The school nurse is called to the playground for an episode of mouth trauma. The nurse finds that the front tooth of a 9-year-old child has been avulsed (knocked out). After recovering the tooth, the initial response should be to

Correct Answer: A

Rationale: The correct immediate action after recovering an avulsed tooth is to rinse it with water and place it back in the socket. This helps preserve the tooth and increases the chances of successful re-implantation. Placing the tooth in a clean plastic bag for transport to the dentist (choice B) is not ideal as immediate re-implantation is preferred. Holding the tooth by the roots until reaching the emergency room (choice C) can further damage the tooth. Asking the child to replace the tooth even if bleeding continues (choice D) is incorrect and may lead to improper re-implantation.

Correct Answer: D

Rationale: The correct answer is D. Stopping Inderal (propranolol) abruptly can cause rebound hypertension, angina, and even a myocardial infarction (heart attack), so it is crucial to taper off the medication under medical supervision. Choices A, B, and C are incorrect because they do not reflect the serious consequences associated with abrupt discontinuation of propranolol.

Correct Answer: B

Rationale: In the context of community health nursing, understanding and managing organizational change is crucial for ensuring continuity of care and maintaining staff morale. The correct answer, option B, is the most appropriate choice because explaining to the unit staff why change is necessary helps create a shared understanding and motivation for the upcoming transition. Option A, discussing defensive behavior, is not the best choice in this scenario as it focuses on individual reactions rather than addressing the need for organizational change. Option C, assisting staff during the acceptance of new changes, is a step that typically occurs after the "unfreezing" phase and may be premature at this stage. Option D, clarifying changes to the community and hospital, is important but not the primary focus during the initial phase of "unfreezing." Educationally, it is important for nurses to understand the stages of change management, such as "unfreezing," to effectively guide teams through transitions. By explaining the rationale behind the correct answer and contrasting it with the other options, nurses can develop skills in leading change processes, fostering team cohesion, and maintaining quality care delivery during periods of organizational transformation.

Correct Answer: C

Rationale: The correct answer is C: Auditory expiratory wheezing. Expiratory wheezing is a common sign of reactive airway disease, such as asthma, where airways are constricted, making it difficult to expel air from the lungs. Choices A, B, and D are incorrect as they are not typically associated with reactive airway disease. Auditory gurgling may suggest airway secretions or fluid accumulation, inspiratory laryngeal stridor indicates upper airway obstruction, and frequent dry coughing is more commonly seen in conditions like upper respiratory infections or postnasal drip.

Correct Answer: C

Rationale: Exercise, especially aerobic activities, is beneficial for clients with asthma as long as it is well-managed. Limiting exercise is not generally recommended unless specifically advised by a healthcare provider, indicating a need for further instruction in this case. Monitoring peak flow, contacting the clinic for increased medication use, and learning stress reduction techniques are all appropriate self-management strategies for asthma, indicating good understanding by the client.