NORCET 10 Prelims-2026: A patient with suspected sepsis has BP 88/60 mmHg, HR 132/min, temperature 39°C, and raised lactate. What is…

NORCET 10 Prelims-2026

Medical & Surgical Nursing

Medium

Appeared in: NORCET 10 Prelims-2026

Explanation

The patient's signs and symptoms (hypotension, tachycardia, elevated lactate) are classic indicators of septic shock, a life-threatening condition caused by a dysregulated response to infection.
The immediate priority in septic shock is to correct circulatory collapse and restore tissue perfusion. This is achieved through rapid intravenous fluid resuscitation.
According to Surviving Sepsis Campaign guidelines, a fluid bolus of approximately 30 mL/kg of isotonic crystalloid is the first-line treatment to stabilize hemodynamics.
Restoring intravascular volume directly addresses the hypotension and improves oxygen delivery to vital organs, preventing further organ damage.

Option A: While crucial and required within the first hour, starting antibiotics is not the most immediate life-saving action. The patient's hypotension poses the most immediate threat of cardiovascular collapse, which must be addressed first.
Option C: Vasopressors are second-line agents used to raise blood pressure only if the patient remains hypotensive after receiving adequate fluid resuscitation. Starting them before fluids can worsen tissue perfusion by constricting already underfilled blood vessels.
Option D: Sepsis is a medical emergency. Delaying treatment to wait for orders is inappropriate and dangerous. Nurses should initiate established protocols, like the sepsis bundle, immediately upon recognition.

Clinical Relevance

Nursing practice connection: Knowing Prioritization of nursing interventions in the management of septic shock helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
Rapid recognition and intervention in sepsis are critical nursing responsibilities. Every hour of delay in treatment significantly increases mortality.
Nurses are often the first to identify deteriorating patients and must be empowered to initiate life-saving protocols like the sepsis bundle.
Accurate monitoring of the patient's response to fluids (BP, HR, urine output, lactate levels) is essential to guide further treatment, including the potential need for vasopressors or advanced care.

How to Approach the Question

First, analyze the patient's clinical data. The combination of hypotension (BP 88/60), tachycardia (HR 132), and high lactate points to a diagnosis of septic shock.
This is a priority-setting question. Apply the ABC (Airway, Breathing, Circulation) framework. The patient's primary problem is circulatory collapse.
Evaluate the options based on which intervention directly and immediately addresses the circulatory failure.
Fluid resuscitation directly increases intravascular volume, which is the primary treatment for the distributive shock seen in sepsis.
Rule out other options. Antibiotics are vital but don't fix the immediate hemodynamic instability. Vasopressors are a second-line therapy after fluids. Waiting is never appropriate in an emergency.

Concept Tested & Keywords

Concept Tested: Prioritization of nursing interventions in the management of septic shock.
Stem keywords: sepsis, BP 88/60 mmHg, HR 132/min, temperature 39°C, raised lactate, priority management
Lead-in keywords: priority
Clinical cues: Hypotension (BP 88/60 mmHg) is a critical sign of circulatory failure.
Clinical cues: Tachycardia (HR 132/min) is a compensatory response to low blood pressure and hypovolemia.

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