A nurse is caring for a child who is having a tonic-clonic seizure and vomiting. Which of the following actions is the nurse's priority?

Place a pillow under the child's head.

Clear the area of hazards.

Position the child side-lying

Loosen restrictive clothing

Answer and Explanation

The Correct Answer is C

A. Place a pillow under the child's head.

Explanation: While providing comfort is important, the priority in this scenario is to ensure the child's safety. Placing a pillow under the head can be considered after addressing immediate safety concerns.

B. Clear the area of hazards.

Explanation: Correct Choice. Ensuring the area is clear of hazards is the nurse's priority. During a seizure, the child can experience uncontrolled movements, and having hazards around can lead to injuries. Clearing the area helps prevent harm. But priority is to position the child side lying.

C. Position the child side-lying.

Explanation: Correct Choice. Placing the child in a side-lying position helps prevent choking and aspiration due to vomiting during the seizure. It also minimizes the risk of airway obstruction and helps manage secretions.

D. Loosen restrictive clothing.

Explanation: While loosening restrictive clothing can facilitate breathing, the priority in this situation is addressing safety concerns related to the seizure and vomiting. Ensuring a clear and safe environment takes precedence.

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Correct Answer is B

Explanation

A. Dizziness is always a sign of a concussion.

This statement is incorrect. While dizziness can be a symptom of a concussion, it is not always indicative of a concussion. There can be various causes of dizziness, and it is essential to consider other symptoms as well when assessing for a concussion.

B. Bike Helmet Safety

Explanation:

The correct answer to include as part of concussion/head injury prevention teaching to children and parents is "Bike helmet safety." This is because wearing a helmet while riding a bike or participating in other activities that involve head injury risks is crucial to prevent head injuries and concussions. Helmets provide protection to the head by absorbing impact energy and reducing the risk of skull fractures or traumatic brain injuries.

C. Normal fluid intake.

While staying hydrated is important for overall health, it is not directly related to concussion or head injury prevention teaching. This choice is unrelated to the topic.

D. Signs of autism.

Signs of autism are unrelated to concussion or head injury prevention teaching. This choice is not relevant to the topic at hand.

A. I use a suppository every night to have a bowel movement. B. I carry a water bottle with me because I drink a lot of water C. I do wheelchair exercises while watching TV. D. I only need to catheterize myself twice every day!

Correct Answer is D

Explanation

A. Using a suppository for bowel movement is a common approach for managing bowel function in people with paralysis and is appropriate.

B. Carrying a water bottle to stay hydrated is important, especially since individuals with paralysis may be at increased risk of urinary tract infections. Adequate hydration is beneficial.

C. Doing wheelchair exercises while watching TV is a proactive way to maintain muscle tone and overall health, which is crucial for individuals with paralysis.

D. "I only need to catheterize myself twice every day!"

Explanation: In the context of spina bifida and paralysis from the waist down, catheterization is often required for bladder management. Individuals with this condition often experience urinary retention and require intermittent catheterization to empty their bladder. However, "twice every day" is not usually sufficient for someone with paraplegia. Adequate catheterization frequency is crucial to prevent urinary retention, infections, and other complications.

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A nurse is caring for a child who is having a tonic-clonic seizure and vomiting. Which of the following actions is the nurse's priority?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

What do we include as part of our concussion/head injury prevention teaching to children and parents:

Correct Answer is B

Explanation

A nurse is caring for an adolescent who has spina bifida and is paralyzed from the waist down. Which of the following statements by the client should indicate to the nurse a need for further teaching?

Correct Answer is D

Explanation

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