A nurse is caring for a school-age child who is experiencing a tonic-clonic seizure. Which of the following actions should the nurse take?
Prevent movement of the child's extremities.
Administer magnesium sulfate to the child.
Put a tongue blade between the child's teeth.
Place a folded blanket under the child's head.
The Correct Answer is D
A. Prevent movement of the child's extremities is incorrect. Attempting to prevent movement during a tonic-clonic seizure is unsafe. The nurse should avoid restraining the child, as this can cause injury. The focus should be on ensuring safety during the seizure.
B. Administer magnesium sulfate to the child is incorrect. Magnesium sulfate is used for certain conditions, such as preeclampsia in pregnant women or seizures due to eclampsia, but it is not typically used to manage tonic-clonic seizures in children. Anticonvulsant medications or emergency interventions are more appropriate.
C. Put a tongue blade between the child's teeth is incorrect. Inserting a tongue blade or any object into the mouth during a seizure is dangerous, as it can lead to injury to the mouth, teeth, or airway. The nurse should not attempt to put anything in the child's mouth.
D. Place a folded blanket under the child's head is correct. The priority during a tonic-clonic seizure is to protect the child from injury. Placing a folded blanket or soft padding under the head helps prevent head trauma if the child falls to the ground during the seizure. The nurse should also ensure the environment is clear of sharp objects.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Flushed skin is incorrect. Hypoglycemia typically causes pale, clammy skin due to the body's stress response. Flushed skin is more commonly associated with hyperglycemia.
B. Headache is correct. Hypoglycemia can cause neurological symptoms such as headache, dizziness, confusion, and irritability due to a lack of glucose available for brain function.
C. Fruity breath odor is incorrect. A fruity or acetone-like breath odor is a sign of diabetic ketoacidosis (DKA), which occurs with hyperglycemia, not hypoglycemia.
D. Thirst is incorrect. Increased thirst (polydipsiA. is a symptom of hyperglycemia due to excess glucose in the bloodstream drawing water out of the cells, leading to dehydration. Hypoglycemia does not typically cause excessive thirst.
Correct Answer is C
Explanation
A. "You should hide your grief as much as possible around your child." is incorrect. It is important for the guardian to express emotions openly and honestly in an age-appropriate way. Hiding grief can make the child feel isolated or that their own emotions are not valid.
B. "Your child likely views death as temporary." is incorrect. By age 10, most children have a mature understanding of death as final and irreversible. Younger children, such as preschoolers, may see death as temporary, but a school-age child is more likely to comprehend its permanence.
C. "You should be prepared to answer your child's questions about dying." is correct. Children facing terminal illness often have questions about death, and it is important for caregivers to provide honest, age-appropriate answers to help ease fears and concerns.
D. "You should limit visits between the siblings at this time." is incorrect. Encouraging family connections can provide emotional support for both the ill child and their siblings. Limiting visits may lead to increased anxiety or regret for the sibling later on.
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