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The FloTrac sensor has been chosen by clinicians more than any other minimally-invasive volume management solution to monitor over 2.5 million patients worldwide.*

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The Center for Medicare and Medicaid Services (CMS) required reporting continues with the 6-hour bundle for patients with septic shock

The 6-hour bundle includes dynamic assessment of fluid responsiveness with a passive leg raise or fluid challenge as noted below. In a recent CMS educational program, it was noted that a dynamic assessment requires more than these passive maneuvers. To calculate percent volume responsiveness, cardiac output or stroke volume must be known in advance and after these maneuvers.

Recognition of Septic Shock

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The parameters from the ClearSight system can help guide your detection of fluid responsiveness and help you make more informed volume administration decisions.

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For A-line patients, the FloTrac sensor measures flow-based parameters continuously before and after a passive leg raise or fluid challenge.

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Meet reassessment requirements with one device by utilizing Edwards oximetry central venous catheter for measurement of continuous ScvO2 and CVP.

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The sepsis bundle guidelines as presented above were published by CMS on August 4, 2014 and are presented for informational purposes only. This information does not constitute reimbursement or medical advice. Edwards makes no representation or warranty regarding this information or its completeness, accuracy or timeliness. It is not intended to make a recommendation regarding clinical practice. Laws, regulations, and payer policies concerning reimbursement are complex and change frequently; service providers are responsible for all decisions relating to clinical services, coding and reimbursement submissions. Accordingly, Edwards strongly recommends consultation with CMS, payers, reimbursement specialists and/or legal counsel regarding guidelines, coding, coverage, and reimbursement matters.

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Cardiogenic Shock NCLEX Questions

Cardiogenic shock NCLEX questions for nursing students!

This quiz will test your knowledge on cardiogenic shock. Cardiogenic shock occurs when the heart has experienced some type of injury that leads the heart to pump insufficiently. This causes the cardiac output to fall below the parameters needed to maintain tissue perfusion. This leads to cell hypoxia and eventually multiple organ dysfunction syndrome (MODS) and death.

There are various types of shock: cardiogenic,hypovolemic, anaphylactic, septic, and neurogenic.

Don’t forget to watch the lecture on cardiogenic shock before taking the quiz.

Cardiogenic Shock NCLEX Questions

This quiz will test your knowledge on cardiogenic shock in preparation for the NCLEX exam.

(NOTE: When you hit submit, it will refresh this same page. Scroll down to see your results.)cardiogenic shock, nclex, nursing, question, quiz, shock.

Cardiogenic Shock NCLEX Questions


1. A patient is being treated for cardiogenic shock. Which statement below best describes this condition? Select all that apply:

A. “The patient will experience an increase in cardiac output due to an increase in preload and afterload.”

B. “A patient with this condition will experience decreased cardiac output and decreased tissue perfusion.”

C. “This condition occurs because the heart has an inadequate blood volume to pump.”

D. “Cardiogenic shock leads to pulmonary edema.”

The answers are: B and D. Cardiogenic shock occurs when the heart can NOT pump enough blood to meet the perfusion needs of the body. The cardiac output will be DECREASED, which will DECREASE tissue perfusion and cause cell injury to organs/tissues. In this condition, the heart is WEAK and can’t pump blood out of the heart. This can be due to either a systolic (contraction) or diastolic (filling) issue along with a structural or dysrhythmia issue. In cardiogenic shock, there is NOT an issue with blood volume, but there is a problem with the heart itself.

2. Cardiac output is very important for determining if a patient is in cardiogenic shock. What is a normal cardiac output in an adult?

A. 2-5 liters/minute

B. 1-3 liters/minute

C. 4-8 liters/minute

D. 8-10 liters/minute

The answer is C. Cardiac output is the amount of blood the heart pumps per minute. The heart’s cardiac output should be anywhere from 4-8 liters of blood per minute.

3. ________________ is the amount the ventricle stretches at the end of diastole.

A. Preload

B. Afterload

C. Stroke Volume

D. Contractility

The answer is A. Preload is the amount the ventricle stretches at the end of diastole (hence it’s the amount the ventricles stretches once it’s filled with blood and right before the contraction of the ventricle ….so it’s the end-diastolic volume).

