# A client taking a direct oral anticoagulant after hip surgery becomes weak and dizzy. The blood pressure is 82/48 mm Hg and the abdomen is firm and distended. Which action is the priority?

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=397283&lang=en  
> language: en  
> subject: Postsurgical Complications  
> category: ROR

## Question

A client taking a direct oral anticoagulant after hip surgery becomes weak and dizzy. The blood pressure is 82/48 mm Hg and the abdomen is firm and distended. Which action is the priority?

## Option

1. Activate rapid evaluation for possible internal bleeding. **✔ Correct answer**
2. Encourage the client to walk to improve circulation.
3. Give the next anticoagulant dose early.
4. Offer a high-fiber snack and reassess tomorrow.

**Correct answer: 1**

## Explanation

Hypotension, dizziness, weakness, and abdominal distention in a client taking an anticoagulant suggest possible internal bleeding and shock. The priority is urgent evaluation and intervention. Ambulation, additional anticoagulant, or delayed reassessment is unsafe.

## In-depth explanation

Clinical Judgment
Use the client cues, timing, labs, and safety risks to select the response that best fits Possible internal bleeding on anticoagulant.

Memory Tip
Match the strongest cue cluster to the safest nursing judgment.

KR vs US
NCLEX items reward cue-based priority thinking rather than isolated recall.

## Clinical scenario

Clinical Practice Guide
For Possible internal bleeding on anticoagulant, compare the complete cue pattern with the client's current stability, ordered data, and expected nursing scope.

Caution
Do not choose an action from one isolated cue when the full scenario changes priority or safety.

## Key concepts

- **Direct Oral Anticoagulant** — An oral medication that reduces clot formation without routine INR monitoring.
- **Internal Bleeding** — Bleeding inside the body that may cause shock or organ compromise.
- **Shock** — Inadequate tissue perfusion that can be life-threatening.

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