PCCN PCCN Multisystem Conditions and Shock 2

Question 1

A progressive care patient meets SIRS criteria and has a suspected infection. According to current definitions, this patient has:

Accepted Answer

Sepsis

Answer

Sepsis is defined as life-threatening organ dysfunction caused by a dysregulated host response to infection; SIRS + infection meets the older sepsis definition and warrants treatment.

Question 2

A patient with MODS (multiple organ dysfunction syndrome) has the following: creatinine 3.1, bilirubin 4.2, PaO2/FiO2 ratio of 180, and GCS of 12. How many organ systems are affected?

Accepted Answer

Four

Answer

Renal (creatinine), hepatic (bilirubin), pulmonary (PaO2/FiO2 < 300), and neurological (GCS) dysfunction indicate four organ systems are failing.

Question 3

Which lactate level is most consistent with significant tissue hypoperfusion in a critically ill patient?

Accepted Answer

4.5 mmol/L

Answer

A lactate ≥ 4 mmol/L indicates severe tissue hypoperfusion and is associated with increased mortality, meeting the threshold for septic shock workup.

Question 4

A patient in neurogenic shock following a cervical spine injury presents with hypotension and bradycardia. This pattern is caused by:

Accepted Answer

Loss of sympathetic nervous system tone below injury level

Answer

Cervical cord injury disrupts sympathetic outflow, causing loss of vasomotor tone and cardiac acceleration, resulting in hypotension and bradycardia.

Question 5

Which assessment finding indicates the progressive care patient with systemic inflammatory response is developing organ hypoperfusion?

Accepted Answer

Urine output of 0.3 mL/kg/hr for 3 hours

Answer

Oliguria (< 0.5 mL/kg/hr) is an early indicator of renal hypoperfusion and impending organ dysfunction in sepsis.

PCCN Exam Practice Test

PCCN Exam Practice Test

PCCN PCCN Multisystem Conditions and Shock 2