4. Cardiac output is equal to the heart rate multiplied by the stroke volume. Treatment for cardiogenic shock includes medications that increase cardiac output. One of the factors that help determine cardiac output is stroke volume. Select all the factors that determine stroke volume?

A. Cardiac Index

B. Preload

C. Pulmonary capillary wedge pressure

D. Afterload

E. Heart rate

F. Contractility

The answers are B, D, and F. Cardiac output is determined by the person’s heart rate times the stroke volume. Stroke volume is the amount of blood pumped from the left ventricle with each BEAT (50-100 ml). It’s determined by the preload, afterload, and contractility of the heart. These factors in a patient with cardiogenic shock can be manipulated with medications to increase the cardiac output.

5. _____________ is the force the heart has to pump against to get blood out of the ventricle.

A. Cardiac output

B. Cardiac index

C. Preload

D. Afterload

The answer is D. Afterload is the pressure the ventricle must pump against to squeeze blood out. In other words, it’s the force the heart has to pump against to get blood out of the ventricle.

6. True or False: If a patient with cardiogenic shock is given a medication that will decrease cardiac afterload, it will decrease stroke volume.

The answer is FALSE. If a patient with cardiogenic shock is given a medication that will decrease cardiac afterload, it will INCREASE (not decrease) stroke volume. HOW? Remember afterload is the resistance the ventricle must pump against to get blood out of the heart. If we DECREASE the resistance the heart must pump against (make it easier for the heart squeeze blood out of the ventricle), it will increase how much blood it will pump out, hence increase the stroke volume.

7. Which patient below is at MOST risk for developing cardiogenic shock?

A. A 52-year-old male who is experiencing a severe allergic reaction from shellfish.

B. A 25-year-old female who has experienced an upper thoracic spinal cord injury.

C. A 72-year-old male who is post-op from a liver transplant.

D. A 49-year-old female who is experiencing an acute myocardial infarction.

The answer is D. An acute MI (heart attack) is the main cause of cardiogenic shock. It happens because a coronary artery has become blocked. Coronary arteries supply the heart muscle’s cells with oxygenated blood. If they don’t receive this oxygenated blood they will die, which causes the heart muscle to quit working (hence pumping efficiently). When the heart muscle fails to pump efficiently, cardiac output fails and cardiogenic shock occur.

8. You’re caring for a patient with cardiogenic shock. Which finding below suggests the patient’s condition is worsening? Select all that apply:

A. Blood pressure 95/68

B. Urinary output 20 mL/hr

C. Cardiac Index 3.2 L/min/m2

D. Pulmonary artery wedge pressure 30 mmHg

The answer is B and D. When answering this question look for values that are abnormal and that point to worsening tissue perfusion (urinary output should be 30 mL/hr or greater….if it’s lower than this it show the kidneys are not being perfused) and worsening cardiac output (the blood pressure and cardiac index are within normal limits BUT pulmonary artery wedge pressure is NOT). A pulmonary artery wedge pressure (also called pulmonary capillary wedge pressure) is the pressure reading of the filling pressure in the left atrium. A normal PAWP is 4-12 mmHg and if it’s >18 mmHg this indicates cardiogenic shock. If it reads high, that means there is back-flowing of blood into the heart and lungs (hence the left ventricle is failing to pump efficiently and increasing the pressure in the left atrium).

9. A patient with cardiogenic shock has a blood pressure of 70/38. In addition, the patient is experiencing dyspnea with a respiratory rate of 32 breaths per minute and has an oxygen saturation of 82% on room air. On auscultation, you note crackles throughout the lung fields. You notify the physician. What order below would you ask for an order clarification?

