A nurse is caring for a client in septic shock. The client is still hypotensive and lethargic following a 2,500 mL fluid bolus of lactated Ringer (LR) solution. Which of the following interventions does the nurse anticipate next?

Epinephrine intramuscular (IM) injection

Norepinephrine intravenous (IV) infusion

Dobutamine intravenous (IV) infusion

Dexamethasone intravenous (IV) injection

Answer and Explanation

The Correct Answer is B

A. Epinephrine IM injection is not appropriate in this scenario, as it is typically reserved for treating anaphylactic shock. It is not used for septic shock where hypotension persists after fluid resuscitation.
B. Norepinephrine IV infusion is the correct choice. It is the first-line vasopressor in septic shock management when a fluid bolus does not adequately raise blood pressure. Norepinephrine works by constricting blood vessels, thereby increasing vascular resistance and blood pressure.
C. Dobutamine IV infusion might be considered if there is evidence of myocardial dysfunction or if additional inotropic support is necessary. However, it is not the immediate next step following fluid resuscitation when addressing persistent hypotension in septic shock.
D. Dexamethasone IV injection is not indicated for treating septic shock directly. It may be used in other contexts, such as treating adrenal insufficiency or reducing inflammation, but it does not play a role in immediate blood pressure management in septic shock.

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Correct Answer is B

Explanation

B. Postmenopausal vaginal bleeding is a common symptom of endometrial cancer. It is one of the most significant warning signs for this condition in older women, as it may indicate abnormal growth in the endometrial lining.
A. Bloating is more commonly associated with ovarian cancer and gastrointestinal issues rather than endometrial cancer specifically.
C. Feeling full quickly after eating is more indicative of ovarian cancer or other gastrointestinal problems.
D. Unexplained weight gain is not a typical primary symptom of endometrial cancer; it is less specific and can be associated with various other conditions.

A. Performing hand hygiene before, during, and after direct contact with the client B. Changing the client's bed linens each day C. Controlling the client's blood glucose level D. Placing the client in a room with positive-pressure airflow

Correct Answer is A

Explanation

A. Performing hand hygiene before, during, and after direct contact with the client is the most effective strategy for preventing the transmission of infections. Hand hygiene interrupts the transmission of pathogens and is a cornerstone of infection control practices.
B. Changing the client's bed linens each day is a standard practice for maintaining cleanliness but does not specifically prevent infection transmission. The primary goal of infection control is to reduce pathogen transmission rather than just maintaining general cleanliness.
C. Controlling the client's blood glucose level is important for overall health and wound healing but does not directly prevent infection transmission. It is not an infection control strategy.
D. Placing the client in a room with positive-pressure airflow is used to protect immunocompromised patients from infections by preventing outside air from entering the room. However, it is not appropriate for preventing the transmission of an infection from a client to others.

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A nurse is caring for a client in septic shock. The client is still hypotensive and lethargic following a 2,500 mL fluid bolus of lactated Ringer (LR) solution. Which of the following interventions does the nurse anticipate next?

Nursing Test Bank

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