# Stage 4 — Generate solutions. Which actions belong in the immediate interdisciplinary plan? Select all that apply.

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> url: https://mymerci.kr/pages/nclex_q.php?qn_id=568867&lang=en  
> language: en  
> subject: Pharmacological and Parenteral Therapies  
> category: PPT

## Question

Stage 4 — Generate solutions. Which actions belong in the immediate interdisciplinary plan? Select all that apply.

1

Collect prescribed blood cultures promptly, ideally before antimicrobial therapy without delaying treatment

2

Administer prescribed broad-spectrum antimicrobial therapy immediately

3

Begin prescribed balanced crystalloid resuscitation with frequent assessment of fluid responsiveness

4

Start prescribed norepinephrine if hypotension persists and titrate toward the ordered MAP goal

5

Coordinate urgent urologic decompression of the obstructed collecting system

6

Wait for final culture susceptibility results before administering any antimicrobial therapy

## Explanation

Immediate care includes cultures when this does not delay treatment, prompt broad-spectrum antimicrobials, crystalloid resuscitation with repeated assessment, norepinephrine for persistent shock, and early control of the obstructed source. Final susceptibility results are used to refine therapy, not to postpone it.

## In-depth explanation

Quick answer
Culture promptly, give antimicrobials, resuscitate, support pressure, and control the obstructed source.

Why this is correct
These interventions target infection, inadequate circulating perfusion, and the anatomic cause of ongoing infection.

Easy analogy or mental picture
The plan needs three tracks: kill the pathogen, restore flow, and drain the source.

Memory hook
Culture, antibiotic, fluid, pressure, source.

NCLEX decision rule
Sepsis interventions are time-sensitive and often parallel; do not convert the bundle into an artificial strict sequence.

Why the other choices are wrong
Waiting for final susceptibility data leaves shock untreated and increases the duration of ineffective circulation.

References
1Surviving Sepsis Campaign International Guidelines for Adults 2026Recognition, cultures, lactate, immediate antimicrobials, crystalloid reassessment, MAP target, norepinephrine, and source control

## Clinical scenario

Case update
The sepsis response team confirms shock and an infected obstructed kidney while the client remains hypotensive.

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