Inpatient Obstetric Nurse (NCC) Practice Exam

What late finding might indicate significant blood loss in a patient?

1. Increased heart rate

2. Falling blood pressure

3. Increased urinary output

4. Improved level of consciousness

The correct answer is: Falling blood pressure

The identification of falling blood pressure as a late finding indicating significant blood loss is grounded in the understanding of the body's compensatory mechanisms in response to hypovolemia. When a patient experiences significant blood loss, the body initially tries to maintain blood flow and oxygen delivery to vital organs through compensatory mechanisms such as increasing heart rate and peripheral vasoconstriction. However, as blood loss continues and exceeds the body's ability to compensate, blood pressure will start to fall. Falling blood pressure is a critical sign that indicates not only ongoing hemorrhage but also the potential onset of shock. It reflects a failure in the cardiovascular reserve as the body becomes less able to sustain adequate circulation with reduced blood volume. This late finding is particularly concerning and typically warrants urgent medical intervention. In contrast, increased heart rate is an early finding associated with blood loss as the body attempts to compensate. Increased urinary output would not generally be expected in scenarios of significant blood loss, and an improved level of consciousness would suggest adequate cerebral perfusion, which may not be the case with significant blood loss leading to hypotension. Thus, recognizing falling blood pressure allows healthcare providers to make timely decisions regarding the management of potential hypovolemic shock.