NURS 434 Exam 4 Study Questions, Reviewed and
Detailed Answers 2026 Update
True or False: Septic shock causes system wide vasodilation which leads to an increase in
systemic vascular resistance. In addition, septic shock causes increased capillary permeability
and clot formation in the microcirculation throughout the body. - Correct Answers False
A patient is diagnosed with septic shock. As the nurse you know this is a __________ form of
shock. In addition, you're aware that __________ and _________ are also this form of shock.
A. obstructive; hypovolemic and anaphylactic
B. distributive; anaphylactic and neurogenic
C. obstructive; cardiogenic and neurogenic
D. distributive; anaphylactic and cardiogenic - Correct Answers B
Your patient, who is post-op from a gastrointestinal surgery, is presenting with a temperature of
103.6 'F, heart rate 120, blood pressure 72/42, increased white blood cell count, and
respirations of 21. An IV fluid bolus is ordered STAT. Which findings below indicate that the
patient is progressing to septic shock? Select all that apply:
A. Blood pressure of 70/34 after the fluid bolus
B. Serum lactate less than 2 mmol/L
,C. Patient needs Norepinephrine to maintain a mean arterial pressure (MAP) greater than 65
mmHg despite fluid replacement
D. Central venous pressure (CVP) of 18 - Correct Answers A
C
You're providing care to four patients. Select all the patients who are at risk for developing
sepsis:
A. A 35-year-old female who is hospitalized with renal insufficiency and has a Foley catheter
and central line in place.
B. A 55-year-old male who is a recent kidney transplant recipient.
C. A 78-year-old female with diabetes mellitus who is recovering from colon surgery.
D. A 65-year-old male recovering from right lobectomy for treatment of lung cancer. - Correct
Answers All of the above
A patient with a severe infection has developed septic shock. The patient's blood pressure is
72/44, heart rate 130, respiration 22, oxygen saturation 96% on high-flow oxygen, and
temperature 103.6 'F. The patient's mean arterial pressure (MAP) is 53 mmHg. Based on these
findings, you know this patient is experiencing diminished tissue perfusion and needs treatment
to improve tissue perfusion to prevent organ dysfunction. In regards to the pathophysiology of
septic shock, what is occurring in the body that is leading to this decrease in tissue perfusion?
Select all that apply:* A. Absolute hypovolemia
B. Vasodilation
C. Increased capillary permeability
D. Increased systemic vascular resistance
E. Clot formation in microcirculation
F. A significantly decreased cardiac output - Correct Answers B
C
E
,A patient is at risk for septic shock when a microorganism invades the body. Which
microorganism is the MOST common cause of sepsis?*
A. Fungus
B. Virus
C. Parasite
D. Bacteria - Correct Answers D
A patient with a fever is lethargic and has a blood pressure of 89/56. The patient's white blood
cell count is elevated. The physician suspects the patient is developing septic shock. What other
findings indicate this patient is in the "early" or "compensated" stage of septic shock? Select all
that apply:*
A. Urinary output of 60 mL over 4 hours
B. Warm and flushed skin
C. Tachycardia
D. Bradypnea - Correct Answers B
C
Your patient is receiving aggressive treatment for septic shock. Which findings demonstrate
treatment is NOT being successful? Select all that apply:*
A. MAP (mean arterial pressure) 40 mmHg
B. Urinary output of 10 mL over 2 hours
C. Serum Lactate 15 mmol/L D. Blood glucose 120 mg/dL
E. CVP (central venous pressure) less than 2 mmHg - Correct Answers A
B
C
E
, The physician orders a patient in septic shock to receive a large IV fluid bolus. How would the
nurse know if this treatment was successful for this patient?
A. The patient's blood pressure changes from 75/48 to 110/82.
B. Patient's CVP 2 mmHg
C. Patient's skin is warm and flushed.
D. Patient's urinary output is 20 mL/hr. - Correct Answers A
A patient in septic shock receives large amounts of IV fluids. However, this was unsuccessful in
maintaining tissue perfusion. As the nurse, you would anticipate the physician to order what
NEXT?
A. IV corticosteroids
B. Colloids
C. Dobutamine
D. Norepinephrine - Correct Answers D
Your patient, who is post-op from a kidney transplant, has developed septic shock. Which
statement below best reflects the interventions you will perform for this patient?
A. Administer Norepinephrine before attempting a fluid resuscitation.
B. Collect cultures and then administer IV antibiotics.
C. Check blood glucose levels before starting any other treatments.
D. Administer Drotrecogin Alpha within 48-72 hours. - Correct Answers B
A patient in septic shock is experiencing hyperglycemia. The patient is started on an insulin drip.
