The nurse is assessing a client with esophageal varices. Which of these findings would be early indicators of bleeding?
Epigastric fullness and increasing combativeness
Yellow sclera, hypertension, and hypoalbuminemia
Bradycardia, lethargy, and hypotension
Tachycardia, restlessness, and pallor
The Correct Answer is D
Choice A reason: Epigastric fullness may suggest variceal pressure, but combativeness isn’t typical early bleeding; it’s more neurological, not a direct blood loss sign.
Choice B reason: Yellow sclera and hypoalbuminemia reflect liver dysfunction, not acute bleeding; hypertension contradicts blood loss, which lowers pressure initially.
Choice C reason: Bradycardia and lethargy occur late in severe hypovolemia, not early; hypotension fits bleeding but isn’t paired with early compensatory signs here.
Choice D reason: Tachycardia compensates for early blood loss in varices, restlessness reflects hypoxia, and pallor shows reduced perfusion, all classic initial bleeding indicators.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: Weighing assesses fluid status pre-dialysis, guiding ultrafiltration goals in peritoneal dialysis to remove excess fluid safely, the priority for efficacy and safety.
Choice B reason: High Fowler’s aids breathing but isn’t critical pre-dialysis; semi-Fowler’s is used during, not before, making this secondary to weight assessment.
Choice C reason: Pain medication eases discomfort during dialysis but isn’t the priority; weight determines fluid removal needs first, ensuring treatment accuracy.
Choice D reason: Trendelenburg position aids hypotension, not routine pre-dialysis preparation, irrelevant to starting peritoneal dialysis compared to weight’s foundational role.
Correct Answer is ["A","D","E"]
Explanation
Choice A reason: Barrel chest develops in emphysema from chronic air trapping, overexpanding lungs and flattening the diaphragm, altering thoracic shape over years.
Choice B reason: Edema relates to right heart failure from cor pulmonale, a late emphysema complication, not a direct or universal finding after five years.
Choice C reason: Productive cough is typical in chronic bronchitis, not emphysema, which features alveolar destruction and minimal mucus, leading to dry cough instead.
Choice D reason: Dyspnea in emphysema results from alveolar loss reducing oxygen exchange, forcing compensatory rapid breathing, a core symptom even after five years.
Choice E reason: Clubbed fingers occur in chronic hypoxia from emphysema, as poor oxygenation over years triggers nail bed angiogenesis, a common late finding.
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