Four students come to the school clinic simultaneously, seeking help from the school nurse. In which order of priority should the nurse provide care to these students? (Arrange the client with the highest priority first, on top, and lowest priority last, on bottom.)

A 12-year-old child with history of asthma who is wheezing and reporting shortness of breath.

A 7-year-old child who has type 1 diabetes mellitus and is experiencing extreme hunger and shakiness.

A 10-year-old child with bleeding lacerations on both knees after falling in gym class.

A 5-year-old child who is crying uncontrollably because of an incontinent bowel episode.

Answer and Explanation

The Correct Answer is A,B,C,D

1. A 12-year-old child with a history of asthma who is wheezing and reporting shortness of breath.

Rationale: The child with asthma who is wheezing and experiencing shortness of breath is the highest priority. Wheezing and shortness of breath are signs of a potentially severe asthma exacerbation, which can quickly become life-threatening if not addressed promptly. Immediate intervention is needed to ensure adequate oxygenation and prevent further respiratory distress.

2. A 7-year-old child who has type 1 diabetes mellitus and is experiencing extreme hunger and shakiness

Rationale: The child with type 1 diabetes mellitus who is experiencing extreme hunger and shakiness may be showing symptoms of hypoglycemia, which can also be potentially dangerous. While not as immediately life-threatening as severe respiratory distress, hypoglycemia needs to be addressed quickly to prevent complications such as loss of consciousness or seizures.

3. A 10-year-old child with bleeding lacerations on both knees after falling in gym class.

Rationale: The child with bleeding lacerations requires prompt care to manage the bleeding and prevent infection. However, this situation is less critical compared to the respiratory distress and hypoglycemia, which have more immediate implications for the child’s health.

4. A 5-year-old child who is crying uncontrollably because of an incontinent bowel episode.

Rationale: While the child’s distress and the need for clean-up are important, this situation is the least urgent in terms of immediate health risks compared to the other three cases. Addressing the child’s comfort and hygiene can follow after more critical needs are met.

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Correct Answer is C

Explanation

A. Rescreen the entire prison population in 6 weeks:
While rescreening may be necessary at some point, it is not the immediate priority. The focus should be on diagnosing and managing the individuals who have already tested positive.

B. Start the two inmates on antitubercular medications:
Starting antitubercular medications is important, but it should only be done after confirming that the individuals have active TB. The positive skin test indicates exposure but does not confirm active TB disease.

C. Refer the two inmates for chest x-rays:
A chest x-ray is crucial to determine whether the positive skin test indicates active TB disease or latent TB infection. This step is essential for accurate diagnosis and appropriate management. It helps distinguish between active TB, which requires treatment, and latent TB, which may require different management strategies.

D. Screen the prison guards for TB:
While screening the prison guards could be a part of a broader infection control plan, it is not the most immediate priority. The focus should be on further evaluating and managing the inmates who have tested positive.

A. Encourage smoking cessation. B. Arrange for childcare. C. Offer nutritional instruction. D. Refer for prenatal care. E. Teach breastfeeding methods. F. Notify her parents.

Correct Answer is ["A","C","D"]

Explanation

A. Encourage smoking cessation:
Smoking during pregnancy can have serious consequences for both the mother and the fetus, such as increased risks of preterm birth, low birth weight, and developmental issues. Encouraging smoking cessation is crucial for improving both maternal and fetal health.

B. Arrange for childcare:
While childcare is an important consideration, it is not an immediate priority at this stage. The focus should be on ensuring the adolescent receives proper prenatal care and support for her health and the health of the baby.

C. Offer nutritional instruction:
Good nutrition is vital for a healthy pregnancy. Offering nutritional instruction helps the adolescent understand how to meet her dietary needs and those of her developing baby, contributing to better pregnancy outcomes.

D. Refer for prenatal care:
Prenatal care is essential for monitoring the health of both the mother and the fetus, providing necessary medical interventions, and offering support. Referring the adolescent for prenatal care is critical for addressing her medical needs throughout her pregnancy.

E. Teach breastfeeding methods:
While teaching breastfeeding methods is important, it is not the most immediate concern. This can be addressed later in the pregnancy or closer to delivery when the adolescent is more prepared to consider breastfeeding.

F.Notify her parents:
Unless the adolescent gives explicit consent or there are concerns for her safety or the safety of the baby, the nurse should maintain confidentiality. In many cases, the decision to notify parents is complex and requires careful consideration of the adolescent's autonomy and legal rights.

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Four students come to the school clinic simultaneously, seeking help from the school nurse. In which order of priority should the nurse provide care to these students? (Arrange the client with the highest priority first, on top, and lowest priority last, on bottom.)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Tuberculosis (TB) screening at a federal prison reveals that two inmates have a positive skin test. Which action is most important for the nurse to take?

Correct Answer is C

Explanation

An adolescent tells the school nurse that she is pregnant. Her last menstrual period was 4 months ago, and she has not yet received any medical care. She smokes but denies any other substance use. Which interventions should the nurse implement? (Select all that apply.)

Correct Answer is ["A","C","D"]

Explanation

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