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."

Answer and Explanation

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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Correct Answer is D

Explanation

A. Naltrexone. This medication is used for opioid and alcohol use disorders. It helps reduce cravings and the pleasurable effects of those substances but is not indicated for smoking cessation.
B. Chlordiazepoxide. This is a benzodiazepine used to manage alcohol withdrawal symptoms, such as anxiety, tremors, and agitation. It is not appropriate for treating nicotine dependence.
C. Clonidine. Although primarily used for hypertension, clonidine has been used off-label to manage symptoms of opioid or nicotine withdrawal. However, it is not the first-line agent for smoking cessation.
D. Bupropion. This is an antidepressant also approved for smoking cessation. It helps reduce nicotine cravings and withdrawal symptoms and is often prescribed under the brand name Zyban for this purpose.

A. Draw up regular insulin prior to NPH insulin. B. Roll the syringe gently to ensure mixture of the insulins. C. Inject into the vastus lateralis. D. Use a 15 angle for the injection

Correct Answer is A

Explanation

A. Draw up regular insulin prior to NPH insulin. This is the correct technique when mixing short-acting (regular) and intermediate-acting (NPH) insulins in the same syringe. Drawing up regular insulin first prevents contamination of the clear insulin vial with the cloudy NPH, which could alter the action of the regular insulin.
B. Roll the syringe gently to ensure mixture of the insulins. Insulin should be mixed in the vial before drawing it into the syringe—not after. NPH insulin should be gently rolled between the hands to mix it, but the syringe itself should not be rolled after drawing both insulins, as this can introduce bubbles and affect dosing accuracy.
C. Inject into the vastus lateralis. The preferred sites for subcutaneous insulin administration are areas with sufficient subcutaneous tissue, such as the abdomen, upper outer arms, thighs, or buttocks. The vastus lateralis is more commonly used for intramuscular injections, such as vaccines.
D. Use a 15° angle for the injection. A 15° angle is appropriate for intradermal injections, not subcutaneous insulin injections. For insulin, the correct angle is typically 45° or 90°, depending on the client’s body habitus and needle length, to ensure proper subcutaneous delivery.

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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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