A nurse in an urgent care clinic is caring for a school-age child who has injuries resulting from physical maltreatment. Which of the following actions should the nurse take first?
Ensure the child's safety.
Tell the child they are not at fault.
Document the location of the child’s injuries
Notify local law enforcement.
The Correct Answer is A
Choice A reason:
Ensuring the child's safety is the top priority. If the child is in immediate danger, steps must be taken to protect them.
Choice B reason:
While providing emotional support to the child is important, ensuring their physical safety takes precedence.
Choice C reason:
Documenting injuries is important for a comprehensive assessment and for legal purposes, but it should follow ensuring the child's immediate safety.
Choice D reason:
Notifying law enforcement may be necessary, but ensuring the child's immediate safety comes first.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason:
Obtaining a pneumococcal immunization is an important preventive measure for children with asthma, as respiratory infections can exacerbate their condition.
Choice B reason:
Encouraging physical activity is important for children with asthma. While some precautions may be necessary, avoiding participation in school sports altogether is not recommended.
Choice C reason:
Having the child inhale deeply and quickly when using the peak flow meter is not the recommended technique. The child should take a deep breath and exhale forcefully to obtain an accurate reading.
Choice D reason:
Salmeterol is a long-acting beta-agonist (LABA) used for maintenance therapy, not for managing acute exacerbations. It should be used in combination with an inhaled corticosteroid for optimal asthma control.
Correct Answer is B
Explanation
Choice A reason:
Placing a folded blanket to pad the back of the infant's head is not recommended, as it can interfere with the proper fit of the car seat harness and potentially be a safety hazard.
Choice B reason:
This statement is correct. Infant car seats should be positioned at a 30-degree angle to provide optimal support for the infant's head and neck, as well as to prevent airway obstruction.
Choice C reason:
While car seats with a four-point harness do exist, a standard infant car seat typically has a five- point harness system.
Choice D reason:
The retainer clip should be positioned at the level of the infant's armpits to ensure that the harness is snug and secure.
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