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 D

Explanation

D. Weight loss can help improve symptoms of polycystic ovarian syndrome (PCOS) by reducing insulin resistance and androgen levels, which are common issues in PCOS.
A. Thyroid function testing is not specifically related to PCOS management, though thyroid function should be monitored if there are symptoms of thyroid dysfunction.
B. A diet with a low glycemic index is generally recommended for managing PCOS, not a high glycemic index.
C. PCOS is associated with decreased fertility rather than increased fertility. Contraception might be recommended for menstrual regulation, but not necessarily two forms due to increased fertility.

A. "I should drink 1 to 1.5 L of fluid each day." B. "I can use aspirin for management of gout pain." C. "I will focus on losing weight to achieve a normal body mass index (BMI)." D. "I will take allopurinol for an acute gout attack in the future."

Correct Answer is C

Explanation

A. A higher fluid intake, ideally 2 to 3 liters per day, is typically recommended to help flush uric acid from the body and prevent gout attacks, not just 1 to 1.5 L.
B. Aspirin is not recommended for gout pain management; nonsteroidal anti-inflammatory drugs (NSAIDs) or corticosteroids are more appropriate.
C. Focusing on losing weight to achieve a normal BMI is important for managing gout, as obesity is a risk factor for gout and can exacerbate symptoms. Weight loss can help reduce uric acid levels and improve overall management of the condition.
D. Allopurinol is used for long-term management to reduce uric acid levels and prevent attacks, but it is not used during acute attacks. Colchicine or NSAIDs are more appropriate for acute gout attacks.

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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

Naxlex Comprehensive Predictor Exams

A nurse in a healthcare provider's office is providing education to a client who has a new diagnosis of polycystic ovarian syndrome. Which of the following responses by the client indicates that the client understands the teaching?

Correct Answer is D

Explanation

A nurse is teaching a client who has a new diagnosis of gout about managing the disorder. Which of the following statements by the client indicates an understanding of the teaching?

Correct Answer is C

Explanation

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