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”
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is {"dropdown-group-1":"B","dropdown-group-2":"B"}
Explanation
Rationale for Correct Choices:
- Decreased cardiac output: The client is post–myocardial infarction and experiences chest pain with minimal exertion, tachycardia (HR 112/min), and signs of anxiety and fear. These findings suggest that myocardial function may be compromised. Decreased cardiac output is a significant risk in post-MI clients due to potential for reinfarction, ischemia, or left ventricular dysfunction.
- Respiratory failure: The client has COPD, an elevated respiratory rate (32/min), and oxygen saturation of 87% on room air, which indicates significant hypoxemia. The productive cough, fatigue, and shortness of breath increase the risk for decompensation into respiratory failure without prompt oxygen therapy and pulmonary support.
Rationale for Incorrect Choices:
- Pancytopenia: This condition involves a reduction in red blood cells, white blood cells, and platelets. There is no evidence of bone marrow suppression, recent chemotherapy, or hematologic disorder in this client’s history.
- Neurogenic shock: Neurogenic shock results from spinal cord injury or disruption of sympathetic nervous system control. The client has no evidence of trauma or spinal pathology, and the elevated heart rate contradicts the expected bradycardia of neurogenic shock.
- Hepatic encephalopathy: This is caused by liver dysfunction, typically in clients with advanced liver disease. There are no signs of altered mental status, liver disease, or elevated ammonia levels in this case.
Correct Answer is B
Explanation
Rationale:
A. Buy disposable dishes for daily use: HIV is not transmitted through saliva or casual household contact, including sharing dishes. Disposable dishes are unnecessary and promote stigma.
B. Clean blood-contaminated surfaces with bleach: A 1:10 bleach solution is effective in killing HIV on surfaces. Proper cleaning of blood spills is essential for preventing transmission.
C. Wash soiled clothes in cold water: Hot water (not cold) and detergent should be used to clean potentially contaminated clothing to reduce the risk of infection.
D. Use condoms with a petroleum-based lubricant: Petroleum-based lubricants degrade latex condoms, increasing the risk of breakage. Water- or silicone-based lubricants should be used instead.
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