At the end of your shift, the ICU supervisor consults with you about which of the oncoming staff members is best to assign to care for a 54-year-old female with septic shock with the following vital signs: BP 86/40, HR 112, O2 saturation 93%, RR 32, and T 103 F. She is currently on a Dopamine drip and is being mechanically ventilated. Which RN is the most appropriate to assign to care for this patient?

Travel RN with 20 years of ICU experience who has been working in this ICU for 4 months

Newly graduated RN who worked in the ICU as a nursing assistant and has finished her orientation

Experienced ICU RN who has been called in on a day off of work to cover the first 4 hours of the shift

RN who has been floated from the post anesthesia care unit (PACU) to the ICU for the shift

Answer and Explanation

The Correct Answer is A

Rationale:
A. The travel RN with 20 years of ICU experience who has been working in this ICU for 4 months is correct because this patient is critically ill with septic shock, requires continuous titration of a vasopressor, and is mechanically ventilated. Assigning an RN who is highly experienced in ICU care and familiar with the unit’s protocols and equipment ensures safe, competent management of complex interventions.

B. The newly graduated RN is incorrect because, despite completing orientation, she does not yet have the full critical thinking skills or experience needed to manage a patient with septic shock on a vasopressor and mechanical ventilation.

C. The experienced ICU RN called in on a day off is incorrect because fatigue and being called in unexpectedly may reduce alertness and effectiveness, which could compromise patient safety during a critical period.

D. The RN floated from PACU is incorrect because although PACU experience involves monitoring post-anesthesia patients, float nurses may not have the ICU-specific knowledge for managing septic shock, titrating vasopressors, or ventilator management.

Nursing Test Bank

Test Bank #1: RN Pharmacology Exams Test Bank #2: RN Medical-Surgical Exams Test Bank #3: RN Fundamentals Exams Test Bank #4: RN Maternal-Newborn Exams Test Bank #5: RN Anatomy and Physiology Exams Test Bank #6: RN Obstetrics and Pediatrics Exams Test Bank #7: RN Fluid and Electrolytes Exams Test Bank #9: RN Adult Health Test Bank #10: RN Dosage Calculation Test Bank #11: RN Community Health Exams Test Bank #12: RN Psychology Exams Test Bank #13: RN Nursing Care Of Children Test Bank #14: RN Foundations of Nursing Exams

Get 100+ Naxlex Exit Exams for $79 Try Naxlex NCLEX-RN (14 Day Free-Trial)

Naxlex Comprehensive Predictor Exams

Exam #1: RN Comprehensive predictor 2023 proctored exam Exam #2: Ati rn vati comprehensive predictor proctored exam Exam #3: Ati Rn Comprehensive Predictor Proctored Exam 2023 Exam #4: Rn Comprehensive Predictor 2023 Proctored Exam - St. Joseph Exam #5: RN Comprehensive Predictor Proctored Exam (National U CA San Diego) Exam #6: Ati rn comprehensive predictor 2023 retake proctored exam Exam #7: RN Hesi Exit Proctored Exam Exam #8: Hesi RN Exit proctored exam Exam #9: Hesi rn exit proctored exam Exam #10: Hesi Rn compass exit B proctored exam

Free Nursing Study Resources

Correct Answer is D

Explanation

Rationale:
A. Applying antibiotic ointment to mucous membranes is not a standard or effective intervention for preventing systemic infection or septic shock. Prophylactic topical antibiotics do not reduce the risk of urosepsis and may contribute to antimicrobial resistance.
B. Passive range-of-motion exercises promote mobility and circulation but do not directly reduce the risk of infection progression or septic shock. They are supportive measures rather than infection-prevention strategies.
C. Initiating total parenteral nutrition may be necessary in some clients who cannot meet nutritional needs enterally, but it does not directly reduce the risk of septic shock. In fact, TPN itself can increase infection risk if central venous access is required.
D. Invasive devices, such as urinary catheters and central lines, are common sources of infection. Removing them as soon as they are no longer needed significantly reduces the risk of healthcare-associated infections and progression to sepsis or septic shock, making this the most effective preventive action.

A. 3.3 ml B. 1.1 ml C. 2.5 ml D. 1 ml

Correct Answer is B

Explanation

Rationale:

A. 3.3 mL would deliver approximately 742 mg, which is far above the prescribed dose.
B. 1.1 mL provides approximately 250 mg, matching the provider’s order.

First, identify the ordered dose and the available concentration.

Ordered dose = 250 mg
Available concentration = 225 mg per 1 mL

Use the medication calculation formula:

Amount to administer (mL) = Ordered dose ÷ Concentration

250 mg ÷ 225 mg/mL = 1.11 mL, which rounds to 1.1 mL
C. 2.5 mL refers to the reconstitution volume, not the amount to administer.
D. 1 mL would deliver only 225 mg, which is less than the prescribed dos

View Question and Answer

Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.

Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

An immunocompromised older adult has developed a urinary tract infection and the care team recognizes the need to prevent an exacerbation of the patient's infection that could result in urosepsis and septic shock. What action should the nurse perform to reduce the patient's risk of septic shock?

Correct Answer is D

Explanation

Cefazolin sodium 250 mg IV every 8 hours is ordered for your patient. You are to reconstitute with 2.5 ml sterile normal saline. After reconstitution the vial contains 225 mg/ml. How many ml will you administer per dose?

Correct Answer is B

Explanation

A nurse is monitoring the fluid replacement of a client who has sustained burns. The nurse should administer which of the following fluids in the first 24 hr following a burn injury?

Shock can result from all of the following except:

A patient who was an unrestrained driver in a high-speed, head-on motor vehicle collision presents with dyspnea, tachycardia, hypotension, jugular venous distension, tracheal deviation to the left, and decreased breath sounds on the right side. What is the most likely diagnosis?

A nurse is caring for a client who is experiencing hypovolemic shock. Which of the following blood products should the nurse anticipate administering to this client?

A patient is experiencing respiratory insufficiency and cannot maintain spontaneous respirations. The nurse suspects that the physician will perform which of the following actions?

You are caring for a patient with circumferential burns on his right leg. You note that the capillary refill in his right big toenail is not as brisk as it was 2 hours ago and that the pedal and tibial pulses are only noted by Doppler. What is your best plan of action?