A 55-year-old man presents to the health nurse at his workplace with epistaxis. He reports he has had four nosebleeds today, and he is concerned because he can usually control the bleeding himself. What would be the most helpful assessment after the nurse has stopped the bleeding?

Record the amount of blood loss

Ask about the last episode of bleeding and how long it took to stop.

Check the client's vital signs

Inquire if the client had a headache along with the bleeding.

Answer and Explanation

The Correct Answer is C

A. Record the amount of blood loss: While important for documentation, patients often cannot accurately estimate blood loss, especially with nasal bleeding. This step is secondary to assessing the client’s current physiological status following multiple episodes.

B. Ask about the last episode of bleeding and how long it took to stop: This can provide useful information for identifying patterns, but it does not assess the client’s immediate condition or potential complications like hypovolemia or hypertension.

C. Check the client's vital signs: Vital signs offer immediate insight into the client’s circulatory and respiratory status. Multiple episodes of epistaxis in one day could indicate hemodynamic instability or uncontrolled hypertension, making this the priority assessment.

D. Inquire if the client had a headache along with the bleeding: A headache could be associated with elevated blood pressure or sinus involvement, but it is not the most urgent concern after repeated nosebleeds. Assessing vital signs takes precedence.

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Free Nursing Study Resources

Correct Answer is B

Explanation

A. "I will take a couple of doses of the leftover prednisone I have to decrease the swelling.Using leftover medications, without a prescription is unsafe and inappropriate. Prednisone is not the first-line treatment and does not address the bacterial cause of the illness.

B. "I should take my prescribed antibiotics three (3) times a day until I have taken them all.” Completing the full course of prescribed antibiotics is essential to fully eradicate the infection, prevent complications like rheumatic fever, and reduce antibiotic resistance.

C. "I should be better with a couple of days of rest and some ibuprofen for the pain/fever."Rest and symptom relief do not treat the bacterial infection. Relying solely on supportive care without antibiotics can lead to prolonged illness and serious complications.

D. "I guess I will have to have my tonsils removed."Tonsillectomy is not a standard treatment for a single episode of strep throat. It may be considered only after recurrent infections or other complications, making this an inaccurate understanding of initial treatment.

A. Productive cough and crackles B. Bradycardia and hypotension C. Elevated WBC and hypertension D. Decreased WBC & clear lung sounds

Correct Answer is A

Explanation

A. Productive cough and crackles:These are hallmark signs of pneumonia. A productive cough indicates mucus in the airways, while crackles on auscultation suggest fluid and inflammation in the alveoli, consistent with lower respiratory tract infection.

B. Bradycardia and hypotension:Bradycardia is not typically associated with pneumonia. Hypotension can occur in severe or septic cases, but it is not specific or diagnostic. Neither finding is present in this case, nor do they support the pneumonia diagnosis.

C. Elevated WBC and hypertension:An elevated WBC count does support infection, but hypertension is not characteristic of pneumonia. Blood pressure changes are not diagnostic and may vary based on the individual’s baseline or stress response.

D. Decreased WBC & clear lung sounds:A low WBC count and clear lung sounds argue against an infectious process like pneumonia. These findings would more likely suggest that infection is absent or resolving, not active.

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A 55-year-old man presents to the health nurse at his workplace with epistaxis. He reports he has had four nosebleeds today, and he is concerned because he can usually control the bleeding himself. What would be the most helpful assessment after the nurse has stopped the bleeding?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is B

Explanation

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Correct Answer is A

Explanation

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