A nurse is collecting data from a client diagnosed with laryngeal cancer who is postoperative following a laryngectomy. Which of the following is a clinical manifestation of a hemorrhage?
Increased pain
Continuous swallowing
Poor fluid intake
Drooling
The Correct Answer is B
Choice A Reason: Increased pain is not a specific sign of hemorrhage, but it may indicate inflammation, infection, or nerve damage.
Choice B Reason: Continuous swallowing is a sign of hemorrhage, as it indicates that blood is accumulating in the throat or esophagus and stimulating the swallowing reflex.
Choice C Reason: Poor fluid intake is not a sign of hemorrhage, but it may indicate difficulty swallowing, nausea, or dehydration.
Choice D Reason: Drooling is not a sign of hemorrhage, but it may indicate impaired oral control, salivary gland damage, or infection.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A Reason: Contacting the health care provider is the first nursing action that the nurse should perform, as it indicates that the client may have compartment syndrome, which is a medical emergency that requires immediate intervention to prevent tissue necrosis and nerve damage.
Choice B Reason: Administering PRN pain medication is not the first nursing action that the nurse should perform, as it may not relieve the pain and may mask the symptoms of compartment syndrome.
Choice C Reason: Documenting the findings is not the first nursing action that the nurse should perform, as it may delay the treatment and worsen the outcome of compartment syndrome.
Choice D Reason: Elevating the extremity is not the first nursing action that the nurse should perform, as it may decrease blood flow and increase tissue ischemia in compartment syndrome.
Correct Answer is D
Explanation
Choice A Reason: Parkinson's disease does not result from too low acetylcholine as a result of an autoimmune reaction, but this may be a description of myasthenia gravis, which affects the neuromuscular junction.
Choice B Reason: Parkinson's disease is not caused by the deterioration of the myelin sheath of the basal ganglia, but this may be a description of multiple sclerosis, which affects the central nervous system.
Choice C Reason: Excess dopamine and deficient acetylcholine are not the two major causes of Parkinson's disease, but they are reversed. Parkinson's disease is caused by low dopamine and high acetylcholine levels in the brain.
Choice D Reason: Parkinson's is caused by depletion of dopamine and excess of acetylcholine, as this affects the balance between these two neurotransmitters that control movement and coordination.
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