiratory function and comfort.

Choice D rationale

Administering oxygen via nasal cannula at 2 L/min can help improve oxygenation in clients with COPD. However, it does not address the issue of mucus congestion and difficulty in expectorating mucus. While supplemental oxygen is important for managing hypoxemia, it is not the primary intervention for mucus clearance. The focus should be on interventions that help thin and mobilize mucus to alleviate the client’s symptoms.

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