CCRN Sepsis and MODS 2 — Questions and Answers
Question 1: According to Surviving Sepsis Campaign guidelines, broad-spectrum antibiotics should be administered within what timeframe for patients with septic shock?
- Within 1 hour of recognition (Correct answer)
- Within 3 hours of recognition
- Within 6 hours of recognition
- After blood culture results return
Correct answer: Within 1 hour of recognition
Antibiotics should be given within 1 hour of recognizing septic shock to reduce mortality.
Question 2: A patient in septic shock remains hypotensive after adequate fluid resuscitation. Which vasopressor is the recommended first-line agent?
- Norepinephrine (Correct answer)
- Dopamine
- Phenylephrine
- Vasopressin
Correct answer: Norepinephrine
Norepinephrine is the first-line vasopressor for septic shock per current guidelines.
Question 3: Which lactate value best indicates tissue hypoperfusion and increased mortality risk in sepsis?
- Greater than 2 mmol/L (Correct answer)
- Less than 1 mmol/L
- Exactly 1.5 mmol/L
- Greater than 0.5 mmol/L
Correct answer: Greater than 2 mmol/L
A lactate above 2 mmol/L signals tissue hypoperfusion and warrants resuscitation.
Question 4: The initial recommended crystalloid fluid bolus for sepsis-induced hypoperfusion is at least:
- 30 mL/kg (Correct answer)
- 10 mL/kg
- 50 mL/kg
- 5 mL/kg
Correct answer: 30 mL/kg
At least 30 mL/kg of IV crystalloid is recommended within the first 3 hours.
Question 5: Which crystalloid is generally preferred for large-volume resuscitation in sepsis to avoid hyperchloremic acidosis?
- Balanced solutions like lactated Ringer's (Correct answer)
- 0.9% normal saline
- Dextrose 5% in water
- 0.45% half-normal saline
Correct answer: Balanced solutions like lactated Ringer's
Balanced crystalloids are favored over normal saline to reduce hyperchloremic metabolic acidosis.
Question 6: A septic patient develops new confusion, increased respiratory rate, and a SBP of 88 mmHg. Using qSOFA, how many criteria are met?
- 3 (Correct answer)
- 1
- 2
- 0
Correct answer: 3
Altered mentation, RR ≥22, and SBP ≤100 are all three qSOFA criteria.
Question 7: Which adjunctive therapy is recommended for septic shock patients who remain hemodynamically unstable despite fluids and vasopressors?
- IV hydrocortisone (Correct answer)
- High-dose insulin
- Activated protein C
- Routine fresh frozen plasma
Correct answer: IV hydrocortisone
IV hydrocortisone is suggested for refractory septic shock requiring ongoing vasopressors.
CCRN Sepsis and MODS 2
According to Surviving Sepsis Campaign guidelines, broad-spectrum antibiotics should be administered within what timeframe for patients with septic shock?