A nurse is caring for a client with a suspected bleeding disorder. Which nursing assessment is most essential to identify potential bleeding sources?

Neurological assessment

Skin integrity assessment

Abdominal assessment

Respiratory assessment

Answer and Explanation

The Correct Answer is B

A) Incorrect. A neurological assessment is important to evaluate the client's central nervous system function, but it is not directly related to identifying bleeding sources.

B) Correct. A skin integrity assessment is essential to identify potential external bleeding sources, such as cuts, bruises, or petechiae, which may indicate underlying bleeding disorders.

C) Incorrect. While an abdominal assessment is crucial in identifying internal bleeding in the abdominal area, it is not the most essential assessment to identify bleeding sources overall.

D) Incorrect. A respiratory assessment is important for assessing oxygenation and respiratory status, but it is not the primary assessment to identify bleeding sources.

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Correct Answer is B

Explanation

A) Incorrect. Checking the client's blood pressure is important but not the most critical action before starting a blood transfusion.

B) Correct. The most crucial step before administering any intervention, including a blood transfusion, is to verify the client's identification using two identifiers (e.g., name and date of birth or medical record number) to ensure the right blood is given to the right client.

C) Incorrect. While assessing the client's oxygen saturation is important, it is not the priority before starting a blood transfusion.

D) Incorrect. Obtaining consent for the blood transfusion is essential, but verifying the client's identification is more critical before administering the transfusion.

A. Monitoring the client's pain level. B. Encouraging the client to breastfeed frequently. C. Assessing the client's uterine contractions. D. Educating the client about contraceptive methods.

Correct Answer is C

Explanation

A) Incorrect. While monitoring the client's pain level is important, it is not the priority when managing postpartum hemorrhage.

B) Incorrect. While breastfeeding can help stimulate uterine contractions, it is not the priority when actively managing postpartum hemorrhage.

C) Correct. Assessing the client's uterine contractions is the priority when managing postpartum hemorrhage. Weak or ineffective contractions can contribute to excessive bleeding after childbirth.

D) Incorrect. While educating the client about contraceptive methods is essential for family planning, it is not the immediate priority when managing postpartum hemorrhage.

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A nurse is caring for a client with a suspected bleeding disorder. Which nursing assessment is most essential to identify potential bleeding sources?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is preparing to administer a blood transfusion to a client with significant blood loss. What is the nurse's most important action before starting the transfusion?

Correct Answer is B

Explanation

A client is experiencing postpartum hemorrhage. What should the nurse prioritize when providing care to this client?

Correct Answer is C

Explanation

A nurse is caring for a client with suspected internal bleeding. Which assessment finding requires immediate intervention?

A nurse is caring for a client with liver cirrhosis. Which assessment finding supports the client's increased risk of hemorrhage?

A nurse is caring for a client who is at risk of hemorrhage. What action should the nurse take to prevent bleeding episodes?

A nurse is providing education to a client with a bleeding disorder about home safety measures. What should the nurse include in the client's teaching?

A client has experienced a significant blood loss due to trauma. Which laboratory result should a nurse expect in the early stages of hemorrhage?

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

A nurse is assessing a client who experienced a significant hemorrhage. Which clinical manifestation should the nurse expect to find during the early stages of hemorrhage?

A nurse is providing education to a client about self-management of minor bleeding episodes at home. Which instruction should the nurse include?