A client with multiple injuries to the head, chest, and abdomen has had their airway stabilized and is breathing on their own. Which symptom would lead the nurse to suspect internal hemorrhaging even when the nurse does not see any bleeding?
Increased sweating
Increased redness at the site
Increased abdominal distention
Increased blood pressure
The Correct Answer is C
A. Increased sweating: This is incorrect. Increased sweating is not typically indicative of internal hemorrhaging. It can be associated with various conditions but is not a specific sign of internal bleeding.
B. Increased redness at the site: This is incorrect. Increased redness would more likely be associated with localized infection or inflammation rather than internal hemorrhaging.
C. Increased abdominal distention: This is correct. Increased abdominal distention can be a sign of internal hemorrhaging, particularly if blood accumulates in the abdominal cavity (hemoperitoneum), leading to abdominal swelling and discomfort.
D. Increased blood pressure: This is incorrect. Internal hemorrhaging often leads to hypotension rather than increased blood pressure, as blood volume decreases and the body attempts to compensate.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Rub the skin completely dry following a decontamination shower: This is incorrect. The skin should be patted dry, not rubbed, to avoid further irritation.
B. Prepare to administer amyl nitrate: This is incorrect. Amyl nitrate is used for cyanide poisoning, not sarin gas exposure.
C. Provide respiratory support with a plastic airway: While respiratory support may be needed, the priority in sarin gas exposure involves addressing symptoms and potential seizures.
D. Initiate seizure precautions: Sarin gas is a nerve agent that can cause seizures due to its effect on the nervous system. Seizure precautions are necessary for clients exposed to sarin gas.
Correct Answer is D
Explanation
A. Pinch the testicles to feel for abnormalities: This is incorrect. The testicles should be gently palpated, not pinched, to detect abnormalities.
B. Expect swelling of the testicles after examination: This is incorrect. There should be no swelling after a testicular self-examination.
C. Perform testicular self-examination every year: This is incorrect. Self-examination should be performed monthly, not yearly, to detect any changes promptly.
D. Examine the testicles after a bath or shower: This is correct. The warmth and relaxation of the scrotum after a bath or shower make it easier to feel for abnormalities.
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