NR 340 CRITICAL CARE NURSING
Sepsis
Latest Review Exam
Q&A
2024
,1. A 65-year-old male patient with a history of chronic renal failure
presents with fever, hypotension, and confusion. Blood cultures are drawn
and empiric antibiotic therapy is initiated. Which initial antibiotic regimen
is most appropriate for this patient suspected of sepsis?
A. Vancomycin and piperacillin-tazobactam
B. Ceftriaxone and azithromycin
C. Clindamycin and gentamicin
D. Metronidazole and ciprofloxacin
Answer: A. Vancomycin and piperacillin-tazobactam
Rationale: This regimen covers a broad spectrum of potential pathogens,
including MRSA, and is recommended for initial empiric therapy in septic
patients with risk factors for multi-drug resistant organisms.
2. A nurse is assessing a patient with suspected sepsis. Which of the
following symptoms would indicate an early sign of sepsis?
A. Bradycardia
B. Hyperglycemia
C. Warm, flushed skin
D. Decreased urine output
Answer: C. Warm, flushed skin
Rationale: Warm, flushed skin can be an early sign of sepsis due to
vasodilation and increased blood flow as part of the body's initial
inflammatory response.
3. In the management of sepsis, what is the significance of lactate levels in
a patient's blood work?
A. Elevated lactate levels indicate increased oxygen delivery to tissues.
B. Elevated lactate levels are a sign of anaerobic metabolism and tissue
hypoperfusion.
C. Low lactate levels suggest an ongoing infection.
D. Low lactate levels indicate effective antibiotic therapy.
Answer: B. Elevated lactate levels are a sign of anaerobic metabolism
and tissue hypoperfusion.
Rationale: Lactate is produced when cells metabolize glucose without
adequate oxygen (anaerobic metabolism). Elevated levels in sepsis
suggest tissue hypoperfusion and can be a marker of severity.
4. A patient with sepsis is prescribed norepinephrine as a first-line
, vasopressor. What is the primary goal of this medication?
A. To reduce heart rate
B. To increase cardiac output
C. To improve renal perfusion
D. To increase blood pressure
Answer: D. To increase blood pressure
Rationale: Norepinephrine is used to increase blood pressure in septic
shock by causing vasoconstriction, which helps to improve perfusion to
vital organs.
5. During the resuscitation of a septic patient, which fluid type is preferred
for initial fluid resuscitation?
A. 0.9% saline
B. 5% dextrose in water
C. Albumin solution
D. Ringer's lactate
Answer: A. 0.9% saline
Rationale: Isotonic crystalloids such as 0.9% saline or Ringer's lactate
are preferred for initial fluid resuscitation in sepsis to restore intravascular
volume.
6. A patient with sepsis has a Sequential Organ Failure Assessment
(SOFA) score of 10. What does this indicate about the patient's condition?
A. The patient is at low risk for mortality.
B. The patient is likely to have a mild form of sepsis.
C. The patient is at high risk for mortality.
D. The patient's sepsis is responding well to treatment.
Answer: C. The patient is at high risk for mortality.
Rationale: The SOFA score is used to track a patient's status during the
stay in an intensive care unit to determine the extent of a person's organ
function or rate of failure. A score of 10 indicates a high risk of mortality.
7. When considering source control in a patient with sepsis, which of the
following actions is most appropriate?
A. Delaying source control until after hemodynamic stability is
achieved.
B. Administering broad-spectrum antibiotics for an extended duration.
C. Performing surgery to remove the infectious source if feasible.
Sepsis
Latest Review Exam
Q&A
2024
,1. A 65-year-old male patient with a history of chronic renal failure
presents with fever, hypotension, and confusion. Blood cultures are drawn
and empiric antibiotic therapy is initiated. Which initial antibiotic regimen
is most appropriate for this patient suspected of sepsis?
A. Vancomycin and piperacillin-tazobactam
B. Ceftriaxone and azithromycin
C. Clindamycin and gentamicin
D. Metronidazole and ciprofloxacin
Answer: A. Vancomycin and piperacillin-tazobactam
Rationale: This regimen covers a broad spectrum of potential pathogens,
including MRSA, and is recommended for initial empiric therapy in septic
patients with risk factors for multi-drug resistant organisms.
2. A nurse is assessing a patient with suspected sepsis. Which of the
following symptoms would indicate an early sign of sepsis?
A. Bradycardia
B. Hyperglycemia
C. Warm, flushed skin
D. Decreased urine output
Answer: C. Warm, flushed skin
Rationale: Warm, flushed skin can be an early sign of sepsis due to
vasodilation and increased blood flow as part of the body's initial
inflammatory response.
3. In the management of sepsis, what is the significance of lactate levels in
a patient's blood work?
A. Elevated lactate levels indicate increased oxygen delivery to tissues.
B. Elevated lactate levels are a sign of anaerobic metabolism and tissue
hypoperfusion.
C. Low lactate levels suggest an ongoing infection.
D. Low lactate levels indicate effective antibiotic therapy.
Answer: B. Elevated lactate levels are a sign of anaerobic metabolism
and tissue hypoperfusion.
Rationale: Lactate is produced when cells metabolize glucose without
adequate oxygen (anaerobic metabolism). Elevated levels in sepsis
suggest tissue hypoperfusion and can be a marker of severity.
4. A patient with sepsis is prescribed norepinephrine as a first-line
, vasopressor. What is the primary goal of this medication?
A. To reduce heart rate
B. To increase cardiac output
C. To improve renal perfusion
D. To increase blood pressure
Answer: D. To increase blood pressure
Rationale: Norepinephrine is used to increase blood pressure in septic
shock by causing vasoconstriction, which helps to improve perfusion to
vital organs.
5. During the resuscitation of a septic patient, which fluid type is preferred
for initial fluid resuscitation?
A. 0.9% saline
B. 5% dextrose in water
C. Albumin solution
D. Ringer's lactate
Answer: A. 0.9% saline
Rationale: Isotonic crystalloids such as 0.9% saline or Ringer's lactate
are preferred for initial fluid resuscitation in sepsis to restore intravascular
volume.
6. A patient with sepsis has a Sequential Organ Failure Assessment
(SOFA) score of 10. What does this indicate about the patient's condition?
A. The patient is at low risk for mortality.
B. The patient is likely to have a mild form of sepsis.
C. The patient is at high risk for mortality.
D. The patient's sepsis is responding well to treatment.
Answer: C. The patient is at high risk for mortality.
Rationale: The SOFA score is used to track a patient's status during the
stay in an intensive care unit to determine the extent of a person's organ
function or rate of failure. A score of 10 indicates a high risk of mortality.
7. When considering source control in a patient with sepsis, which of the
following actions is most appropriate?
A. Delaying source control until after hemodynamic stability is
achieved.
B. Administering broad-spectrum antibiotics for an extended duration.
C. Performing surgery to remove the infectious source if feasible.
