A nurse is caring for a postoperative client. Which of the following findings indicate the client may be actively bleeding?
Bounding pulses
Restlessness
Warm skin
Brisk capillary refill
The Correct Answer is B
A. Active bleeding with significant blood is characterized by weak and thread pulses and not bounding pulses.
B. Restlessness can be a sign of hypovolemia and decreased tissue perfusion, which may occur with active bleeding.
C. Warm skin may not necessarily indicate active bleeding but rather normal thermoregulation or vasodilation.
D. Brisk capillary refill is a sign of adequate peripheral perfusion and is not typically associated with active bleeding which is characterized by delayed capillary refill.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Although this client may have physical limitations, they are still engaging in social activities by going to the gym, indicating less likelihood of social isolation.
B. This client has regular social interactions with family members, suggesting they are not socially isolated.
C. Regular social gatherings with friends indicate social engagement and are not indicative of social isolation.
D. Restricting activities outside the home to only essential tasks like getting the mail due to pain or other reasons can indicate social isolation and limited social interactions.
Correct Answer is A
Explanation
A. This statement reflects a misconception about menopause and sexual health, indicating a need for education on safe sex practices.
B. This statement indicates the client is taking steps to address discomfort during sexual activity, which is appropriate.
C. This statement reflects body image concerns commonly experienced by older adults and may warrant further exploration but does not necessarily indicate a need for immediate intervention.
D. This statement indicates a normal interest in sexual activity and does not necessarily indicate a need for intervention.
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