NURS 120 | Infection Control & Sepsis Comprehensive Exam 2026
|WCU
1. A patient with a suspected infection has a serum lactate level of 4.2 mmol/L.
Which pathophysiological state is most likely occurring at the cellular level?
A. Aerobic metabolism with efficient ATP production
B. Respiratory alkalosis due to compensatory hyperventilation
C. Increased renal clearance of metabolic byproducts
D. Anaerobic metabolism resulting from impaired tissue perfusion
Answer: D
Rationale: Lactate levels >2.0 mmol/L indicate tissue hypoxia and a shift from aerobic to
anaerobic metabolism, a hallmark of sepsis and septic shock.
2. In the ‘Chain of Infection,’ a nurse’s contaminated hands would be classified
as which of the following?
A. Mode of transmission
B. Portal of entry
C. Reservoir
D. Susceptible host
Answer: A
Rationale: Contaminated hands are a primary mode of transmission for pathogens in a
healthcare setting.
,3. Which clinical indicator is a component of the Quick Sequential Organ Failure
Assessment (qSOFA) score?
A. Heart rate > 100 bpm
B. Systolic blood pressure ≤ 100 mmHg
C. Temperature > 38.3°C
D. White blood cell count > 12,000/mm³
Answer: B
Rationale: The qSOFA score includes altered mental status (GCS <15), respiratory rate
≥22/min, and systolic blood pressure ≤100 mmHg.
4. A patient is admitted with a diagnosis of Clostridioides difficile. Which
infection control measure is mandatory?
A. Wearing an N95 respirator during care
B. Performing hand hygiene with alcohol-based foam only
C. Maintaining the patient in a negative-pressure room
D. Using soap and water for hand hygiene after contact
Answer: D
Rationale: C. diff spores are resistant to alcohol-based sanitizers; mechanical friction with
soap and water is required to remove them.
5. During the 1-hour Sepsis Bundle, what is the priority action for a nurse when
a patient presents with hypotension and a lactate of 4.5?
A. Administer broad-spectrum antibiotics
B. Initiate a 30 mL/kg crystalloid bolus
C. Obtain blood cultures
D. Start norepinephrine to maintain MAP > 65
Answer: B
Rationale: Aggressive fluid resuscitation is the priority for hypotension or lactate levels ≥
4 mmol/L to restore perfusion.
, 6. A patient has been diagnosed with Disseminated Intravascular Coagulation
(DIC) secondary to sepsis. Which lab finding is most consistent with this?
A. Shortened Prothrombin Time (PT)
B. Increased Fibrinogen levels
C. Elevated D-dimer levels
D. Elevated platelet count
Answer: C
Rationale: DIC involves systemic activation of coagulation and fibrinolysis, leading to
depleted clotting factors and elevated D-dimer (fibrin degradation products).
7. What is the definitive purpose of ‘Shift to the Left’ in a WBC differential?
A. An increase in mature neutrophils (segments)
B. An increase in immature neutrophils (bands)
C. A decrease in total leukocyte count
D. The presence of viral-fighting lymphocytes
Answer: B
Rationale: A ‘shift to the left’ indicates that the bone marrow is releasing immature
neutrophils (bands) to fight an acute bacterial infection.
8. When dawning PPE for a patient on Droplet and Contact precautions, which
item should be applied first?
A. Gown
B. Mask
C. Gloves
D. Goggles
Answer: A
Rationale: The standard donning sequence is Gown, Mask, Goggles/Face Shield, and then
Gloves.
|WCU
1. A patient with a suspected infection has a serum lactate level of 4.2 mmol/L.
Which pathophysiological state is most likely occurring at the cellular level?
A. Aerobic metabolism with efficient ATP production
B. Respiratory alkalosis due to compensatory hyperventilation
C. Increased renal clearance of metabolic byproducts
D. Anaerobic metabolism resulting from impaired tissue perfusion
Answer: D
Rationale: Lactate levels >2.0 mmol/L indicate tissue hypoxia and a shift from aerobic to
anaerobic metabolism, a hallmark of sepsis and septic shock.
2. In the ‘Chain of Infection,’ a nurse’s contaminated hands would be classified
as which of the following?
A. Mode of transmission
B. Portal of entry
C. Reservoir
D. Susceptible host
Answer: A
Rationale: Contaminated hands are a primary mode of transmission for pathogens in a
healthcare setting.
,3. Which clinical indicator is a component of the Quick Sequential Organ Failure
Assessment (qSOFA) score?
A. Heart rate > 100 bpm
B. Systolic blood pressure ≤ 100 mmHg
C. Temperature > 38.3°C
D. White blood cell count > 12,000/mm³
Answer: B
Rationale: The qSOFA score includes altered mental status (GCS <15), respiratory rate
≥22/min, and systolic blood pressure ≤100 mmHg.
4. A patient is admitted with a diagnosis of Clostridioides difficile. Which
infection control measure is mandatory?
A. Wearing an N95 respirator during care
B. Performing hand hygiene with alcohol-based foam only
C. Maintaining the patient in a negative-pressure room
D. Using soap and water for hand hygiene after contact
Answer: D
Rationale: C. diff spores are resistant to alcohol-based sanitizers; mechanical friction with
soap and water is required to remove them.
5. During the 1-hour Sepsis Bundle, what is the priority action for a nurse when
a patient presents with hypotension and a lactate of 4.5?
A. Administer broad-spectrum antibiotics
B. Initiate a 30 mL/kg crystalloid bolus
C. Obtain blood cultures
D. Start norepinephrine to maintain MAP > 65
Answer: B
Rationale: Aggressive fluid resuscitation is the priority for hypotension or lactate levels ≥
4 mmol/L to restore perfusion.
, 6. A patient has been diagnosed with Disseminated Intravascular Coagulation
(DIC) secondary to sepsis. Which lab finding is most consistent with this?
A. Shortened Prothrombin Time (PT)
B. Increased Fibrinogen levels
C. Elevated D-dimer levels
D. Elevated platelet count
Answer: C
Rationale: DIC involves systemic activation of coagulation and fibrinolysis, leading to
depleted clotting factors and elevated D-dimer (fibrin degradation products).
7. What is the definitive purpose of ‘Shift to the Left’ in a WBC differential?
A. An increase in mature neutrophils (segments)
B. An increase in immature neutrophils (bands)
C. A decrease in total leukocyte count
D. The presence of viral-fighting lymphocytes
Answer: B
Rationale: A ‘shift to the left’ indicates that the bone marrow is releasing immature
neutrophils (bands) to fight an acute bacterial infection.
8. When dawning PPE for a patient on Droplet and Contact precautions, which
item should be applied first?
A. Gown
B. Mask
C. Gloves
D. Goggles
Answer: A
Rationale: The standard donning sequence is Gown, Mask, Goggles/Face Shield, and then
Gloves.
