A client is brought to the emergency department with suspected internal bleeding. Which assessment finding would the nurse identify as an early sign of compensatory response to hypovolemia?

Bradycardia

Increased blood pressure

Warm, flushed skin

Decreased urine output

Answer and Explanation

The Correct Answer is B

A) Incorrect. Bradycardia is not typically an early sign of compensatory response to hypovolemia. The body often responds to hypovolemia with an increased heart rate (tachycardia).

B) Correct. In the early stages of hypovolemia, the body may attempt to compensate by increasing blood pressure to maintain perfusion to vital organs.

C) Incorrect. Warm, flushed skin may be present in the initial stages of hypovolemia, but it is not necessarily an early sign of compensatory response.

D) Incorrect. Decreased urine output is a later sign of hypovolemia when the body's compensatory mechanisms are no longer effective in maintaining blood flow to the kidneys.

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Correct Answer is C

Explanation

A) Correct. Anticoagulant medication can interfere with the body's clotting mechanism, increasing the risk of bleeding.

B) Correct. A family history of bleeding disorders can be a risk factor for hemorrhage due to potential genetic predisposition.

C) Incorrect. Regular low-impact exercise is a positive lifestyle choice that helps maintain cardiovascular health and does not directly contribute to an increased risk of hemorrhage.

D) Correct. Recent major surgery can be a risk factor for hemorrhage due to potential surgical site bleeding or complications.

A. Gastric analysis B. Abdominal ultrasound C. Esophagogastroduodenoscopy (EGD) D. Stool culture

Correct Answer is C

Explanation

A) Incorrect. Gastric analysis is not commonly used to confirm the presence of blood in the stomach or identify the source of bleeding.

B) Incorrect. Abdominal ultrasound may be helpful in evaluating certain abdominal conditions but is not the primary test for diagnosing upper gastrointestinal bleeding.

C) Correct. Esophagogastroduodenoscopy (EGD) is a direct visualization procedure that uses a flexible endoscope to examine the esophagus, stomach, and duodenum. It allows for visualization of the source of bleeding and potential interventions like cauterization or sclerotherapy.

D) Incorrect. Stool culture is used to detect gastrointestinal infections but is not specific to diagnosing upper gastrointestinal bleeding.

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A client is brought to the emergency department with suspected internal bleeding. Which assessment finding would the nurse identify as an early sign of compensatory response to hypovolemia?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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