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A patient is admitted from home with fever, productive cough, weakness, and confusion. History includes type 2 diabetes and recent influenza-like illness. Current assessment findings: temperature 39.2°C (102.6°F), heart rate 118/min, respiratory rate 26/min, blood pressure 92/54 mm Hg, oxygen saturation 91% on room air. The patient is difficult to arouse and has cool extremities. The provider suspects sepsis secondary to pneumonia and has entered orders for blood cultures, broad-spectrum IV antibiotics, serum lactate, and IV crystalloids. Which nursing action is the priority?

A client has a diagnosis of sepsis. Recent vital signs include the following changes: heart rate increased from 80 beats/min to 100 beats/min, respiratory rate increased from 18 breaths/min to 24 breaths/min, temperature increased from 99.2°F (37.2°C) to 102.2°F (39°C). Laboratory findings include a change in WBC from 11,000/mm3 to 13,000/mm3. Complete the sentences by choosing from the list of options. Based on the clinical finding changes, the nurse suspects 1) Systemic inflammatory response syndrome (SIRS)     Disseminated intravascular coagulation (DIC)    Multiple organ dysfunction syndrome (MODS)  which is an exaggerated inflammatory response to infection or sepsis, ischemia or reperfusion, infarction, malignancy, or injury. Multiple organ dysfunction syndrome (MODS) is the failure of         2) 2            3            4 or more organ systems in an acutely ill client with sepsis where homeostasis cannot be maintained without intervention.      3) Multiple organ dysfunction syndrome (MODS)          Systemic inflammatory response syndrome (SIRS)          Acute respiratory distress syndrome (ARDS) occurs first followed by       4) Multiple organ dysfunction syndrome (MODS)          Systemic inflammatory response syndrome (SIRS)          Acute respiratory distress syndrome (ARDS) if the client’s condition worsens.

The nurse is setting goals in the plan of care for a client who has systemic inflammatory response syndrome (SIRS). Which of the following would be appropriate goals for this client? Select all that apply.

The nurse has received report on four clients. Which one should the nurse assess first?

The nurse hears the following new-onset lung sound in a client who was admitted 48 hours ago with a myocardial infarction and is having sharp pleuritic chest pain that radiates to the left shoulder and increases on inspiration. What are appropriate nursing interventions? Select all that apply.

A client lost considerable blood following a motor vehicle accident. Upon admission to the emergency department, the nurse is aware that which of the following are signs and symptoms of hypovolemic shock? Select all that apply.

The nurse caring frequently for older adults in the hospital is aware of risk factors that place them at a higher risk for shock. Which of the following factors would the nurse recognize as supporting such a risk? (Select all that apply.)

A trauma patient has severe compressible bleeding from an extremity. Direct pressure with a thick, dry dressing has not controlled the hemorrhage. Which interventions should the nurse anticipate? Select all that apply.

The re-take midterm exam will be given Saturday (9/26) and will open at 8:00 AM and close an Noon. 

A solid insulating sphere of radius R contains a uniform volume distribution of positive charge. Which of the graphs correctly gives the magnitude E of the electric field as a function of r from the center of the sphere?