A nurse is caring for a 7-year-old child in the urgent care with complaints of blurred vision. The nurse should complete which of the following as the priority action?

Administer saline drops

Obtain visual acuity

Cleanse the eyes

Obtain a history

Answer and Explanation

The Correct Answer is B

A.   Administering saline drops may be appropriate if there is a foreign body or irritation, but it is not the priority in a case of blurred vision.
B.   The priority is to assess the child's visual acuity to determine the severity and possible cause of the blurred vision. This is essential to guide further diagnostic steps.
C.   Cleansing the eyes may be helpful if there is visible debris or infection, but it is not the first priority in assessing blurred vision.
D.   Obtaining a history is important but would follow after the visual acuity assessment, as it can help provide context for the symptoms.

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Correct Answer is C

Explanation

A. Vibration is typically performed during exhalation, not inspiration. This helps to loosen secretions.
B. Percussion should not last 15 minutes per lung segment; it is generally performed for shorter periods to avoid discomfort or injury.
C. Administering albuterol prior to CPT helps open the airways, making it easier for the child to expectorate secretions. This is a standard practice for improving the effectiveness of CPT.
D. It is not recommended to perform CPT immediately after a meal, as it may increase the risk of aspiration or discomfort. It is usually advised to wait at least 30 minutes after eating.

A. Speech and communication abilities B. Physical mobility and safety measures C. Cognitive development and educational needs D. Social and emotional well-being

Correct Answer is B

Explanation

A. Speech and communication abilities are important, but physical safety must come first to prevent accidents or injuries.
B. Safety measures are the highest priority, as children with cognitive impairments may have physical or developmental limitations that increase the risk of falls, accidents, or other harm.
C. Cognitive development and educational needs are important but should be addressed after ensuring
the child’s physical safety.

D. Social and emotional well-being are essential aspects of care, but the immediate focus should be on preventing harm.

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A nurse is caring for a 7-year-old child in the urgent care with complaints of blurred vision. The nurse should complete which of the following as the priority action?

Nursing Test Bank

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