A nurse is educating a client about the risk factors for hemorrhage. Which statement made by the client requires further clarification?

A. Having a previous C-section is a known risk factor for postpartum hemorrhage due to potential uterine scarring and complications during delivery.
B. A history of clotting disorders in the family can increase the risk of postpartum hemorrhage because it may indicate a predisposition to bleeding complications.
C. Expecting twins increases the risk of postpartum hemorrhage due to the larger uterine size and increased blood flow required to support multiple fetuses.
D. Planning to breastfeed exclusively does not increase the risk of postpartum hemorrhage. In fact, breastfeeding can help reduce the risk by promoting uterine contractions that help control bleeding after delivery. This statement indicates a need for further clarification.

A) Incorrect. Swelling and bruising around the wound are common signs of external bleeding and do not directly indicate internal bleeding.

B) Correct. Cool and pale skin in the extremities may be indicative of vasoconstriction and reduced blood flow, which can occur in response to internal bleeding.

C) Incorrect. Blood oozing from the wound site is a typical sign of external bleeding and does not necessarily indicate internal bleeding.

D) Incorrect. Visible blood clot formation at the wound site is a normal part of the body's hemostatic response to control external bleeding and does not directly suggest internal bleeding.