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HESI Exit Exam Sepsis Protocols Question
Bank: Infection, Shock & Critical Care
Table of Contents
Subtopic 1: Early Recognition and Clinical Assessment of Sepsis ..................................... 2
Subtopic 2: Pathophysiology and Risk Factors of Sepsis .................................................. 9
Subtopic 3: Diagnostic Strategies and Laboratory Markers in Sepsis ............................... 17
Subtopic 4: Fluid Resuscitation and Hemodynamic Management in Sepsis .................... 25
Subtopic 5: Antimicrobial Therapy and Source Control in Sepsis .................................... 32
Subtopic 6: Organ Dysfunction and Supportive Care in Sepsis ....................................... 40
Subtopic 7: Sepsis in Special Populations ..................................................................... 48
Subtopic 8: Hemodynamic Monitoring and Shock Management in Sepsis ....................... 55
Subtopic 9: Antimicrobial Stewardship and Timing in Sepsis .......................................... 63
Subtopic 10: Multiorgan Dysfunction and Long-Term Sepsis Complications .................... 71
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Subtopic 1: Early Recognition and Clinical Assessment of
Sepsis
Question 1:
Which of the following clinical findings is most indicative of early sepsis in an adult patient?
A. Bradycardia and hypertension
B. Tachypnea and hypotension
C. Decreased urinary output and jaundice
D. Cyanosis and confusion
Correct Answer: B. Tachypnea and hypotension
Rationale: Early sepsis often presents with signs of systemic inflammation, including
increased respiratory rate and low blood pressure due to vasodilation and capillary leak.
Question 2:
What is the significance of elevated lactate levels (>2 mmol/L) in a patient suspected of
sepsis?
A. It confirms infection
B. It rules out shock
C. It indicates possible tissue hypoperfusion
D. It signifies renal failure
Correct Answer: C. It indicates possible tissue hypoperfusion
Rationale: Elevated lactate levels are a marker of cellular hypoxia and anaerobic
metabolism, often present in sepsis and septic shock.
Question 3:
A patient with suspected sepsis has a heart rate of 125 bpm, RR of 24, and a WBC count of
15,000. Which criteria are being met according to SIRS?
A. Only HR and WBC count
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B. Only RR and HR
C. All three (HR, RR, WBC count)
D. None
Correct Answer: C. All three (HR, RR, WBC count)
Rationale: SIRS criteria include HR >90 bpm, RR >20, and WBC count >12,000 or <4,000 or
>10% bands. This patient meets all criteria.
Question 4:
Which physical finding is most concerning for progressing septic shock?
A. Warm, flushed skin
B. Fever of 101°F
C. Cold, clammy extremities
D. Mild dyspnea
Correct Answer: C. Cold, clammy extremities
Rationale: As sepsis progresses to septic shock, peripheral vasoconstriction leads to cold
and clammy skin due to poor perfusion.
Question 5:
A nurse is using the qSOFA screening tool. Which of the following criteria are included?
A. Blood pressure, temperature, and heart rate
B. Respiratory rate, altered mentation, systolic BP <100 mmHg
C. WBC count, platelet count, creatinine
D. Oxygen saturation, HR, and RR
Correct Answer: B. Respiratory rate, altered mentation, systolic BP <100 mmHg
Rationale: qSOFA uses RR ≥22, altered mental status, and SBP ≤100 mmHg as criteria to
identify patients at risk of poor outcomes from sepsis.
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Question 6:
Which of the following lab values best correlates with systemic inflammatory response in
sepsis?
A. Hematocrit
B. Platelet count
C. Procalcitonin
D. ALT/AST
Correct Answer: C. Procalcitonin
Rationale: Procalcitonin levels rise in response to bacterial infections and are often used
as a biomarker for sepsis.
Question 7:
What is the most reliable early indicator of organ dysfunction in sepsis?
A. Cyanosis
B. Fever
C. Altered mental status
D. Hyperglycemia
Correct Answer: C. Altered mental status
Rationale: Changes in mentation are often early signs of cerebral hypoperfusion and
sepsis-related encephalopathy.
Question 8:
A patient has a temperature of 96.8°F, HR of 110, and confusion. What is the nurse’s priority
concern?
