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?

"Have your child lie down and turn their head to the side for 10 minutes.”

"Place a warm, wet washcloth over your child's forehead and the bridge of their nose.”

"Tell your child to blow their nose gently and then sit down and but their head backward.”

“Use your thumb and forefinger to apply pressure to the sides of your child's nose”

Answer and Explanation

The Correct Answer is D

Rationale:

A. "Have your child lie down and turn their head to the side for 10 minutes." Lying down increases blood flow to the head, which can worsen the nosebleed or cause aspiration if blood is swallowed. Upright posture is preferred to reduce venous pressure in nasal vessels.

B. "Place a warm, wet washcloth over your child's forehead and the bridge of their nose." Warm compresses can dilate blood vessels and worsen bleeding. Cold compresses are more appropriate to constrict blood vessels and reduce blood flow.

C. "Tell your child to blow their nose gently and then sit down and put their head backward." Blowing the nose can dislodge clots and worsen bleeding. Tilting the head back can cause blood to run down the throat, increasing the risk of nausea, vomiting, or aspiration.

D. "Use your thumb and forefinger to apply pressure to the sides of your child's nose."
Pinching the soft part of the nose for 10–15 minutes while the child leans slightly forward is the first-line intervention for epistaxis. This reduces bleeding and prevents aspiration.

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Correct Answer is C

Explanation

Rationale:

A. Arrange for the nurses to have as few shifts together as possible: Avoiding the conflict by separating the nurses does not resolve the underlying issue. This strategy may worsen team dynamics and prevent meaningful resolution or improved communication.

B. Ask each nurse to take turns making the assignments: Allowing staff members to alternate assignment duties risks bias, inconsistency, and potential resentment. It also avoids addressing the source of the conflict and bypasses managerial responsibility.

C. Encourage collaboration between the two nurses when making the assignments:
Collaboration fosters open communication, mutual understanding, and shared responsibility. Involving both nurses promotes fairness and can help rebuild trust while ensuring transparency in assignments.

D. Tell the nurses that the assignments will be more equitable in the future: Reassuring staff without involving them in the solution may seem dismissive and fails to actively resolve the conflict. Transparency and participation are more effective than vague promises.

A. Perform the Credés maneuver. B. Maintain the irrigation solution rate. C. Replace the indwelling urinary catheter. D. Warm the irrigation solution.

Correct Answer is B

Explanation

Rationale:

A. Perform the Credé’s maneuver: This manual technique is used to assist bladder emptying in clients with urinary retention due to neurogenic bladder. It is not appropriate or necessary when continuous bladder irrigation is in place and the catheter is draining.

B. Maintain the irrigation solution rate: Pink-tinged urine is expected during the early postoperative period following TURP, indicating mild bleeding. There is no need to adjust the irrigation rate unless there are signs of obstruction or bright red bleeding with clots.

C. Replace the indwelling urinary catheter: Catheter replacement is only necessary if there is a blockage or malfunction. In this case, the system appears to be functioning correctly, and there’s no indication of obstruction.

D. Warm the irrigation solution: Warming the irrigation fluid is not required and does not affect hematuria. The solution should be at room temperature unless otherwise prescribed. Hematuria at this stage is managed by monitoring, not fluid temperature changes.

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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?

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