Correct Answer: A

Rationale: In the scenario described, the patient is experiencing refractory hypotension despite adequate fluid resuscitation, indicating the presence of septic shock. In septic shock, systemic vasodilation and vascular hyporesponsiveness contribute to hypotension. Therefore, the primary management approach is to restore vascular tone and blood pressure to maintain organ perfusion. Administering vasopressor medications (Choice A) is the crucial intervention to achieve this goal. Vasopressors, such as norepinephrine or vasopressin, constrict blood vessels and increase blood pressure, helping to stabilize the patient in septic shock. While options B and C (performing blood cultures and initiating broad-spectrum antibiotics) are important for identifying the causative pathogen and treating the infection, they are secondary to the immediate need for hemodynamic support in septic shock. Prophylactic anticoagulation (Choice D) is not the primary intervention for

Correct Answer: B

Rationale: The presentation described is consistent with nummular eczema, also known as discoid eczema. Nummular eczema typically presents as circular or oval-shaped patches of eczematous rash with fine scaling and central clearing. It is often pruritic and can be triggered by exposure to irritants such as new soaps or laundry detergents. The distribution on the trunk and proximal extremities is also typical for nummular eczema. Tinea corporis (ringworm) would present with a more raised, scaly, and well-defined border with central clearing. Pityriasis rosea presents with a herald patch followed by smaller oval or round lesions in a "Christmas tree" distribution. Lichen planus would present with polygonal, purplish, flat-topped papules typically located on flexural surfaces and extremities.

Correct Answer: A

Rationale: Quality improvement measures are most effective when everyone within an organization is involved. This includes not only professional and management staff but also consumers or customers who are directly impacted by the products or services being provided. By involving everyone, a more comprehensive and diverse perspective can be gained, leading to better identification of areas for improvement and more successful implementation of quality improvement initiatives. Additionally, by involving all stakeholders, there is a greater buy-in and commitment to the process, increasing the likelihood of sustainable improvements being made.

Correct Answer: B

Rationale: The IR (Incident Report) typically focuses on the details surrounding an incident or event, such as what happened, who was/were involved, and who witnessed the incident. Information about daily medications given to the patient is not usually included in an incident report, unless it directly relates to the incident itself (e.g., medication error). The primary focus of an incident report is to document the incident in a clear and factual manner for record-keeping and analysis purposes.

Correct Answer: D

Rationale: If a nurse notices a discrepancy between the surgical count and the number of instruments on the sterile field during surgery, it is crucial to inform the surgical team immediately and initiate a thorough search. Patient safety is of utmost importance, and any missing instruments could potentially pose a risk to the patient. By informing the team and conducting a thorough search, the missing instrument can be located promptly to ensure it is not inadvertently left inside the patient's body. Continuing with the procedure or ignoring the discrepancy without further investigation could lead to serious consequences for the patient's well-being. It is always better to address any discrepancies or concerns during surgery proactively to maintain a high standard of patient care and safety.