A blood glucose goal for this patient would be:*
A. <110 mg/dL
B. <80 mg/dL
C. >200 mg/dL
D. <180 mg/dL - Correct Answers D
Detailed Answers 2026 Update
True or False: Septic shock causes system wide vasodilation which leads to an increase in
systemic vascular resistance. In addition, septic shock causes increased capillary permeability
and clot formation in the microcirculation throughout the body. - Correct Answers False
A patient is diagnosed with septic shock. As the nurse you know this is a __________ form of
shock. In addition, you're aware that __________ and _________ are also this form of shock.
A. obstructive; hypovolemic and anaphylactic
B. distributive; anaphylactic and neurogenic
C. obstructive; cardiogenic and neurogenic
D. distributive; anaphylactic and cardiogenic - Correct Answers B
Your patient, who is post-op from a gastrointestinal surgery, is presenting with a temperature of
103.6 'F, heart rate 120, blood pressure 72/42, increased white blood cell count, and
respirations of 21. An IV fluid bolus is ordered STAT. Which findings below indicate that the
patient is progressing to septic shock? Select all that apply:
A. Blood pressure of 70/34 after the fluid bolus
B. Serum lactate less than 2 mmol/L
,C. Patient needs Norepinephrine to maintain a mean arterial pressure (MAP) greater than 65
mmHg despite fluid replacement
D. Central venous pressure (CVP) of 18 - Correct Answers A
C
You're providing care to four patients. Select all the patients who are at risk for developing
sepsis:
A. A 35-year-old female who is hospitalized with renal insufficiency and has a Foley catheter
and central line in place.
B. A 55-year-old male who is a recent kidney transplant recipient.
C. A 78-year-old female with diabetes mellitus who is recovering from colon surgery.
D. A 65-year-old male recovering from right lobectomy for treatment of lung cancer. - Correct
Answers All of the above
A patient with a severe infection has developed septic shock. The patient's blood pressure is
72/44, heart rate 130, respiration 22, oxygen saturation 96% on high-flow oxygen, and
temperature 103.6 'F. The patient's mean arterial pressure (MAP) is 53 mmHg. Based on these
findings, you know this patient is experiencing diminished tissue perfusion and needs treatment
to improve tissue perfusion to prevent organ dysfunction. In regards to the pathophysiology of
septic shock, what is occurring in the body that is leading to this decrease in tissue perfusion?
Select all that apply:* A. Absolute hypovolemia
B. Vasodilation
C. Increased capillary permeability
D. Increased systemic vascular resistance
E. Clot formation in microcirculation
F. A significantly decreased cardiac output - Correct Answers B
C
E
,A patient is at risk for septic shock when a microorganism invades the body. Which
microorganism is the MOST common cause of sepsis?*
A. Fungus
B. Virus
C. Parasite
D. Bacteria - Correct Answers D
A patient with a fever is lethargic and has a blood pressure of 89/56. The patient's white blood
cell count is elevated. The physician suspects the patient is developing septic shock. What other
findings indicate this patient is in the "early" or "compensated" stage of septic shock? Select all
that apply:*
A. Urinary output of 60 mL over 4 hours
B. Warm and flushed skin
C. Tachycardia
D. Bradypnea - Correct Answers B
C
Your patient is receiving aggressive treatment for septic shock. Which findings demonstrate
treatment is NOT being successful? Select all that apply:*
A. MAP (mean arterial pressure) 40 mmHg
B. Urinary output of 10 mL over 2 hours
C. Serum Lactate 15 mmol/L D. Blood glucose 120 mg/dL
E. CVP (central venous pressure) less than 2 mmHg - Correct Answers A
B
C
E
, The physician orders a patient in septic shock to receive a large IV fluid bolus. How would the
nurse know if this treatment was successful for this patient?
A. The patient's blood pressure changes from 75/48 to 110/82.
B. Patient's CVP 2 mmHg
C. Patient's skin is warm and flushed.
D. Patient's urinary output is 20 mL/hr. - Correct Answers A
A patient in septic shock receives large amounts of IV fluids. However, this was unsuccessful in
maintaining tissue perfusion. As the nurse, you would anticipate the physician to order what
NEXT?
A. IV corticosteroids
B. Colloids
C. Dobutamine
D. Norepinephrine - Correct Answers D
Your patient, who is post-op from a kidney transplant, has developed septic shock. Which
statement below best reflects the interventions you will perform for this patient?
A. Administer Norepinephrine before attempting a fluid resuscitation.
B. Collect cultures and then administer IV antibiotics.
C. Check blood glucose levels before starting any other treatments.
D. Administer Drotrecogin Alpha within 48-72 hours. - Correct Answers B
A patient in septic shock is experiencing hyperglycemia. The patient is started on an insulin drip.
A blood glucose goal for this patient would be:*
A. <110 mg/dL
B. <80 mg/dL
C. >200 mg/dL
D. <180 mg/dL - Correct Answers D
