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

Answer and Explanation

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.

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Correct Answer is B

Explanation

Choice A reason: Heparin prevents clotting during dialysis but doesn’t reduce hemoglobin or hematocrit directly. It’s not a primary cause of anemia in renal failure, unlike erythropoietin deficiency.

Choice B reason: Kidneys in chronic renal failure fail to produce erythropoietin, a hormone stimulating red blood cell production, leading to low hemoglobin and hematocrit, the key cause here.

Choice C reason: Minor blood loss occurs in dialysis, but it’s not the primary reason for chronic anemia. Erythropoietin deficiency from renal failure has a greater impact on counts.

Choice D reason: Poor protein intake affects overall health but isn’t the main driver of anemia in renal failure. Erythropoietin loss from kidney dysfunction is the dominant factor.

A. Chest pain while at rest B. A complete occlusion of the coronary artery C. Chest pain upon exertion that resolves with rest D. A partial occlusion of the coronary artery

Correct Answer is A

Explanation

Choice A reason: NSTEMI causes chest pain at rest due to reduced blood flow from partial occlusion, unlike stable angina, reflecting demand-supply mismatch without full blockage.

Choice B reason: Complete occlusion causes ST-elevation MI (STEMI), not NSTEMI, which involves partial blockage, leading to subendocardial ischemia without full transmural infarction.

Choice C reason: Chest pain on exertion resolving with rest describes stable angina, not NSTEMI, which occurs unpredictably, often at rest, due to unstable plaque rupture.

Choice D reason: NSTEMI results from partial coronary occlusion, causing ischemia without ST elevation, detectable by troponin rise, distinguishing it from STEMI’s complete blockage.

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The nurse is assessing a client with esophageal varices. Which of these findings would be early indicators of bleeding?

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Naxlex Comprehensive Predictor Exams

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