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. Hyperthyroidism: While hyperthyroidism requires medical management, it is not a contraindication to the use of combination oral contraceptives (COCs). Hormonal contraception can generally be used safely with thyroid disorders under monitoring.

B. Hypocalcemia: Low calcium levels are not influenced significantly by COCs and do not increase the risk of adverse outcomes with their use. Therefore, hypocalcemia is not considered a contraindication.

C. Thrombophlebitis: Thrombophlebitis, a condition involving blood clots and vein inflammation, is a major contraindication to COCs. Estrogen increases the risk of thromboembolic events, making COCs unsafe for clients with current or past clotting disorders.

D. Diverticulosis: Diverticulosis is an intestinal condition not impacted by hormonal contraceptive use. It does not increase the risk of complications related to COCs and is not a contraindication.

A. Coarse lung sounds B. Widening pulse pressure C. Muffled heart sounds D. Decreased jugular vein distention

Correct Answer is C

Explanation

Rationale:

A. Coarse lung sounds: Coarse lung sounds are typically associated with pulmonary issues such as fluid overload or pneumonia. They are not specific to cardiac tamponade and may appear later or not at all in this condition.

B. Widening pulse pressure: Cardiac tamponade causes narrowing of the pulse pressure due to decreased stroke volume, not widening. A narrowing pulse pressure is a more reliable hemodynamic sign of tamponade.

C. Muffled heart sounds: Muffled or distant heart sounds are a classic early sign of cardiac tamponade. They result from fluid accumulation in the pericardial sac, which insulates the heart and dampens the transmission of sound.

D. Decreased jugular vein distention: Cardiac tamponade typically causes increased jugular vein distention due to impaired venous return to the heart. A decrease in JVD would not be expected and may indicate a different process.

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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?

Nursing Test Bank

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