A nurse is caring for a 10-month-old child who was brought to the emergency department by his parents following a head injury.
Which of the following actions should the nurse take first?
Assess respiratory status.
Inspect for fluid leaking from the ears.
Examine the scalp for lacerations.
Check pupil reactions.
The Correct Answer is A
The first action the nurse should take is to assess the respiratory status of the infant.
After a head injury, it is important to ensure that the child’s airway is clear and that they are breathing adequately.
This is a crucial step in providing care for a patient with a head injury.
Choice B is wrong because inspecting for fluid leaking from the ears is not the first priority.
Choice C is wrong because examining the scalp for lacerations is not the first priority.
Choice D is wrong because checking pupil reactions is not the first priority.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Deep-breathing and counting exercises can help the child relax and cope with anxiety before the procedure.
Choice A is wrong because a 30-minute teaching session may not be necessary or appropriate for a school-age child.
Choice C is wrong because it’s important to use clear and honest language when explaining the procedure to the child.
Choice D is wrong because it’s important to explain the procedure to the child in a calm and quiet environment, not in the playroom.
Correct Answer is D
Explanation
Checking the toddler’s ID band against the medical record is the best way to confirm their identity before administering medication.
This ensures that the right medication is given to the right patient.
Choice A is wrong because room numbers can change and are not a reliable way to identify a patient.
Choice B is not the best answer because it relies on another person’s knowledge and memory, which can be fallible.
Choice C is wrong because parents may be stressed or distracted and may not provide accurate information.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today