A nurse is assessing a client who gave birth 12 hours ago and is experiencing excessive vaginal bleeding.
Which of the following findings indicates the client is experiencing decreased cardiac output?
Bradycardia.
Flushed face.
Hypotension.
Polyuria.
The Correct Answer is C
Choice A rationale
Bradycardia, or a heart rate below 60 beats per minute, is inconsistent with decreased cardiac output in this context. Tachycardia is a more typical compensatory response to significant blood loss postpartum.
Choice B rationale
A flushed face is not a physiological indicator of decreased cardiac output. Decreased cardiac output commonly leads to pallor and cool, clammy skin due to reduced peripheral perfusion.
Choice C rationale
Hypotension, defined as blood pressure below 90/60 mmHg, occurs due to reduced blood volume and cardiac output in excessive postpartum bleeding, impairing adequate perfusion to organs and tissues.
Choice D rationale
Polyuria, or excessive urination, does not directly indicate decreased cardiac output. Instead, oliguria or decreased urine output, often below 30 mL/hour, is a common sign of poor perfusion.
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Related Questions
Correct Answer is D
Explanation
Choice A rationale
Tingling of fingers in pregnancy is linked to hormonal changes and fluid retention, which may cause mild carpal tunnel syndrome. This is a common and non-complication-related discomfort in pregnancy.
Choice B rationale
Absence of clonus indicates no hyperreflexia or neurological compromise. In pregnancy, clonus presence may signal severe preeclampsia, but absence signifies normal neurological function.
Choice C rationale
Leg cramps result from changes in calcium and magnesium metabolism during pregnancy. These are common but are not associated with serious complications unless persistent and related to electrolyte imbalances.
Choice D rationale
Blurred vision may result from severe preeclampsia or elevated blood pressure, signifying potential end-organ damage. It requires immediate medical evaluation to prevent progression to eclampsia.
Correct Answer is A
Explanation
Choice A rationale
Molar pregnancy often manifests as intermittent dark brown vaginal discharge due to trophoblastic tissue expulsion. It warrants assessment as it correlates with hCG elevation and abnormal placental development.
Choice B rationale
Although significant blood loss could occur, dark brown discharge is not indicative of active hemorrhage. Hypovolemic shock typically results from acute red blood loss, not the chronic nature of this presentation.
Choice C rationale
Choriocarcinoma is a concern in cases following molar pregnancies, yet dark brown discharge alone does not confirm malignancy. Laboratory testing may be indicated, but it is not the immediate priority here.
Choice D rationale
Suction and curettage are treatment options for molar pregnancy but are contingent upon confirmed diagnosis. This intervention is premature without comprehensive assessment findings suggesting molar pregnancy.
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