Your patient, post-operative from a gastrointestinal surgery, presents with a temperature of 103.6 'F, heart rate 120, blood pressure 72/42, increased white blood cell count, and respirations of 21. An IV fluid bolus is ordered STAT.

Which of the following findings indicate that the patient is progressing to septic shock? Select all that apply:

Patient requires Metoprolol (Lopresor) STAT

Patient requires Norepinephrine to maintain a mean arterial pressure (MAP) greater than 65 mmHg despite fluid replacement

Serum lactate less than 2 mmol/L

Blood pressure of 70/34 after the fluid bolus

Answer and Explanation

Correct Answer : B,D

Choice A rationale
The need for Metoprolol (Lopresor) STAT does not necessarily indicate progression to septic shock. Metoprolol is a beta-blocker used to treat high blood pressure, heart failure, and angina. While it may be used in the management of sepsis to control heart rate, its use does not specifically indicate progression to septic shock.
Choice B rationale
The need for Norepinephrine to maintain a mean arterial pressure (MAP) greater than 65 mmHg despite fluid replacement is a strong indicator of septic shock. Norepinephrine is a vasopressor, a type of medication used to increase blood pressure. In septic shock, vasopressors are often required to maintain adequate blood pressure and organ perfusion despite aggressive fluid resuscitation.
Choice C rationale
A serum lactate level less than 2 mmol/L is generally not indicative of septic shock. Elevated lactate levels can indicate tissue hypoperfusion, a condition that may occur in septic shock. However, a level less than 2 mmol/L is typically considered within the normal range.
Choice D rationale
A blood pressure of 70/34 after the fluid bolus could indicate progression to septic shock. In septic shock, despite aggressive fluid resuscitation, blood pressure often remains dangerously low, which can lead to inadequate blood flow to the organs.

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Free Nursing Study Resources

Correct Answer is ["B","C","D","E"]

Explanation

Choice A rationale
Advocating for a diet rich in saturated fats is not a recommended strategy to prevent cardiovascular disease. Saturated fats can raise the level of cholesterol in your blood and increase your risk of heart disease.
Choice B rationale
Recommending cessation of smoking is a crucial intervention to prevent cardiovascular disease. Chemicals in tobacco can damage the heart and blood vessels, leading to narrowing of the arteries (atherosclerosis), which can ultimately lead to a heart attack.
Choice C rationale
Regular blood pressure monitoring is important as high blood pressure is a significant risk factor for heart disease. Controlling blood pressure helps ensure that your heart is not working harder than it should be, which can prevent damage to your heart and arteries.
Choice D rationale
Regular cholesterol screenings are essential because high levels of cholesterol can lead to the buildup of plaques in your arteries, increasing your risk of heart disease.
Choice E rationale
Regular physical exercise helps control your weight and can reduce your chances of developing other conditions that may put a strain on your heart, such as high blood pressure, high cholesterol, and diabetes.
Choice F rationale
Suggesting no more than 5 alcoholic drinks a day is not a recommended strategy to prevent cardiovascular disease. In fact, it is advised to limit alcohol intake as excessive drinking can lead to high blood pressure, heart failure, or even stroke.

A. Pleural friction rub B. Distended neck veins C. Widening pulse pressure D. Bradycardia .

Correct Answer is B

Explanation

Choice A rationale
A pleural friction rub is an audible raspy breathing sound, a medical sign present in some patients with pleurisy and other conditions affecting the chest cavity. It is not a typical symptom of cardiac tamponade.
Choice B rationale
Distended neck veins are a result of the collapsed blood vessels that should return blood to the heart. This is a common symptom of cardiac tamponade.
Choice C rationale
Widening pulse pressure occurs with valvular heart disease, not typically with cardiac tamponade.
Choice D rationale
Bradycardia, or a slower-than-normal heart rate, is not typically associated with cardiac tamponade.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

As a nurse in a community-based setting, you are educating clients on strategies to prevent cardiovascular disease. Which interventions should you include? (Select all that apply)

Correct Answer is ["B","C","D","E"]

Explanation

A nurse is caring for a client who has developed cardiac tamponade. Which of the following symptoms should the nurse expect to observe?

Correct Answer is B

Explanation

When teaching clients in a community-based setting strategies for preventing cardiovascular disease, which interventions should the nurse include?

A nurse is caring for a client on a cardiac monitor. The patient’s heart monitor shows a pattern of undulations of varying contours and amplitude with no measurable ECG pattern. What is the first action the nurse should take?

For a patient recovering from an acute myocardial infarction (AMI) who inquires about safely resuming sexual intercourse, what would be the best response from the nurse?

What factor would contraindicate the use of propranolol (Inderal) in a 38-year-old obese African American patient with diabetes who is being evaluated for hypertension control?

A newborn child has been diagnosed with tetralogy of Fallot. What symptoms would the nurse expect to observe in this child?

A patient is being admitted to the emergency department with intermittent chest pain. They provide a list of daily medications. Which medication from the list has the most immediate implications for the patient’s care?

A 56-year-old individual visits his primary care provider for a routine checkup.The physical examination reveals edema, an enlarged liver (hepatomegaly), and muffled heart sounds. Which of the following findings should the nurse be most concerned about?