A 77-year-old man from a nursing facility has fever, confusion, cough, and hypotension. Blood pressure is 84/50 mm Hg, lactate is 4.2 mmol/L, and

Question

A 77-year-old man from a nursing facility has fever, confusion, cough, and hypotension. Blood pressure is 84/50 mm Hg, lactate is 4.2 mmol/L, and chest radiograph shows a right lower-lobe infiltrate. Which of the following is the most appropriate next step in management?

Accepted Answer

Begin IV crystalloids and broad-spectrum antibiotics promptly

Answer

Delay antibiotics until sputum culture finalizes

Answer

Give beta-blocker for tachycardia before fluids

Answer

Discharge with oral antihistamine

Answer

Restrict fluids because lactate is elevated

Sepsis — USMLE Step 3 MCQ

A 77-year-old man from a nursing facility has fever, confusion, cough, and hypotension. Blood pressure is 84/50 mm Hg, lactate is 4.2 mmol/L, and chest radiograph shows a right lower-lobe infiltrate. Which of the following is the most appropriate next step in management?