A nurse enters the room of a school-age child and finds them on the floor experiencing a tonic-clonic seizure. Which of the following actions should the nurse take?
Turn the child onto their back.
Restrain the child's upper extremities.
Place a padded tongue blade in the child's mouth.
Place a pillow under the child's head.
The Correct Answer is D
The correct action to take in this situation is to place a pillow or cushion under the child's head.
This will help protect the child from injuring their head during the seizure.
It is important not to turn the child onto their back during a seizure, as this can obstruct the airway and potentially lead to respiratory distress.
Restraining the child's upper extremities is also not recommended, as it can cause injury to the child or the person trying to restrain them.
Placing a padded tongue blade or any object in the child's mouth is no longer recommended during a seizure. Doing so can cause injury to the child's mouth or teeth and is not necessary for seizure management.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Before any invasive procedure, it is essential to ensure that the client has provided informed consent. Informed consent involves providing the client with information about the procedure, its risks, benefits, and alternatives, allowing them to make an informed decision about their healthcare. The nurse should verify that the client has been adequately informed about the esophagogastroduodenoscopy procedure and has given consent before proceeding.
Informing the client about the procedure duration of 60 minutes is not a priority action. While it is helpful to provide the client with information about the procedure, the specific duration of the procedure may vary depending on various factors, and it does not require immediate attention prior to the procedure.
Ensuring that the client's bladder is full is not necessary for an esophagogastroduodenoscopy procedure. The procedure involves examining the upper gastrointestinal tract and does not involve the bladder or urinary system.
Administering an oral contrast solution is not typically required for an esophagogastroduodenoscopy procedure. Oral contrast solutions are commonly used for other
diagnostic imaging procedures, such as computed tomography (CT) scans or barium studies, but not for esophagogastroduodenoscopy.
Correct Answer is D
Explanation
A. Room number of the client:
- The room number alone is not sufficient for accurate client identification. Room numbers may change, and multiple clients may share the same room. Relying on the room number alone can lead to errors.
B. Client's telephone number:
- The client's telephone number is not typically used as a primary identifier for medication administration. It may be part of the client's record, but it is not the primary means of confirming identity before administering medications.
C. Client's full medical diagnosis:
- While the client's medical diagnosis is important for understanding their overall health condition, it is not a primary identifier for medication administration. Diagnoses can be complex and may not be unique to a single individual within a healthcare setting.
D. Name of the client:
- Matching the client's name with their identification band or other official records is a crucial step in preventing medication errors and ensuring the right medication is given to the right person.
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