A patient admitted to the ICU develops septic shock with refractory hypotension despite fluid resuscitation. Which intervention should the healthcare team prioritize to improve the patient's hemodynamic status?

Correct Answer: A

Rationale: In a patient with septic shock and refractory hypotension despite fluid resuscitation, the healthcare team should prioritize administering vasopressor medications to increase systemic vascular resistance. Vasopressors such as norepinephrine or vasopressin can be used to support blood pressure and perfusion to vital organs by constricting blood vessels and improving blood flow. By increasing systemic vascular resistance, vasopressors help to counteract the excessive vasodilation seen in septic shock and improve hemodynamic stability. It is crucial to address hypotension promptly in septic shock to prevent organ dysfunction and failure. Other interventions, such as fluid removal through continuous renal replacement therapy, assessing cardiac function with echocardiogram, or optimizing oxygen delivery through a transfusion of packed red blood cells, may be considered based on specific patient factors but do not address the primary issue of inadequate perf

Correct Answer: B

Rationale: The past medical history section typically includes information about a person's medical background before the current point in time. This would involve details such as prenatal history, birth history, childhood illnesses, surgeries, and medical conditions that have occurred in the past. "Current history" would be more appropriate for the present medical status and ongoing health issues, hence it does not belong in the past medical history section.

Correct Answer: D

Rationale: For a diagnostic pelvic ultrasound, one important preparation is to have the patient void or empty their bladder before the procedure. This allows for better visualization of the pelvic organs and structures during the ultrasound scan. A full bladder can obstruct the view and make it difficult to obtain accurate images. Therefore, it is essential for the patient to follow instructions to empty their bladder before the pelvic ultrasound to ensure the best results.

Correct Answer: A

Rationale: When collecting evidence from a rape victim, it is important to handle the victim's clothing properly to preserve any potential evidence. The preferred method is to remove the clothing and place them in a paper bag. Paper bags are used in order to prevent the alteration or degradation of any DNA evidence that may be present on the clothing. Paper bags allow the clothing to breathe and prevent the growth of mold or other contaminants that can occur in plastic bags or trash bags. Additionally, paper bags help preserve trace evidence such as fibers or hairs that may be crucial in the investigation of the case. It is essential to handle and store the clothing correctly to maintain the integrity of the evidence for the investigation and potential prosecution.

Correct Answer: A

Rationale: Beta-blockers are a class of medications commonly used to manage hypertension. One of the main mechanisms of action of beta-blockers is to reduce heart rate and contractility by blocking the beta-adrenergic receptors in the heart. As a result, one of the potential adverse effects of beta-blockers is bradycardia, which refers to a slower than normal heart rate. Therefore, the nurse should closely monitor the patient for signs and symptoms of bradycardia when starting or adjusting the dose of a beta-blocker. Symptoms of bradycardia may include dizziness, fainting, fatigue, or shortness of breath. If bradycardia is severe or symptomatic, it may require dose adjustments or discontinuation of the beta-blocker to prevent complications.

Correct Answer: D

Rationale: The current emphasis for public health practice has shifted towards advocating for social justice due to a growing recognition that social determinants greatly impact health outcomes. Addressing issues such as poverty, inequality, access to healthcare, discrimination, and other social factors is crucial for achieving better population health. By advocating for social justice, public health practitioners aim to create a more equitable and just society where everyone has the opportunity to lead healthy lives. This broader approach acknowledges the complex interplay between social, economic, and environmental factors in shaping health behaviors and outcomes.

Correct Answer: A

Rationale: The best response by the supervisor is to acknowledge the newly hired nurse's emotions by saying, "I understand how you feel. Tell me more." This response shows empathy and validates the nurse's feelings, creating a supportive environment for open communication. It allows the nurse to express their concerns and fears, leading to a constructive discussion and providing an opportunity for guidance and reassurance. This approach fosters a positive mentorship and learning experience for the newly hired nurse.

Correct Answer: A

Rationale: A normal thyroid state is referred to as euthyroid, which means the thyroid gland is functioning within normal parameters and the levels of thyroid hormones in the body are balanced. In contrast, hyperthyroid refers to an overactive thyroid gland, causing excessive production of thyroid hormones, while parathyroid is a different gland responsible for regulating calcium levels in the body. Panthroid is not a recognized medical term related to thyroid function. Therefore, the best response to the patient's question about the normal thyroid state is "Euthyroid."

Correct Answer: A

Rationale: The first priority for a nurse caring for a patient experiencing a seizure is safety. Ensuring the safety of the patient is crucial to prevent injury during the seizure episode. This includes clearing the area around the patient of any harmful objects, preventing the patient from falling or hitting their head, placing them in a safe position to prevent aspiration if they vomit, and staying with the patient until the seizure ends. Once the patient is safe, the nurse can then focus on other aspects of care such as assessing airway, providing emotional support, and monitoring for complications.