A. Rule out stroke
B. Give oxygen
C. Initiate sepsis protocol
HESI Exit Exam Sepsis Protocols Question
Bank: Infection, Shock & Critical Care
Table of Contents
Subtopic 1: Early Recognition and Clinical Assessment of Sepsis ..................................... 2
Subtopic 2: Pathophysiology and Risk Factors of Sepsis .................................................. 9
Subtopic 3: Diagnostic Strategies and Laboratory Markers in Sepsis ............................... 17
Subtopic 4: Fluid Resuscitation and Hemodynamic Management in Sepsis .................... 25
Subtopic 5: Antimicrobial Therapy and Source Control in Sepsis .................................... 32
Subtopic 6: Organ Dysfunction and Supportive Care in Sepsis ....................................... 40
Subtopic 7: Sepsis in Special Populations ..................................................................... 48
Subtopic 8: Hemodynamic Monitoring and Shock Management in Sepsis ....................... 55
Subtopic 9: Antimicrobial Stewardship and Timing in Sepsis .......................................... 63
Subtopic 10: Multiorgan Dysfunction and Long-Term Sepsis Complications .................... 71
, 2
Subtopic 1: Early Recognition and Clinical Assessment of
Sepsis
Question 1:
Which of the following clinical findings is most indicative of early sepsis in an adult patient?
A. Bradycardia and hypertension
B. Tachypnea and hypotension
C. Decreased urinary output and jaundice
D. Cyanosis and confusion
Correct Answer: B. Tachypnea and hypotension
Rationale: Early sepsis often presents with signs of systemic inflammation, including
increased respiratory rate and low blood pressure due to vasodilation and capillary leak.
Question 2:
What is the significance of elevated lactate levels (>2 mmol/L) in a patient suspected of
sepsis?
A. It confirms infection
B. It rules out shock
C. It indicates possible tissue hypoperfusion
D. It signifies renal failure
Correct Answer: C. It indicates possible tissue hypoperfusion
Rationale: Elevated lactate levels are a marker of cellular hypoxia and anaerobic
metabolism, often present in sepsis and septic shock.
Question 3:
A patient with suspected sepsis has a heart rate of 125 bpm, RR of 24, and a WBC count of
15,000. Which criteria are being met according to SIRS?
A. Only HR and WBC count
, 3
B. Only RR and HR
C. All three (HR, RR, WBC count)
D. None
Correct Answer: C. All three (HR, RR, WBC count)
Rationale: SIRS criteria include HR >90 bpm, RR >20, and WBC count >12,000 or <4,000 or
>10% bands. This patient meets all criteria.
Question 4:
Which physical finding is most concerning for progressing septic shock?
A. Warm, flushed skin
B. Fever of 101°F
C. Cold, clammy extremities
D. Mild dyspnea
Correct Answer: C. Cold, clammy extremities
Rationale: As sepsis progresses to septic shock, peripheral vasoconstriction leads to cold
and clammy skin due to poor perfusion.
Question 5:
A nurse is using the qSOFA screening tool. Which of the following criteria are included?
A. Blood pressure, temperature, and heart rate
B. Respiratory rate, altered mentation, systolic BP <100 mmHg
C. WBC count, platelet count, creatinine
D. Oxygen saturation, HR, and RR
Correct Answer: B. Respiratory rate, altered mentation, systolic BP <100 mmHg
Rationale: qSOFA uses RR ≥22, altered mental status, and SBP ≤100 mmHg as criteria to
identify patients at risk of poor outcomes from sepsis.
, 4
Question 6:
Which of the following lab values best correlates with systemic inflammatory response in
sepsis?
A. Hematocrit
B. Platelet count
C. Procalcitonin
D. ALT/AST
Correct Answer: C. Procalcitonin
Rationale: Procalcitonin levels rise in response to bacterial infections and are often used
as a biomarker for sepsis.
Question 7:
What is the most reliable early indicator of organ dysfunction in sepsis?
A. Cyanosis
B. Fever
C. Altered mental status
D. Hyperglycemia
Correct Answer: C. Altered mental status
Rationale: Changes in mentation are often early signs of cerebral hypoperfusion and
sepsis-related encephalopathy.
Question 8:
A patient has a temperature of 96.8°F, HR of 110, and confusion. What is the nurse’s priority
concern?
A. Rule out stroke
B. Give oxygen
C. Initiate sepsis protocol
