Inflammatory Response
Mediators that stimulate the local inflammatory response are released from which type of activated cell?
a. Platelets
b. Endothelial cells
c. Leukocytes
d. Bacteria
b. Endothelial cells
The patient is assessed with the following: Temp 39.5 degrees C, HR 110 bpm, RR 12/min, WBC 15,000 with greater than 10% bands. How many of the criteria for SIRS does this patient exhibit?
a. 1
b. 2
c. 3
d. 4
c. 3
MODS is characterized by the dysfunction of how many organ systems?
a. 1
b. 2 or more
c. 3 or more
d. 4 or more
b. 2 or more
What are the results of the respiratory dysfunction associated with MODS?
a. A high PaCO2 with a high PaO2
b. Increased diffusion across the alveolar membrane
c. Refractory hypoxia
d. Profound hemoptysis
c. Refractory hypoxia
Which strategy is essential to reducing the mortality. associated with MODS?
a. Early recognition and management of MODS
b. Administration of acetaminophen for febrile episodes
c. Prompt administration of aminoglycosides as ordered
d. Knowing how to operate a dialysis machine
a. Early recognition and management of MODS
How does the endothelium orchestrate the local inflammatory response? (SATA)
a. By decreasing capillary permeability
b. By promoting adhesion of white blood cells
c. By altering local vasomotor tone
d. By inducing thrombin generation
e. By blocking apoptosis
b. By promoting adhesion of white blood cells
c. By altering local vasomotor tone
d. By inducing thrombin generation
Which statement about the pathogenesis of SIRS is accurate?
a. It is not associated with MODS
b. It is an abnormal generalized pro-inflammatory response
c. It is an attempt to limit inflammation
d. It is associated with an excessive anti-inflammatory response
b. It is an abnormal generalized pro-inflammatory response
Primary MODS can develop in response to which factor?
a. The insult itself
b. Secondary complications
c. An exaggerated SIRS
d. Septic shock
a. The insult itself
Which finding reflects worsening cardiovascular function?
a. High cardiac output
b. Increasing PAR values
c. Increasing PaO2/FiO2
d. Tachycardia
b. Increasing PAR values
What is the best way to prevent MODS?
a. Place the patient on mechanical ventilation
b. Initiate antibiotics with the onset of fever
c. Ensure optimal oxygenation
d. Prevent SIRS and sepsis
d. Prevent SIRS and sepsis
What is the primary benefit of the redness, heat, and swelling associated with local inflammation?
a. It encourages the host to protect the injury site
b. It destroys infective organisms
c. It alters the pH of the injury area
d. It facilitates entry of immune cells into the area of injury
d. It facilitates entry of immune cells into the area of injury
What are risk factors for SIRS? (SATA)
a. Older age
b. Immunosuppression
c. Gut hypo-perfusion
d. Low BMI
e. Malnutrition
a. Older age
b. Immunosuppression
c. Gut hypo-perfusion
e. Malnutrition
Why is advancing age a risk factor for developing MODS?
a. Older adults do not have the money to pay for services
b. Older adults do not take antibiotics as prescribed
c. Older adults have decreased functional reserve
d. Older adults have enhanced stress response
c. Older adults have decreased functional reserve
Mortality in MODS-related AKI is lower in which case?
a. Urine output is greater than 400 mL/day
b. Serum creatinine is greater than 4.0
c. Neurologic function is maintained
d. Hemodialysis is delayed until absolutely necessary
a. Urine output is greater than 400 mL/day
Which nursing interventions decrease the incidence of infection? (SATA)
a. Monitoring vital signs every 2 hours
b. Strict adherence to hand hygiene
c. Use of ventilator bundle
d. Meticulous catheter care
e. Maintenance of patient skin integrity
b. Strict adherence to hand hygiene
c. Use of ventilator bundle
d. Meticulous catheter care
e. Maintenance of patient skin integrity
If the host inflammatory response becomes generalized, what is the result?
a. A reduction in secretion of mediators
b. Increased pain at the site of injury
c. Widespread involvement of endothelial cells
d. Localized vasoconstriction and coagulation
c. Widespread involvement of endothelial cells
What are the most common underlying causes of SIRS? (SATA)
a. Trauma
b. Autoimmune disorders
c. Acute pancreatitis
d. Major surgery
e. Infection
a. Trauma
c. Acute pancreatitis
d. Major surgery
e. Infection
Which pathophysiologic condition occurs as a result of anaerobic metabolism?
a. Metabolic shutdown
b. Apoptosis
c. Uncontrolled systemic inflammation
d. Microvascular coagulopathy
a. Metabolic shutdown
What is the most severe manifestation of hematological dysfunction?
a. Anemia
b. Thrombocytopenia
c. DIC
d. Jaundice
c. DIC
The nurse has orders to obtain blood cultures and begin IV antibiotic therapy. Which statement is correct regarding these orders?
a. IV antibiotics should be started before obtaining blood cultures
b. Blood cultures should be obtained before starting antibiotics
c. The sequence in which the orders are carried out does not matter
d. The prescribing provider should be consulted to clarify the orders
b. Blood cultures should be obtained before starting antibiotics