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    Wgu rn hesi health assessment proctored exam

    While completing an admission assessment for a client with rectal bleeding, the nurse observes dried, dark red blood on the surface of a purple, shiny tissue mass that extrudes from the anal opening. When documenting in the client's electronic medical record (EMR), which finding should the nurse enter in the client's physical assessment?

    Explanation & Rationale

    A. Dried dark red blood is consistent with the bleeding from hemorrhoids, which is often seen on external hemorrhoids, especially if they have become thrombosed or irritated. B. Anal mucosa prolapse and loose sphincter tone are not consistent with the presence of dried blood from hemorrhoids. C. Tears of the anal mucosa (anal fissures) would present as fresh, bright red blood, not dark and dried. D. Serosanguineous and purulent exudate is not typically seen in hemorrhoids and would suggest infection or abscess.

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