An emergency department nurse triages a group of school children injured in a school bus crash. Which of the following children should the nurse have the provider evaluate first?

A child who has a forehead wound that is bleeding copiously

A child who has a compound fracture of the femur and is crying in pain

A child who reports diplopia and nausea and was unconscious at the scene but is now awake

A child who has several missing permanent teeth and a swollen, ecchymotic upper lip

Answer and Explanation

The Correct Answer is C

A. A child who has a forehead wound that is bleeding copiously: While bleeding wounds require attention, they are not immediately life-threatening compared to other injuries described.

B. A child who has a compound fracture of the femur and is crying in pain: While painful, a

femur fracture is not typically immediately life-threatening unless it is causing severe bleeding or compromising circulation.

C. A child who reports diplopia and nausea and was unconscious at the scene but is now awake:

These symptoms suggest potential head trauma and require urgent evaluation to assess for intracranial injuries.

D. A child who has several missing permanent teeth and a swollen, ecchymotic upper lip: These injuries, while concerning, are not immediately life-threatening compared to the potential head injury described in option C.

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Correct Answer is D

Explanation

A. Instilling erythromycin ophthalmic ointment in the newborn's eyes is important to prevent neonatal conjunctivitis, but drying the newborn takes precedence to prevent heat loss and stimulate breathing immediately after birth.

B. Weighing the newborn and placing identification bracelets can be done after drying the newborn.

C. Placing identification bracelets on the newborn is important for identification purposes but does not take precedence over drying the newborn to prevent heat loss and stimulate breathing.

D. Dry the newborn: Drying the newborn is the priority immediately after birth to prevent heat

loss and stimulate breathing. The newborn is wet from amniotic fluid and may be cold due to the temperature difference between the intrauterine and extrauterine environment. Drying the newborn with a warm, soft towel helps to prevent hypothermia and promotes the initiation of breathing, which is essential for oxygenation and lung expansion. This action supports the

newborn's transition to extrauterine life and sets the stage for subsequent assessments and interventions.

A. Prohibit visitors for the first 24 hr. B. Keep a 3-foot distance from the radiation implant. C. Maintain the client on bed rest for 72 hr. D. Require the client wear a dosimeter badge.

Correct Answer is D

Explanation

A. Prohibiting visitors is not necessary for clients with sealed internal radiation implants. Visitors should be allowed unless specific restrictions are required based on the type of radiation therapy.

B. While maintaining distance from the radiation source is important, there is no specific guideline stating a 3-foot distance. The nurse should follow institutional policies and radiation safety guidelines regarding proximity to the radiation source.

C. There is no need to maintain the client on bed rest for 72 hours after receiving a sealed

internal radiation device. The client should be encouraged to ambulate and perform activities of daily living as tolerated.

D. Requiring the client to wear a dosimeter badge allows healthcare providers to monitor the amount of radiation exposure received by the client and ensures that radiation safety protocols are followed.

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An emergency department nurse triages a group of school children injured in a school bus crash. Which of the following children should the nurse have the provider evaluate first?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is D

Explanation

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Correct Answer is D

Explanation

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