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Sepsis CD-ROM Posttest

INSTRUCTIONS: Select the most appropriate response. To receive credit, participants must earn a score of 80% or higher.

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1.	Sepsis is defined as infection accompanied by _______________.
A:		Organ dysfunction, hypoperfusion, or hypotension.
B:		Fever.
C:		Shock.
D:		Persistent perfusion abnormalities.

2.	Research has demonstrated that delaying antibiotic therapy _____________________.
A:		Decreases inappropriate antibiotic use
B:		Increases mortality risk
C:		Decreases antibiotic costs
D:		Improves patient outcomes

3.	Infections in patients with sepsis are most commonly ______________.
A:		Genitourinary
B:		Respiratory
C:		Abdominal
D:		Wound related

4.	_____________________ infections are most common causes of sepsis.
A:		Polymicrobial
B:		Anaerobic
C:		Fungal
D:		Gram-positive and -negative bacterial

5.	Early goal-directed therapy (EGDT) is a ____________________ protocol that specifies the achievement of _______________ endpoints.
A:		Resuscitation, hemodynamic
B:		Resuscitation, temperature
C:		Maintenance therapy, glucose
D:		Maintenance therapy, systolic blood pressure

6.	Based on the results of a number of studies, implementation of early goal-directed therapy (EGDT) reduces the relative risk of mortality due to sepsis by approximately:
A:		5% to 20%
B:		15% to 30%
C:		30% to 55%
D:		>75%

7.	___________________ and venous oxygen levels are good indicators of tissue oxygenation in most clinical settings.
A:		Blood pressure
B:		Cardiac index
C:		Stroke index
D:		Serum lactate levels

8.	Patients with severe sepsis most often experience dysfunction in which organ system?
A:		Cardiovascular
B:		CNS
C:		Respiratory
D:		Hematologic

9.	The following are signs of organ hypoperfusion or dysfunction EXCEPT:
A:		Decreased serum lactate levels
B:		Acute alteration of mental status
C:		Acute respiratory distress syndrome (ARDS)
D:		Oliguria

10.	The Surviving Sepsis Campaign (SSC) Evaluation for Severe Sepsis Screening Tool poses 3 questions regarding _________________, signs and symptoms of infection, and indications of organ dysfunction.
A:		Elapsed time since admission
B:		Elements of the patient’s history suggestive of infection
C:		Duration of emergency department wait
D:		Emergency contact information

11.	Care “bundles” are defined as ________________ practice recommendations related to a disease process that result in better outcomes when executed _________.
A:		Common-sense, as time allows
B:		Common-sense, as a group
C:		Evidence-based, as a group
D:		Evidence-based, as time allows

12.	_____ recommendations in the SSC/ Institute for Healthcare Improvement (IHI) severe sepsis resuscitation bundle should be completed within __ hours of identifying severe sepsis.
A:		A minimum of 3, 6
B:		A minimum of 3, 12
C:		All, 6
D:		All, 12

13.	The SSC/IHI severe sepsis resuscitation bundle specifies that a broad-spectrum antibiotic should be administered within ___ hours of ED admission and _______ blood cultures have been obtained.
A:		3, after
B:		6, after
C:		3, before
D:		6, before

14.	According to the SSC/IHI severe sepsis management bundle, each of the following should be performed, when appropriate, within 24 hours of identifying severe sepsis EXCEPT:
A:		Serum lactate determination
B:		Glucose control >70, but <150 mg/dL
C:		Recombinant human activated protein C (rhAPC) administration, according to standardized hospital policy
D:		Low-dose glucocorticoid administration for septic shock, according to standardized hospital policy

15.	Tools for starting the SSC, developing sepsis protocols, and assessing protocol success at your institution are available ______________.
A:		Only by special mail order request
B:		At the SSC website (http://www.survivingsepsis.org)
C:		At the IHI website (http://www.ihi.org/IHI/Topics/CriticalCare/Sepsis)
D:		At both the SSC and IHI websites