Midterml Exam:l NRl 572/l NR572l
(NEWl 2026/l 2027l Update)l Advancedl
Acutel Carel Managementl Guide|l
Questionsl &l Answersl |l Gradel A|l
100%l Correctl (Verifiedl Solutions)-
Chamberlain
QUESTION
Mesentary
Answer:
l al foldl ofl thel peritoneuml thatl attachesl thel stomach,l smalll intestine,l pancreas,l spleen,l
andl otherl organsl tol thel posteriorl walll ofl thel abdomen.
QUESTION
omentum
Answer:
l al foldl ofl peritoneuml connectingl thel stomachl withl otherl abdominall organsl anteriorly
QUESTION
intraperitoneall organs
Answer:
l Stomach,l firstl partl ofl duodenum,l jejunum,l ileum,l transversel andl sigmoidl colon,l liver,l
spleen
Completelyl coveredl withl thel viscerall peritoneuml insidel peritoneall cavity
,QUESTION
Retroperitoneall organs
Answer:
l Kidneys,l ureters,l suprarenal,l glands,l rectum
Partiallyl coveredl withl parietall peritoneuml butl outsidel ofl thel peritoneall cavity
QUESTION
Sepsis
Answer:
l Al life-threateningl organl dysfunctionl causedl byl al regulatedl hostl inflammatoryl responsel
tol infectionl suspectedl orl confirmed.l
Organl dysfunctionl :l hypotension,l confusion,l delirium,l hypoxemia,l respiratoryl failure,l
oliguria,l elevated,l creatinine,l liverl failure,l ileus,l sepsis-l induced,l cardiomyopathy,l
coagulopathy,l leukocytosis,l thrombocytopenia,l skinl mottling,l etc.
QUESTION
Septicl shock
Answer:
l Al subsetl ofl sepsisl inl whichl particularlyl profoundl circulatory,l cellular,l andl metabolicl
abnormalitiesl arel associatedl withl al greaterl riskl ofl mortalityl thanl withl sepsisl alone.
Distributivel shock
QUESTION
Differentialsl forl sepsis
Answer:
l AKI,l ARDS,l adrenall crisis,l cardiogenic,l hemorrhagic,l orl hypovolemicl shock,l MI,l
anaphylacticl reaction,l PE,l DKA,l salicylatel toxicity,l toxicl shockl syndrome,l toxicl
epidermall necrolysisl (TEN),l thyrotoxicosis
,QUESTION
Diagnosticsl forl sepsis
Answer:
l Twol setsl ofl bloodl culturesl (anaerobicl andl aerobicl froml twol differentl sites)
Chestl x-rayl (pulmonaryl edema,l pneumonia,l ARDS)
Urine,l sputum,l andl otherl culturesl
EKGl (arrhythmias,l ischemia,l infarction)
2Dl echol (valve,l vegetation,l cardiacl output)
Diagnosticl imagingl forl infectiousl sourcel andl abdomenl
CSFl analysisl (ventriculostomy,l ventriculoperitoneall shunt/VPl shunt)
Procalcitoninl (associatedl withl bacteriall infectionl andl sepsis)
Cl reactivel proteinl
CBCl withl differentiall (anemia,l thrombocytopenia,l leukocytosisl withl bandemia)
Metabolicl panell (AKI,l anionl gapl acidosis,l hyperglycemia,l hyperbilirubinemia)
Seruml lactatel (>4mmol/Ll consistentl withl systemicl hypol perfusion)
ABGl (PaO2,l PaCO2,l pH)
Bloodl culturel froml CVCl ifl presentl tol assessl forl catheterl relatedl sepsisl
Disseminatedl intravascularl coagulationl panell (DIC)-l INR,l aPTT,l fibrinogen
*Seruml lactate-l >4mmoll =l systemicl hypoperfusion*
QUESTION
Septicl shockl diagnosticl criteria
Answer:
l 1)l Persistentl hypotensionl requiringl vasopressorsl tol maintainl MAPl greaterl thanl 65
2)l Elevatedl seruml lactatel levell despitel adequatel fluidl resuscitationl (>2)
Lacticl acidosisl isl perilous!l =l MODSl andl deathl ifl tissuel hypoperfusionl froml septicl
shockl continuesl orl worsens=l increasedl lacticl acidosis
QUESTION
MODS
Answer:
l Multiplel systeml organl dysfunctionl syndrome
, Assessmentl toolsl :
Sequentiall organl failurel assessmentl (SOFA)
Quickl SOFAl (qSOFA)
Usedl tol clinicallyl categorizel clientsl withl sepsisl andl organl dysfunction
QUESTION
SOFA
Answer:
l Sequentiall (sepsisl related)l Organl Failurel Assessment:
-gradesl functionl ofl sixl organl systemsl onl al scalel ofl 0-4
-basedl onl thel degreel ofl dysfunctionl usingl objectivel measurements
-al scorel ofl twol orl morel pointsl meetsl thel criterial forl organl dysfunction
-Asl thel scorel increases,l hospitall mortalityl increases
-requiresl ABGl andl seruml bloodl workl results
QUESTION
qSOFAl score
Answer:
l H-l hypotension
A-l alteredl mentall status
T-l tachypnea
Presencel ofl 2l criterial (1l pointl each):
GCSl <15,l RRl >22,l SBPl <100
Scorel >2l inl non-icul patientsl associatedl withl significantlyl increasedl hospitall mortality.
