A nurse receives a telephone call from a parent reporting that their school-age child has a nosebleed and that they cannot stop the bleeding. Which of the following instructions should the nurse provide to the parent?
"Place a warm, wet washcloth over your child's forehead and the bridge of their nose."
"Use your thumb and forefinger to apply pressure to the sides of your child's nose."
"Have your child lie down and turn their head to the side for 10 minutes."
“Tell your child to blow their nose gently, and then sit down and tilt their head backward."
The Correct Answer is B
A. "Place a warm, wet washcloth over your child's forehead and the bridge of their nose." Warm compresses may actually dilate blood vessels, which can worsen the bleeding. Cold compresses are preferred to help constrict vessels.
B. "Use your thumb and forefinger to apply pressure to the sides of your child's nose." This is the correct first-aid measure for epistaxis. The parent should pinch the soft part of the nose continuously for 10–15 minutes while the child leans forward.
C. "Have your child lie down and turn their head to the side for 10 minutes." Lying down can increase blood flow to the nose and may cause blood to be swallowed, which can lead to nausea or vomiting.
D. “Tell your child to blow their nose gently, and then sit down and tilt their head backward." Tilting the head back can cause blood to drain into the throat, increasing the risk of aspiration and stomach upset. Leaning forward is the proper position.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Match the client's blood type with the type and cross match specimen. While type and crossmatch are important for allogeneic transfusions, an autologous transfusion uses the client’s own previously donated blood, so this is not the primary method for identification.
B. Confirm the provider's prescription matches the number on the blood component. Although important, this step alone does not verify the client’s identity. The nurse must also confirm the blood unit matches the correct client.
C. Ask the client to state his blood type and the date of the blood donation. Client recall is not a reliable form of identification for transfusion safety, as it is prone to error or misunderstanding.
D. Ensure that the client's identification band matches the number on the blood unit. This is the correct and safest method to confirm identity before administering an autologous blood product. It ensures the blood product is matched to the correct patient.
Correct Answer is B
Explanation
A. "Morphine 3.0 mg sub q every 4 hr PRN for pain." Including a trailing zero (3.0 mg) is considered unsafe and is discouraged in medication documentation. It increases the risk of a tenfold overdose if the decimal is missed.
B. "Morphine 3 mg subcutaneous every 4 hr PRN for pain." This entry uses the correct dosage format without a trailing zero, the full term "subcutaneous" instead of abbreviations, and proper medical terminology. It adheres to safe documentation practices as per The Joint Commission guidelines.
C. "Morphine 3 mg SC q 4 hr PRN for pain." The abbreviation “SC” is considered unsafe and prone to misinterpretation. Also, "q" for "every" is discouraged in clinical documentation due to potential misreading and error.
D. "Morphine 3 mg SQ every 4 hr PRN for pain." The abbreviation “SQ” can be misinterpreted or mistaken for “5 every” or other terms. Safe practice requires spelling out “subcutaneous” to prevent errors in medication administration.
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