The nurse in a school clinic is caring for a 7-year-old girl who comes in for epistaxis. The nurse will initiate which of the following interventions? (Select the 2 responses that apply)

Apply a heat pack to the bridge of the nose.

Lightly suction blood from nares and mouth.

Have the child tilt her head forward.

Have the child sit upright.

Answer and Explanation

The Correct Answer is C

Choice A reason: Applying a heat pack to the bridge of the nose is not recommended as it may increase blood flow and worsen the bleeding.
Choice B reason: Lightly suctioning blood from nares and mouth is not typically necessary and could be uncomfortable for the child.
Choice C reason: This is one of the correct choices. Tilting the head forward prevents blood from flowing down the throat, which can cause nausea or vomiting.
Choice D reason: This is one of the correct choices. Sitting upright reduces blood pressure in the veins of the nose and may help slow the bleeding.

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Correct Answer is C

Explanation

Choice A reason: A 7-year-old child may have some difficulty with separation but is typically able to understand the reason for hospitalization better than younger children.
Choice B reason: A 5-month-old infant may show signs of distress but does not have the same understanding of separation as an older child.
Choice C reason: This is the correct choice. A 4-year-old child is at a developmental stage where separation from family can cause significant distress and difficulty.
Choice D reason: A 15-month-old toddler may experience separation anxiety, but it is generally more intense in preschool-aged children.

A. Acute diarrhea; dehydration. B. Failure to pass meconium; abdominal distension. C. Projectile vomiting; altered electrolytes. D. Currant jelly-like gelatinous stools; pain.

Correct Answer is B

Explanation

Choice A reason: Acute diarrhea and dehydration are not typical of Hirschsprung disease, which is characterized by bowel obstruction.
Choice B reason: This is the correct choice. Failure to pass meconium within the first 48 hours of life and abdominal distension are classic signs of Hirschsprung disease.
Choice C reason: Projectile vomiting and altered electrolytes could be signs of other conditions but are not specific to Hirschsprung disease.
Choice D reason: Currant jelly-like gelatinous stools and pain are more indicative of intussusception rather than Hirschsprung disease. Hirschsprung disease typically presents with a failure to pass stool and abdominal distension.

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The nurse in a school clinic is caring for a 7-year-old girl who comes in for epistaxis. The nurse will initiate which of the following interventions? (Select the 2 responses that apply)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

In planning care, the nurse recognizes that which child should have the most difficulty with separation from family during hospitalization?

Correct Answer is C

Explanation

A newborn is diagnosed with Hirschsprung disease. Which clinical manifestations found on assessment support this newborn’s diagnosis?

Correct Answer is B

Explanation

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