NBCSN Nationally Certified School Nurse Practice Exam

What injury is characterized by guarding and signs of blood loss?

1. Liver laceration

2. Fractured rib

3. Pneumothorax

4. Appendicitis

The correct answer is: Liver laceration

A liver laceration is characterized by guarding and signs of blood loss due to the liver's location and its vascular nature. When the liver is injured, it can bleed significantly, leading to internal hemorrhage. Guarding is a protective mechanism where the patient tenses their abdominal muscles to minimize pain and prevent further injury, often observed in cases of abdominal trauma. Signs of blood loss may include tachycardia, hypotension, or signs of shock, indicating that the body is responding to significant internal bleeding. In contrast, while fractured ribs can also cause pain and may lead to guarding, they are less likely to present with systemic signs of blood loss unless there are complications such as a hematoma or damage to nearby structures. A pneumothorax involves air in the pleural space and can result in respiratory distress, but does not typically lead to significant guarding or direct signs of blood loss, as it primarily affects lung function rather than causing internal hemorrhage. Appendicitis can cause abdominal pain and guarding as well, but it generally presents with localized pain rather than the signs of extensive blood loss associated with a liver injury.