A client is receiving anticoagulant therapy to prevent blood clots. The nurse identifies a potential adverse effect of anticoagulation as:

Increased risk of bleeding.

Elevated blood pressure readings.

Hyperactivity and restlessness.

Increased blood viscosity.

Answer and Explanation

The Correct Answer is A

A) Correct. Anticoagulant therapy prevents blood from clotting effectively, which can lead to an increased risk of bleeding.

B) Incorrect. Anticoagulant therapy is not associated with elevated blood pressure readings.

C) Incorrect. Hyperactivity and restlessness are not typical adverse effects of anticoagulant therapy.

D) Incorrect. Anticoagulant therapy does not increase blood viscosity (thickness); instead, it reduces the blood's ability to form clots.

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Correct Answer is B

Explanation

A) Incorrect. While pain management is important, it is not the priority in the management of massive hemorrhage and hypovolemia.

B) Correct. The priority intervention for a client experiencing massive hemorrhage and hypovolemia is to initiate a blood transfusion to replace lost blood and improve oxygen-carrying capacity.

C) Incorrect. Emotional support is essential, but it is not the priority in the acute management of hemorrhage and hypovolemia.

D) Incorrect. Deep breathing exercises are not the priority when the client is experiencing massive hemorrhage and requires urgent interventions to stabilize their condition.

A. Respiratory rate B. Blood pressure C. Urinary output D. Hemoglobin level

Correct Answer is D

Explanation

A) Incorrect. While the respiratory rate is an important vital sign to monitor, it does not directly indicate the effectiveness of a blood transfusion.

B) Incorrect. Blood pressure is a critical vital sign, but it is not specific to assessing the effectiveness of a blood transfusion.

C) Incorrect. Urinary output is essential for assessing kidney function and fluid balance, but it does not directly reflect the impact of a blood transfusion.

D) Correct. Monitoring the hemoglobin level is crucial to determine if the blood transfusion has been effective in increasing the client's red blood cell count and improving oxygen-carrying capacity.

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A client is receiving anticoagulant therapy to prevent blood clots. The nurse identifies a potential adverse effect of anticoagulation as:

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who is experiencing massive hemorrhage. Which intervention should the nurse prioritize to address hypovolemia?

Correct Answer is B

Explanation

A nurse is caring for a client who experienced a hemorrhage and received a blood transfusion. Which clinical manifestation should the nurse monitor to determine the effectiveness of the transfusion?

Correct Answer is D

Explanation

A nurse is preparing to administer a blood transfusion to a client with significant blood loss. What is the nurse's most important action before starting the transfusion?

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A nurse is assessing a client who experienced a significant hemorrhage. Which clinical manifestation should the nurse expect to find during the early stages of hemorrhage?

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