CPEN Sepsis and Infectious Disease Emergencies

Question 1

According to current Surviving Sepsis Campaign guidelines for pediatrics, what is the recommended time frame for administering IV antibiotics after recognizing septic shock?

Accepted Answer

Within 1 hour

Answer

The Surviving Sepsis Campaign recommends IV antibiotics within 1 hour of recognizing pediatric septic shock to reduce mortality.

Question 2

A 6-month-old presents with temperature of 38.5°C, heart rate of 180 bpm, respiratory rate of 55, and appears lethargic. What is the MOST appropriate initial intervention?

Accepted Answer

Obtain blood cultures and start broad-spectrum antibiotics

Answer

Blood cultures should be obtained immediately followed by empiric broad-spectrum antibiotics, as this toxic-appearing infant has a presentation highly concerning for sepsis.

Question 3

What is the recommended initial fluid bolus for a pediatric patient presenting in septic shock?

Accepted Answer

20 mL/kg of isotonic crystalloid

Answer

Current PALS guidelines recommend an initial fluid bolus of 20 mL/kg of isotonic crystalloid (normal saline or Lactated Ringer's) for pediatric septic shock.

Question 4

Which laboratory finding is MOST consistent with severe sepsis and tissue hypoperfusion?

Accepted Answer

Elevated serum lactate level greater than 2 mmol/L

Answer

Elevated lactate greater than 2 mmol/L indicates anaerobic metabolism from tissue hypoperfusion and is a key diagnostic and prognostic marker in severe sepsis.

Question 5

A 2-year-old with septic shock receives three fluid boluses totaling 60 mL/kg with minimal hemodynamic improvement. What is the NEXT most appropriate intervention?

Accepted Answer

Initiate vasoactive medications such as epinephrine or norepinephrine

Answer

After adequate fluid resuscitation without improvement, vasoactive/vasopressor support should be initiated for fluid-refractory septic shock.

CPEN - Certified Pediatric Emergency Nurse Practice Test

CPEN - Certified Pediatric Emergency Nurse Practice Test

CPEN Sepsis and Infectious Disease Emergencies