A nurse in an emergency department is caring for a child who experienced a submersion injury. Which of the following is the priority action for the nurse to take?
Apply warming blankets.
Administer an IV bolus.
Assist with intubation.
Obtain an ABG sample.
The Correct Answer is C
A. Applying warming blankets is important for maintaining the child's body temperature, but it is not the top priority in this situation.
B. Administering an IV bolus may be necessary, but it is not the priority action. The child's airway and breathing take precedence.
C. This is the correct action. In cases of submersion injury, there is a risk of respiratory distress or failure due to aspiration of water. Assisting with intubation helps ensure a patent airway and adequate oxygenation.
D. Obtaining an arterial blood gas (ABG) sample is an important assessment, but it is not the top priority. Ensuring a patent airway and providing adequate oxygenation come first.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Unexplained weight gain is not a typical finding in Hodgkin's lymphoma. Weight loss is more commonly associated with this condition.
B. Night sweats are a common symptom of Hodgkin's lymphoma. They can be indicative of the body's response to the cancer.
C. Flushed skin is not typically associated with Hodgkin's lymphoma. Pallor or jaundice may be more commonly observed.
D. Decreased body temperature is not a typical finding in Hodgkin's lymphoma. Infection or fever may lead to an elevated body temperature.
Correct Answer is A
Explanation
A. Increased expectoration (coughing up mucus) indicates that the chest physiotherapy treatments have been effective in helping to clear the airways of mucus, which is a common goal in managing cystic fibrosis.
B. Increased urine output is not a direct indicator of the effectiveness of chest physiotherapy in managing cystic fibrosis.
C. Increased heart rate is not a specific indicator of the effectiveness of chest physiotherapy in managing cystic fibrosis. In fact, an increased heart rate may indicate stress or discomfort.
D. Reduced pain is a positive outcome but may not be directly related to the effectiveness of chest physiotherapy in managing cystic fibrosis. The primary goal of chest physiotherapy is to improve airway clearance.
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