A nurse is collecting data about a client's circulatory system. Which of the following pulse sites should the nurse avoid checking bilaterally at the same time?
Carotid
Popliteal
Femoral
Brachial
The Correct Answer is A
Choice A reason: The carotid pulse sites should not be checked bilaterally at the same time because palpating both carotid arteries simultaneously can restrict blood flow to the brain and may also stimulate the vagus nerve, potentially causing bradycardia or even syncope.
Choice B reason: The popliteal pulse, located at the back of the knee, can be checked bilaterally without the risk of restricting blood flow to vital organs or stimulating a vagal response.
Choice C reason: The femoral pulse, found in the groin area, can also be checked bilaterally as it does not pose the same risks as the carotid pulse when checked simultaneously.
Choice D reason: The brachial pulse, located on the inside of the arm just above the elbow, is another site that can be checked bilaterally without significant risk.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: Scarlet fever is caused by a bacterium that produces a toxin leading to a rash. It is typically spread through respiratory droplets, and while standard precautions are necessary, an N95 respirator is not required.
Choice B reason: Tuberculosis is an airborne infectious disease that requires the use of an N95 respirator to protect against inhaling the bacteria, especially in cases of pulmonary tuberculosis. This type of respirator filters out at least 95% of airborne particles, including Mycobacterium tuberculosis.
Choice C reason: Mycoplasmal pneumonia, also known as "walking pneumonia," is caused by Mycoplasma pneumoniae and is typically less severe than other types of bacterial pneumonia. Standard precautions, including the use of surgical masks, may be sufficient unless there is a risk of aerosol-generating procedures.
Choice D reason: Scabies is caused by a mite that burrows into the skin. It is spread through direct skin-to-skin contact, and an N95 respirator is not needed for protection against scabies.
Correct Answer is A
Explanation
Choice A reason: Clean gloves are necessary when touching or being in close proximity to any wound, especially one that is infected with MRSA. MRSA is a highly contagious bacterium that can spread through direct contact with the infected area or through indirect contact with contaminated objects. Wearing clean gloves helps prevent the transmission of MRSA to the nurse and to other patients.
Choice B reason: Protective eyewear is not typically required for checking a patient's pulse. However, if there is a risk of splashing or spraying of bodily fluids, protective eyewear becomes necessary to protect the mucous membranes of the eyes from exposure to infectious materials.
Choice C reason: Sterile gloves are used during procedures that require an aseptic technique, such as the changing of a sterile dressing or during invasive procedures. Checking a patient's pulse does not require sterile gloves, as it is not an aseptic procedure.
Choice D reason: A surgical mask should be worn if there is a risk of droplet transmission or if the nurse will be in close contact with the patient's wound. MRSA can be present in nasal secretions and can be spread by droplets, so wearing a mask can provide an additional layer of protection against the transmission of MRSA.
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