A nurse in an emergency department is caring for a child who experienced a submersion injury. Which of the following is the priority action for the nurse to take?
Apply warming blankets.
Administer an IV bolus.
Assist with intubation.
Obtain an ABG sample.
The Correct Answer is C
A. Applying warming blankets is important for maintaining the child's body temperature, but it is not the top priority in this situation.
B. Administering an IV bolus may be necessary, but it is not the priority action. The child's airway and breathing take precedence.
C. This is the correct action. In cases of submersion injury, there is a risk of respiratory distress or failure due to aspiration of water. Assisting with intubation helps ensure a patent airway and adequate oxygenation.
D. Obtaining an arterial blood gas (ABG) sample is an important assessment, but it is not the top priority. Ensuring a patent airway and providing adequate oxygenation come first.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. "Your child's feet should be 3 to 6 inches off the ground when seated on the bicycle." This instruction is not related to safety. Proper seat height is important for comfort and efficiency but does not directly impact safety.
B. This is the correct instruction. Maintaining a distance of at least 3 feet from the curb while riding in the street allows space for maneuvering and helps prevent collisions with obstacles or parked cars.
C. "Your child should walk the bicycle through intersections." This is a good safety practice. Walking the bicycle through intersections reduces the risk of accidents with other vehicles.
D. "Your child should ride the bicycle against the flow of traffic." This is incorrect.
Children should ride their bicycles in the same direction as traffic. Riding against traffic increases the risk of accidents.
Correct Answer is B
Explanation
A. Absent nuchal rigidity is a positive sign in the context of managing bacterial
meningitis, but it alone does not determine when droplet precautions can be discontinued.
B. This is the correct answer. A negative cerebrospinal fluid (CSF) culture indicates that the bacterial infection has been effectively treated. Once the CSF culture is negative, the child is no longer considered contagious and can be removed from droplet precautions.
C. The initiation of antibiotics is an important step in treating bacterial meningitis, but the passage of time alone does not indicate when precautions can be discontinued. The
effectiveness of treatment is better determined by laboratory and clinical indicators.
D. The temperature is an important clinical parameter, but a temperature below 37.4° C (99.3° F) alone does not determine when droplet precautions can be discontinued. The decision is based on the resolution of the infectious process, as indicated by negative cultures.
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