The nurse is caring for a child who has just returned from the operating room after a tonsillectomy. What symptom would the nurse monitor for which would be an early indication of bleeding?
Continuous swallowing while asleep
Decreased blood pressure
Throat pain
Dark brown, bloody emesis
The Correct Answer is A
Rationale:
A. Continuous swallowing while asleep: Continuous swallowing can indicate that the child is swallowing blood from a bleeding site in the throat. This subtle but important sign often appears early after tonsillectomy and signals the need for immediate assessment.
B. Decreased blood pressure: A drop in blood pressure is a late indicator of significant hemorrhage and hypovolemia. Waiting for hypotension before acting risks severe complications, so earlier signs should guide nursing interventions.
C. Throat pain: Throat pain is a normal postoperative symptom due to tissue trauma from surgery. While uncomfortable, it does not necessarily indicate bleeding and should be differentiated from signs of hemorrhage.
D. Dark brown, bloody emesis: Vomiting dark brown blood reflects older, clotted blood and usually occurs after bleeding has already been ongoing. It is a later sign compared to subtle early indicators like continuous swallowing.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Rationale:
A. "I will give him his ADHD medication with his meals": Stimulant medications for ADHD can sometimes cause gastrointestinal upset, and giving them with food may help minimize this side effect.
B. "I will take my child to the physician every three months for a weight and height check.": Regular monitoring of growth is essential because stimulant medications can decrease appetite and potentially slow growth. A three-month interval is an appropriate follow-up.
C. "I will let him do his homework while he is watching his favorite television show.": Children with ADHD are easily distracted, and doing homework while watching television can make it harder to focus and complete tasks. A quiet, structured environment without competing stimuli supports better concentration and academic performance.
D. "I will stick to the same routine each day after school.": Consistent daily routines help children with ADHD feel secure and maintain focus. Predictable schedules reduce anxiety and behavioral outbursts, while also helping the child manage transitions more effectively.
Correct Answer is D
Explanation
Rationale:
A. Digoxin: Digoxin is used to improve cardiac contractility and manage heart failure symptoms, but it does not promote closure of the patent ductus arteriosus (PDA). It may be part of supportive care but is not the primary treatment for PDA.
B. Prostaglandin: Prostaglandins keep the ductus arteriosus open, which is useful in some congenital heart defects requiring ductal patency. However, in PDA, the goal is to close the ductus, so prostaglandin administration would be contraindicated.
C. Furosemide: Furosemide is a diuretic used to manage fluid overload and heart failure symptoms but does not affect ductus arteriosus closure. It may be used adjunctively if heart failure develops.
D. Indomethacin: Indomethacin is a nonsteroidal anti-inflammatory drug that inhibits prostaglandin synthesis, promoting closure of the patent ductus arteriosus. It is the first-line medication used to medically close PDA in neonates.
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