QUESTION
Septicl shockl treatment
Answer:
(NEWl 2026/l 2027l Update)l Advancedl
Acutel Carel Managementl Guide|l
Questionsl &l Answersl |l Gradel A|l
100%l Correctl (Verifiedl Solutions)-
Chamberlain
QUESTION
Mesentary
Answer:
l al foldl ofl thel peritoneuml thatl attachesl thel stomach,l smalll intestine,l pancreas,l spleen,l
andl otherl organsl tol thel posteriorl walll ofl thel abdomen.
QUESTION
omentum
Answer:
l al foldl ofl peritoneuml connectingl thel stomachl withl otherl abdominall organsl anteriorly
QUESTION
intraperitoneall organs
Answer:
l Stomach,l firstl partl ofl duodenum,l jejunum,l ileum,l transversel andl sigmoidl colon,l liver,l
spleen
Completelyl coveredl withl thel viscerall peritoneuml insidel peritoneall cavity
,QUESTION
Retroperitoneall organs
Answer:
l Kidneys,l ureters,l suprarenal,l glands,l rectum
Partiallyl coveredl withl parietall peritoneuml butl outsidel ofl thel peritoneall cavity
QUESTION
Sepsis
Answer:
l Al life-threateningl organl dysfunctionl causedl byl al regulatedl hostl inflammatoryl responsel
tol infectionl suspectedl orl confirmed.l
Organl dysfunctionl :l hypotension,l confusion,l delirium,l hypoxemia,l respiratoryl failure,l
oliguria,l elevated,l creatinine,l liverl failure,l ileus,l sepsis-l induced,l cardiomyopathy,l
coagulopathy,l leukocytosis,l thrombocytopenia,l skinl mottling,l etc.
QUESTION
Septicl shock
Answer:
l Al subsetl ofl sepsisl inl whichl particularlyl profoundl circulatory,l cellular,l andl metabolicl
abnormalitiesl arel associatedl withl al greaterl riskl ofl mortalityl thanl withl sepsisl alone.
Distributivel shock
QUESTION
Differentialsl forl sepsis
Answer:
l AKI,l ARDS,l adrenall crisis,l cardiogenic,l hemorrhagic,l orl hypovolemicl shock,l MI,l
anaphylacticl reaction,l PE,l DKA,l salicylatel toxicity,l toxicl shockl syndrome,l toxicl
epidermall necrolysisl (TEN),l thyrotoxicosis
,QUESTION
Diagnosticsl forl sepsis
Answer:
l Twol setsl ofl bloodl culturesl (anaerobicl andl aerobicl froml twol differentl sites)
Chestl x-rayl (pulmonaryl edema,l pneumonia,l ARDS)
Urine,l sputum,l andl otherl culturesl
EKGl (arrhythmias,l ischemia,l infarction)
2Dl echol (valve,l vegetation,l cardiacl output)
Diagnosticl imagingl forl infectiousl sourcel andl abdomenl
CSFl analysisl (ventriculostomy,l ventriculoperitoneall shunt/VPl shunt)
Procalcitoninl (associatedl withl bacteriall infectionl andl sepsis)
Cl reactivel proteinl
CBCl withl differentiall (anemia,l thrombocytopenia,l leukocytosisl withl bandemia)
Metabolicl panell (AKI,l anionl gapl acidosis,l hyperglycemia,l hyperbilirubinemia)
Seruml lactatel (>4mmol/Ll consistentl withl systemicl hypol perfusion)
ABGl (PaO2,l PaCO2,l pH)
Bloodl culturel froml CVCl ifl presentl tol assessl forl catheterl relatedl sepsisl
Disseminatedl intravascularl coagulationl panell (DIC)-l INR,l aPTT,l fibrinogen
*Seruml lactate-l >4mmoll =l systemicl hypoperfusion*
QUESTION
Septicl shockl diagnosticl criteria
Answer:
l 1)l Persistentl hypotensionl requiringl vasopressorsl tol maintainl MAPl greaterl thanl 65
2)l Elevatedl seruml lactatel levell despitel adequatel fluidl resuscitationl (>2)
Lacticl acidosisl isl perilous!l =l MODSl andl deathl ifl tissuel hypoperfusionl froml septicl
shockl continuesl orl worsens=l increasedl lacticl acidosis
QUESTION
MODS
Answer:
l Multiplel systeml organl dysfunctionl syndrome
, Assessmentl toolsl :
Sequentiall organl failurel assessmentl (SOFA)
Quickl SOFAl (qSOFA)
Usedl tol clinicallyl categorizel clientsl withl sepsisl andl organl dysfunction
QUESTION
SOFA
Answer:
l Sequentiall (sepsisl related)l Organl Failurel Assessment:
-gradesl functionl ofl sixl organl systemsl onl al scalel ofl 0-4
-basedl onl thel degreel ofl dysfunctionl usingl objectivel measurements
-al scorel ofl twol orl morel pointsl meetsl thel criterial forl organl dysfunction
-Asl thel scorel increases,l hospitall mortalityl increases
-requiresl ABGl andl seruml bloodl workl results
QUESTION
qSOFAl score
Answer:
l H-l hypotension
A-l alteredl mentall status
T-l tachypnea
Presencel ofl 2l criterial (1l pointl each):
GCSl <15,l RRl >22,l SBPl <100
Scorel >2l inl non-icul patientsl associatedl withl significantlyl increasedl hospitall mortality.
QUESTION
Septicl shockl treatment
Answer:
