A nurse is caring for a client who sustained blood loss. Which is a manifestation of hypovolemia?
Dyspnea
Increased blood pressure
Weak pulse
Decreased heart rate
The Correct Answer is C
A: Dyspnea, or difficulty breathing, can occur in various conditions but is not a primary manifestation of hypovolemia. Hypovolemia primarily affects the cardiovascular system due to reduced blood volume.
B: Increased blood pressure is not a typical manifestation of hypovolemia. In fact, hypovolemia usually leads to decreased blood pressure due to the reduced volume of circulating blood.
C: A weak pulse is a common manifestation of hypovolemia. The reduced blood volume leads to decreased cardiac output, resulting in a weak and thready pulse.
D: Decreased heart rate is not typical in hypovolemia. The body usually compensates for low blood volume by increasing the heart rate (tachycardia) to maintain adequate circulation.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A: Clostridium difficile infection typically develops after prolonged antibiotic use and is not the most likely cause of diarrhea immediately after starting enteral feeding.
B: Antibiotic therapy can cause diarrhea, but it is not the most likely cause in this scenario where the diarrhea started soon after beginning enteral feeding.
C: Formula intolerance is the most likely cause of diarrhea shortly after starting enteral feeding. The patient’s digestive system may not tolerate the formula well, leading to diarrhea.
D: Bacterial contamination is a possible cause but is less likely to cause immediate diarrhea after starting enteral feeding compared to formula intolerance. Proper handling and preparation of the formula should minimize this risk.
Correct Answer is D,A,C,B
Explanation
A: Pulling the fire alarm is essential to alert others to the fire and initiate the emergency response. However, it should follow the immediate rescue of clients.
B: Extinguishing the fire is important but should be done after ensuring the safety of clients and confining the fire.
C: Confining the fire helps prevent it from spreading and should be done after pulling the fire alarm.
D: Rescuing the clients is the first priority to ensure their safety. Clients should be moved to a safe area away from the fire.
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