# The nurse reviews recovery after a percutaneous liver biopsy. Which findings require immediate follow-up? Highlight the findings associated with bleeding or pneumothorax.

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> url: https://mymerci.kr/pages/nclex_q.php?qn_id=497294&lang=en  
> language: en  
> subject: Complications of Procedures  
> category: ROR

## Question

The nurse reviews recovery after a percutaneous liver biopsy. Which findings require immediate follow-up? Highlight the findings associated with bleeding or pneumothorax.

Nurses' Notes
1010: The nurse receives a client after an ultrasound-guided percutaneous liver biopsy. The initial recovery note states that mild puncture-site soreness improves with supported positioning. At 1025, the dressing remains dry and the client is alert and answers orientation questions correctly. The nurse then observes that blood pressure is falling while the pulse becomes progressively faster. At 1035, the client reports that abdominal pain is increasing with new guarding. The puncture dressing still shows no external drainage. The respiratory assessment now finds that new shortness of breath occurs with reduced breath sounds on one side. The client reports that small sips of water are tolerated without nausea or swallowing difficulty. A repeat blood count shows that hemoglobin has fallen substantially from the preprocedure value. The nurse confirms that the peripheral intravenous line remains patent. The client says that mild right shoulder discomfort has not increased. At 1045, the nurse applies ordered oxygen, maintains intravenous access, and calls the rapid response team. The nurse prepares the client for urgent imaging and additional laboratory testing. The provider is informed that instability developed despite a dry external dressing.

## Explanation

Falling blood pressure with tachycardia, increasing abdominal pain with guarding, new dyspnea with reduced breath sounds, and a falling hemoglobin require follow-up. These findings suggest hemorrhage or pneumothorax rather than routine soreness.

## In-depth explanation

Quick answer
Highlight the hemodynamic decline, increasing guarded abdominal pain, new dyspnea with reduced breath sounds, and falling hemoglobin. Together they point to major bleeding or pneumothorax after the biopsy.

Why this is correct
Liver biopsy can cause pain, bleeding, bile leak, and pneumothorax. Worsening pain plus circulatory change or hemoglobin loss suggests hemorrhage, while sudden respiratory asymmetry suggests pleural injury and requires rapid evaluation.[2]

Easy analogy or mental picture
Picture two nearby compartments after a needle procedure: the abdomen can collect blood and the chest can collect air. Vital signs, pain, hemoglobin, and breath sounds show which compartment may be failing; imaging still confirms the problem.

Memory hook
After biopsy, worsening pain plus circulation or breathing change is not routine.

NCLEX decision rule
When recovery worsens after liver biopsy, think concealed bleeding or pleural injury; compare vital signs, abdominal findings, hemoglobin, and bilateral breath sounds before labeling discomfort as expected.

Why the other choices are wrong
Mild localized soreness that improves, an intact dressing, stable orientation, and tolerated oral fluids fit uncomplicated recovery. Right shoulder discomfort can occur, but progressive pain with instability is the important distinction.References

- [1]NCSBN: 2026 NCLEX-RN Test PlanNational Council of State Boards of Nursing

- [2]AASLD: Why Non-invasive Risk Scores Are UsedAmerican Association for the Study of Liver Diseases

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