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NUR 265 Advanced Medical-Surgical Nursing Exam 3 | Versions V1, V2,
V3 | Original Practice Questions with Answers & Rationales
Exam 3 Content Focus: Multi-System Failure, Trauma,
Emergency Nursing, Shock & Critical Care Management
VERSION 1 (V1)
Questions
1. A client with septic shock remains hypotensive (MAP 55
mmHg) after receiving 30 mL/kg of IV crystalloid fluid. What is
the priority intervention?
A. Administer additional fluid boluses indefinitely
B. Initiate norepinephrine infusion as prescribed
C. Administer a beta-blocker
D. Decrease monitoring frequency
Answer: B
Rationale: Septic shock unresponsive to initial fluid
resuscitation requires vasopressor therapy (norepinephrine) to
maintain MAP ≥65 mmHg and restore tissue perfusion.
2. What is the definition of multiple organ dysfunction
syndrome (MODS)?
,https://www.stuvia.com/user/performance
A. Failure of a single organ
B. Progressive dysfunction of two or more organ systems due to
severe illness or injury
C. Transient organ dysfunction
D. Only renal and hepatic failure
Answer: B
Rationale: MODS is the progressive dysfunction of two or more
organ systems, often triggered by sepsis, trauma, or shock, and
is associated with high mortality.
3. What is the most common cause of MODS?
A. Diabetes mellitus
B. Sepsis
C. Hypertension
D. Chronic obstructive pulmonary disease
Answer: B
Rationale: Sepsis is the most common cause of MODS, as the
systemic inflammatory response leads to widespread
endothelial damage and organ dysfunction.
4. What is the hallmark sign of sepsis?
A. Isolated fever
B. Fever or hypothermia, tachycardia, tachypnea, and organ
,https://www.stuvia.com/user/performance
dysfunction
C. Only hypotension
D. Only altered mental status
Answer: B
Rationale: Sepsis is characterized by a systemic inflammatory
response with fever or hypothermia, tachycardia, tachypnea,
and evidence of organ dysfunction.
5. What is the first-line treatment for sepsis?
A. Delayed antibiotics until cultures return
B. Early broad-spectrum antibiotics and fluid resuscitation
within the first hour
C. Antipyretics only
D. Observation without intervention
Answer: B
Rationale: The Surviving Sepsis Campaign recommends early
broad-spectrum antibiotics and aggressive fluid resuscitation
within the first hour (1-hour bundle) to reduce mortality.
6. What is the definition of septic shock?
A. Sepsis with normal blood pressure
B. Sepsis with hypotension unresponsive to fluid resuscitation,
requiring vasopressors
, https://www.stuvia.com/user/performance
C. Sepsis without organ dysfunction
D. Sepsis with only fever
Answer: B
Rationale: Septic shock is sepsis with hypotension that persists
despite adequate fluid resuscitation, requiring vasopressors to
maintain MAP ≥65 mmHg and lactate >2 mmol/L.
7. What is the first-line vasopressor for septic shock?
A. Dopamine
B. Norepinephrine
C. Epinephrine
D. Phenylephrine
Answer: B
Rationale: Norepinephrine is the first-line vasopressor for septic
shock due to its potent vasoconstrictive effects and minimal
impact on heart rate.
8. What is the purpose of the 1-hour sepsis bundle?
A. To delay treatment until all tests are complete
B. To initiate rapid assessment, blood cultures, lactate
measurement, fluids, and antibiotics within 1 hour
C. To reduce monitoring frequency
D. To avoid unnecessary interventions
NUR 265 Advanced Medical-Surgical Nursing Exam 3 | Versions V1, V2,
V3 | Original Practice Questions with Answers & Rationales
Exam 3 Content Focus: Multi-System Failure, Trauma,
Emergency Nursing, Shock & Critical Care Management
VERSION 1 (V1)
Questions
1. A client with septic shock remains hypotensive (MAP 55
mmHg) after receiving 30 mL/kg of IV crystalloid fluid. What is
the priority intervention?
A. Administer additional fluid boluses indefinitely
B. Initiate norepinephrine infusion as prescribed
C. Administer a beta-blocker
D. Decrease monitoring frequency
Answer: B
Rationale: Septic shock unresponsive to initial fluid
resuscitation requires vasopressor therapy (norepinephrine) to
maintain MAP ≥65 mmHg and restore tissue perfusion.
2. What is the definition of multiple organ dysfunction
syndrome (MODS)?
,https://www.stuvia.com/user/performance
A. Failure of a single organ
B. Progressive dysfunction of two or more organ systems due to
severe illness or injury
C. Transient organ dysfunction
D. Only renal and hepatic failure
Answer: B
Rationale: MODS is the progressive dysfunction of two or more
organ systems, often triggered by sepsis, trauma, or shock, and
is associated with high mortality.
3. What is the most common cause of MODS?
A. Diabetes mellitus
B. Sepsis
C. Hypertension
D. Chronic obstructive pulmonary disease
Answer: B
Rationale: Sepsis is the most common cause of MODS, as the
systemic inflammatory response leads to widespread
endothelial damage and organ dysfunction.
4. What is the hallmark sign of sepsis?
A. Isolated fever
B. Fever or hypothermia, tachycardia, tachypnea, and organ
,https://www.stuvia.com/user/performance
dysfunction
C. Only hypotension
D. Only altered mental status
Answer: B
Rationale: Sepsis is characterized by a systemic inflammatory
response with fever or hypothermia, tachycardia, tachypnea,
and evidence of organ dysfunction.
5. What is the first-line treatment for sepsis?
A. Delayed antibiotics until cultures return
B. Early broad-spectrum antibiotics and fluid resuscitation
within the first hour
C. Antipyretics only
D. Observation without intervention
Answer: B
Rationale: The Surviving Sepsis Campaign recommends early
broad-spectrum antibiotics and aggressive fluid resuscitation
within the first hour (1-hour bundle) to reduce mortality.
6. What is the definition of septic shock?
A. Sepsis with normal blood pressure
B. Sepsis with hypotension unresponsive to fluid resuscitation,
requiring vasopressors
, https://www.stuvia.com/user/performance
C. Sepsis without organ dysfunction
D. Sepsis with only fever
Answer: B
Rationale: Septic shock is sepsis with hypotension that persists
despite adequate fluid resuscitation, requiring vasopressors to
maintain MAP ≥65 mmHg and lactate >2 mmol/L.
7. What is the first-line vasopressor for septic shock?
A. Dopamine
B. Norepinephrine
C. Epinephrine
D. Phenylephrine
Answer: B
Rationale: Norepinephrine is the first-line vasopressor for septic
shock due to its potent vasoconstrictive effects and minimal
impact on heart rate.
8. What is the purpose of the 1-hour sepsis bundle?
A. To delay treatment until all tests are complete
B. To initiate rapid assessment, blood cultures, lactate
measurement, fluids, and antibiotics within 1 hour
C. To reduce monitoring frequency
D. To avoid unnecessary interventions