A. Dopamine IV stat

B. Normal saline IV bolus stat

C. Furosemide IV stat

D. Place patient on CPAP (continuous positive airway pressure)

The answer is B. This patient with cardiogenic shock is experiencing a decrease in cardiac output (hence the blood pressure), so an order for Dopamine can help provide a positive inotropic effect (increase the contractility of the heart which will increase stroke volume and cardiac output). The patient is also experiencing pulmonary congestion due to the cardiogenic shock. The heart is failing to pump blood forward, so it is backing up in the lungs. This is leading to an increased respiratory rate, dyspnea, and low oxygen saturation. The order for Furosemide (which is a diuretic) will help remove the extra fluid volume from the lungs and the CPAP (continuous positive airway pressure) will help with oxygenation. The nurse would question the order for a normal saline IV bolus. This bolus would add more fluid to the lungs and further congest the fluids.

10. You’re assessing your patient with cardiogenic shock, what signs and symptoms do you expect to find in this condition? Select all that apply:

A. Warm, flushed skin

B. Prolonged capillary refill

C. Urinary output >30 mL/hr

D. Systolic blood pressure <90 mmHg

E. Crackles in lung fields

F. Dyspnea

D. Decreased BUN and creatinine

G. Strong peripheral pulses

H. Chest pain

The answers are B, D, E, F, and H. Signs and symptoms of cardiogenic shock will be related to LOW cardiac output and decreased perfusion to organs/tissues. Capillary refill will be prolonged >2 seconds, urinary output will be <30 mL/hr, systolic blood pressure will be <90 mmHg, pulmonary edema will present with fluid in the lungs (hence crackles in the lungs), dyspnea, and chest pain (due to decreased blood flow to the heart muscle).

11. A patient is receiving treatment for an acute myocardial infarction. The nurse is closely monitoring the patient for signs and symptoms associated with cardiogenic shock. Which value below is associated with cardiogenic shock?

A. Cardiac index 1.5 L/min/m2

B. Pulmonary capillary wedge pressure (PCWP) 10 mmHg

C. Central venous pressure (CVP) 4 mmHg

D. Troponin <0.01 ng/mL

The answer is A. A patient who has experienced an acute myocardial infarction is at risk for cardiogenic shock. A normal cardiac index should be 2.5-4 L/min/m2. Cardiac index is the specific cardiac output based on the patient’s size. Any number less than 2.2 L/min/m2 can be associated with cardiogenic shock. All the other values are within normal limits. PCWP would be >18 mmHg in cardiogenic shock, and CVP would be high.

12. A patient who has cardiogenic shock is experiencing labored breathing and low oxygen levels. A STAT chest x-ray is ordered. The x-ray results show pulmonary edema. The physician orders Furosemide IV. What finding would require immediate nursing action?

A. Blood pressure 98/54

B. Urinary output 45 mL/hr

C. Potassium 1.8 mEq/L

D. Heart rate 110 bpm

The answer is C. Furosemide (Lasix) is a diuretic which wastes potassium. The nurse would want to ensure the potassium level is normal (3.5 to 5 mEq/L) before administering IV Furosemide. The nurse would need to notify the physician of the potassium level so supplementation can be provided.

13. They physician orders a Dobutamine IV drip on a patient in cardiogenic shock. After starting the IV drip, the nurse would make it priority to monitor for?

A. Rebound hypertension

B. Ringing in the ears

C. Worsening hypotension

D. severe headache

The answer is C. Dobutamine increases contractility and cardiac output, BUT causes vasodilation due to the way it acts on receptors and this may make hypotension WORSE. The patient may be started on norepinephrine or dopamine if worsening of hypotension occurs.

14. Which medications below are used in cardiogenic shock that provide a positive inotropic effect on the heart? Select all that apply:

A. Nitroglycerin

B. Sodium Nitroprussidde

C. Dobutamine

D. Norepinephrine

E. Dopamine

The answers are C and E. Dobutamine and Dopamine are vasopressors that have a POSITIVE inotropic effect on the heart. This means these medications increase the strength of the heart’s contractions (increases contractility), which increases stroke volume.

15. A patient with cardiogenic shock has an intra-aortic balloon pump. As the nurse you know that during ________ the balloon deflates and during _____ the balloon inflates in a section of the aorta.

A. systole, diastole

B. diastole, systole

C. inspiration, expiration

D. expiration, inspiration

The answer is A. An intra-aortic balloon pump is a balloon attached to the catheter inside a section of the aorta. It will inflate and deflate during systole (contraction) and diastole (relaxation). When the balloon deflates during systole it creates a suction-like pressure that will draw blood out of the weak heart and into the coronary arteries and systemic circulation (hence increasing cardiac output and blood supply to the heart muscle). When the balloon inflates during diastole it will create pressure that will push blood into the coronary arteries (hence further increasing blood supply to the heart muscle).

16. You’re precepting a new nurse. You ask the new nurse to list the purpose of why a patient with cardiogenic shock may benefit from an intra-aortic balloon pump. What responses below indicate the new nurse understands the purpose of an intra-aortic balloon pump? Select all that apply:

A. “This device increases the cardiac afterload, which will increase cardiac output.”

B. “This device will help increase blood flow to the coronary arteries.”

C. “The balloon pump will help remove extra fluid from the heart and lungs.”

D. “The balloon pump will help increase cardiac output.”

The answers are B and D. An intra-aortic balloon pump increases coronary artery blood flow and cardiac output.
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For a while it looked as if he might end up in the water himself.E2020 Algebra 2 Semester 2 Exam AnswersLanguage Arts Worksheets Topics Language Arts worksheets Word Search Maker Word scramble worksheets generator Noun Chart worksheet word scramble worksheets word search worksheets ; Spanish English Translation Flashcards Preposition quiz List of prepositions Pronoun quiz Proper noun quiz Adjective quiz Adverb quiz Transitive or intransitive verbsEnglish Language Arts 9 - Edgenuity Inc. The lesson objectives are assessed through assignments, quizzes, unit tests, and cumulative exams. Jounior English Edgenuity Unit 2 Test - Joomlaxe.com Choose from 500 different sets of e2020 english flashcards on Quizlet. Log in Sign up. e2020 english Flashcards.Sep 03, 2021Edgenuity Algebra 1 Unit Test Answers - fullexams.com. Edgenuity Answer Keys Edgenuity algebra 1 unit test answers. You can skip right to the answer collection by clicking below. Answers are sorted by Math, Social Studies, Language Arts, Science, and World Languages Edgenuity algebra 1 unit test answers. 5.There was no window in the room and the light was left on the whole time, but some movement of my shadow must have stirred his senses for I heard a gurgling moan. Here the wall followed the line of the ridge exactly, expecting the door to block his way. She could continue to escape media attention. She sounded angry, of course.answers silooo com. e2020 english language arts answers tmolly de. e2020 ela 10 b unit test stufey de. english language arts standards writing grade 11 12. counseling office online course catalog. e2020 mon core ela 11 b answers telefonare it. e2020 geometry b inscribed angles chipin de. e2020 study sets and flashcards quizlet. e2020 ela 11 …Why should that moment have come into her mind. He would have just left her there. He greeted them at the entrance, he was a likable guy.E2020 Cumulative Exam Answers For English - … E2020/Edgenuity Answers. Welcome to Edge-Answers, a site for getting through Edgenuity as fast as possible. Created by students for students, Edge-Answers is a sharing tool we use to help each other to pass the Edgenuity and E2020 quizzes and tests. E2020 …She reached for a bar of bright white lye soap and the bath brush. The creature possessed no internal organs.plate tectonics quizlet edgenuity - Keeram

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Quizlet shock quiz

In my position, this is not understandable. As if in a fog, I continue the fun I started and slowly turn to the bum, trying not to move my legs. I almost succeed. I see how his eyes widen, and he instinctively reaches out to my pussy with his whole body. I also wonder, but what have I got there.

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And with what. The road was not close, there was a lot of time for reflection. Of course, I was thinking about my wife, about her betrayal and about her revelations. Then memories flooded in. I remembered our whole life with Anyone, from our acquaintance to the present day, in all the details.

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Tina had already become. An adult girl, she studied in the first year of the institute, but she never forgot her father and loved him, just as before. A few days after her birthday, when classes at the institute were over, Tina was sitting with her friends Zhanna and Tatiana in the park, and discussed further plans for the weekend.



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