A child with a brain tumor has a decreased respiratory hate and is less responsive to verbal commands than he was when the nurses assessed the client the previous hour. What should the nurse do next?
Raise the head of the bed
Notify the health care provider (HCP)
Obtain an oximeter reading
Implement seizure precautions
The Correct Answer is B
A. Raising the head of the bed may help with respiratory effort but does not address the underlying issue of decreased responsiveness. Immediate assessment and intervention are necessary.
B. Notifying the healthcare provider is critical as the child’s decreased responsiveness and respiratory rate indicate a potential deterioration in condition that requires prompt medical evaluation.
C. While obtaining an oximeter reading can provide useful information about oxygenation, the priority is to notify the HCP about the change in the child's neurological status.
D. Implementing seizure precautions is important for a child with a brain tumor, but the immediate concern is the change in responsiveness, necessitating HCP notification first.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","B","D","E"]
Explanation
A. Washing hands frequently is important for preventing infections, which can trigger a sickle cell crisis.
B. Cold weather can cause blood vessels to constrict, increasing the risk of a sickle cell crisis, making this statement correct.
C. Restricting fluids during illness is not advisable; staying hydrated is crucial for preventing sickle cell crises.
D. Carrying a water bottle encourages adequate hydration, which is essential for individuals with sickle cell anemia to help prevent crises.
E. Taking medications as directed is vital for managing sickle cell disease and preventing complications.
Correct Answer is D
Explanation
A. Administering Children's Tylenol (acetaminophen) is appropriate for pain relief in toddlers and does not indicate a need for further teaching.
B. Children's Ibuprofen is also acceptable for pain management in this age group, demonstrating the caregiver's understanding of pain management options.
C. Completing the entire course of antibiotics is essential to ensure the infection is fully treated and helps prevent antibiotic resistance.
D. Baby aspirin is contraindicated in children due to the risk of Reye’s syndrome, indicating that the caregiver needs further teaching regarding safe medication administration for pain.
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