A nurse receives a telephone call from a parent reporting that their school-age child has a nosebleed and that they cannot stop the bleeding. Which of the following instructions should the nurse provide to the parent?

"Have your child lie down and turn their head to the side for 10 minutes.”

"Place a warm, wet washcloth over your child's forehead and the bridge of their nose.”

"Tell your child to blow their nose gently and then sit down and but their head backward.”

“Use your thumb and forefinger to apply pressure to the sides of your child's nose”

Answer and Explanation

The Correct Answer is D

Rationale:

A. "Have your child lie down and turn their head to the side for 10 minutes." Lying down increases blood flow to the head, which can worsen the nosebleed or cause aspiration if blood is swallowed. Upright posture is preferred to reduce venous pressure in nasal vessels.

B. "Place a warm, wet washcloth over your child's forehead and the bridge of their nose." Warm compresses can dilate blood vessels and worsen bleeding. Cold compresses are more appropriate to constrict blood vessels and reduce blood flow.

C. "Tell your child to blow their nose gently and then sit down and put their head backward." Blowing the nose can dislodge clots and worsen bleeding. Tilting the head back can cause blood to run down the throat, increasing the risk of nausea, vomiting, or aspiration.

D. "Use your thumb and forefinger to apply pressure to the sides of your child's nose."
Pinching the soft part of the nose for 10–15 minutes while the child leans slightly forward is the first-line intervention for epistaxis. This reduces bleeding and prevents aspiration.

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Correct Answer is D

Explanation

Rationale:

A. Diplopia: Double vision (diplopia) is not a typical symptom of systemic lupus erythematosus (SLE). It is more commonly associated with neurologic or ocular conditions like multiple sclerosis or cranial nerve palsy.

B. Esophagitis: Esophagitis is not a hallmark manifestation of SLE. While SLE can affect any organ system, gastrointestinal involvement is less common and typically secondary to medications rather than the disease itself.

C. Bradykinesia: Bradykinesia is characterized by slowed movements and is commonly associated with Parkinson’s disease, not with SLE.

D. Fever: Fever is a common finding during acute exacerbations of SLE. It results from systemic inflammation and immune activation, which are characteristic of disease flare-ups.

A. Client presents for evaluation of severe pain in upper abdomen that radiates into their back. B. States pain began approximately 12 hr ago and is worse when they are supine or after they eat. C. Rates pain as 7 on a scale of 0 to 10. Sclera noted to be yellow. D. Heart rate regular, lungs clear to auscultation. E. Abdomen firm, bowel sounds hypoactive. F. Client guards abdomen and grimaces during palpation. Reports last bowel movement was yesterday. G. Reports no recent illnesses takes no prescribed medications. H. Client is alert and oriented x4.

Correct Answer is ["A","B","C","E","F"]

Explanation

Rationale for Correct Choices:

Pain radiating to the back, worsens after eating or lying down: This is characteristic of acute pancreatitis, where inflammation irritates surrounding tissues and worsens in the supine position due to gravitational pressure. Postprandial worsening suggests pancreatic enzyme stimulation.
Scleral icterus (yellow sclera and palate): Jaundice suggests biliary obstruction or liver involvement, possibly due to gallstone pancreatitis or alcoholic liver disease. This also aligns with the elevated bilirubin levels and warrants further hepatic and biliary assessment.
Abdomen distended, rigid, and tender with guarding: These are signs of peritonitis or severe intra-abdominal inflammation, requiring urgent evaluation. Guarding and rigidity indicate localized or diffuse peritoneal irritation from pancreatic enzymes.
Hypoactive bowel sounds: Reduced bowel activity is often seen in pancreatitis due to paralytic ileus caused by inflammation and stress response. Monitoring for progression to ileus or obstruction is necessary.
Client guards abdomen and grimaces during palpation: Guarding and pain upon palpation are signs of significant intra-abdominal inflammation. It may reflect worsening pancreatitis or complications such as necrosis or peritonitis.

Rationale for Incorrect Choices:

Heart rate regular, lungs clear to auscultation: These are normal findings and do not require follow-up.
Client is alert and oriented x4: Indicates normal neurologic status. No immediate concern here.
Reports no recent illnesses, takes no prescribed medications: This helps rule out medication-induced pancreatitis and doesn't indicate a need for follow-up.

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A nurse receives a telephone call from a parent reporting that their school-age child has a nosebleed and that they cannot stop the bleeding. Which of the following instructions should the nurse provide to the parent?

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Correct Answer is D

Explanation

Correct Answer is ["A","B","C","E","F"]

Explanation

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