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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Free Nursing Study Resources

Correct Answer is D

Explanation

D. Bradykinesia, or slowness of movement, is a hallmark symptom of Parkinson's disease. It is characterized by a gradual reduction in the speed of voluntary movements and is one of the primary motor symptoms associated with the disease.
A. Chorea, characterized by involuntary, irregular movements, is more commonly associated with Huntington's disease rather than Parkinson's disease.
B. Pruritus (itching) is not a characteristic symptom of Parkinson's disease.
C. Xerostomia (dry mouth) is not a primary symptom of Parkinson's disease, though it may occur as a secondary effect.

A. HbA1c level of 7.5% (nl. 4.4-6.4%) B. 2-hour post-prandial blood glucose level of 122 mg/dL (nl. <120 mg/dL) C. Random blood glucose level of 300 mg/dL (nl. <200 mg/dL) D. Fasting blood glucose level of 48 mg/dL (nl. 60-110 mg/dL)

Correct Answer is C

Explanation

A. An HbA1c level of 7.5% indicates suboptimal long-term glucose control. The target for many diabetic patients is usually below 7%, but it may not require immediate action compared to more acute indicators.
B. A 2-hour post-prandial blood glucose level of 122 mg/dL is slightly above the normal range but not significantly high. This result alone is not as indicative of inadequate control as other values.
C. A random blood glucose level of 300 mg/dL is significantly elevated and indicates poor glucose control. This value is much higher than the normal range and suggests a need for further teaching and adjustment of diabetes management.
D. A fasting blood glucose level of 48 mg/dL is low and could indicate hypoglycemia rather than inadequate control. This level requires immediate attention but does not reflect poor long-term diabetes management.

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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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Explanation

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