CCRN - Review Sepsis and MODS Questions and Answers

Question 1

A 68-year-old patient is admitted from the emergency department with a diagnosis of community-acquired pneumonia.
The patient has a temperature of 38.9°C, heart rate of 120 bpm, respiratory rate of 28/min, and a blood pressure of 88/50 mmHg.
According to the Surviving Sepsis Campaign's Hour-1 Bundle, which of the following is a priority intervention?

Accepted Answer

Administer broad-spectrum antibiotics.

Answer

Obtain a procalcitonin level.

Answer

Insert a pulmonary artery catheter.

Answer

Administer low-dose corticosteroids.

Question 2

A patient in the ICU is diagnosed with septic shock. The critical care nurse understands that the profound hypotension associated with this condition is primarily caused by which pathophysiological mechanism?

Accepted Answer

Massive peripheral vasodilation.

Answer

Pathologic myocardial depression.

Answer

A severe reduction in absolute intravascular volume.

Answer

Intense systemic vasoconstriction.

Question 3

A patient with a known infection has been receiving intravenous fluids for sepsis-induced hypotension. Despite receiving 30 mL/kg of crystalloid fluid, the patient's mean arterial pressure (MAP) is 60 mmHg and requires a norepinephrine infusion to maintain a MAP ≥ 65 mmHg. A repeat lactate level is 4.5 mmol/L. These findings are most indicative of which condition?

Accepted Answer

Septic Shock.

Answer

Systemic Inflammatory Response Syndrome (SIRS).

Answer

Sepsis.

Answer

Multiple Organ Dysfunction Syndrome (MODS).

Question 4

A 55-year-old patient with septic shock has a mean arterial pressure (MAP) of 58 mmHg after receiving an adequate crystalloid fluid bolus. The physician orders a continuous vasopressor infusion. Which agent does the nurse anticipate administering as the first-line choice?

Accepted Answer

Norepinephrine.

Answer

Phenylephrine.

Answer

Epinephrine.

Answer

Vasopressin.

Question 5

A patient in the ICU for five days with severe sepsis from peritonitis now exhibits jaundice, a total bilirubin level of 4.5 mg/dL (77 µmol/L), and an INR of 1.8. These findings are most indicative of the onset of dysfunction in which organ system as part of MODS?

Accepted Answer

Hepatic.

Answer

Renal.

Answer

Hematologic.

Answer

Cardiovascular.

Question 6

The critical care nurse is trending serial lactate levels in a patient undergoing resuscitation for septic shock. What is the primary clinical significance of a persistently elevated or rising lactate level in this setting?

Accepted Answer

It reflects ongoing tissue hypoxia and anaerobic metabolism.

Answer

It is a direct marker of bacterial cell lysis.

Answer

It indicates the development of acute kidney injury.

Answer

It confirms the successful eradication of the infection.