A nurse is preparing to assess a client for pulse deficit. Which of the following actions should the nurse plan to take?

After inflation, deflate a blood pressure cuff on the client's arm while palpating their brachial pulse.

Compare the client's carotid pulse while resting to their carotid pulse after standing for 1 min.

Measure the client's apical pulse while another nurse measures their radial pulse.

Assess both of the client's radial pulses at the same time and compare the quality of pulsations.

Answer and Explanation

The Correct Answer is C

Rationale:
A. After inflation, deflate a blood pressure cuff on the client's arm while palpating their brachial pulse: This technique assesses blood pressure, not pulse deficit. Pulse deficit requires comparing simultaneous heartbeats at different sites rather than using a cuff for measurement.

B. Compare the client's carotid pulse while resting to their carotid pulse after standing for 1 min: This evaluates orthostatic changes in heart rate, not pulse deficit. Pulse deficit specifically identifies a difference between apical and peripheral pulses during the same cardiac cycle.

C. Measure the client's apical pulse while another nurse measures their radial pulse: A pulse deficit is determined by counting the apical pulse and comparing it to the radial pulse simultaneously. A difference indicates that some heartbeats are not producing a palpable peripheral pulse, which is important in conditions like atrial fibrillation.

D. Assess both of the client's radial pulses at the same time and compare the quality of pulsations: Comparing radial pulses on both sides evaluates for peripheral pulse equality or arterial obstruction, not pulse deficit.

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Correct Answer is C

Explanation

Rationale:
A. "Take your diuretic medication with your evening meal.": Taking diuretics in the evening can increase nocturia and exacerbate urinary incontinence. Diuretics are typically scheduled in the morning to minimize nighttime urination.

B. "Limit your fluid intake to 500 milliliters per day.": Severely restricting fluids can lead to dehydration and concentrated urine, which may irritate the bladder and worsen urge incontinence. Adequate hydration should be maintained while managing bladder habits.

C. "Plan to urinate every 3 hours while you are awake.": Scheduled voiding or bladder retraining involves establishing regular intervals for urination. Urinating every 2–3 hours helps the bladder gradually increase capacity and reduces episodes of urge incontinence by promoting control.

D. "Decrease your intake of cranberry juice.": Cranberry juice may acidify urine but is not a primary intervention for bladder retraining. Avoiding irritants like caffeine or alcohol is more relevant for managing urge incontinence.

A. "Can you tell me more about the surgery I am having?" B. "Signing this form indicates that I give my permission for the surgery, right? C. "I will talk with the doctor about my surgery when I get into the operating room." D. "Every so often, I think about whether or not to have this surgery."

Correct Answer is B

Explanation

Rationale:
A. "Can you tell me more about the surgery I am having?": Before signing consent, the client should already have received complete information about the nature, purpose, risks, and benefits of the surgery from the provider.

B. "Signing this form indicates that I give my permission for the surgery, right?": Informed consent is a legal and ethical document granting permission for the procedure. It shows that the client comprehends their role in authorizing the surgery after receiving adequate information from the healthcare provider.

C. "I will talk with the doctor about my surgery when I get into the operating room.": Consent discussions should occur before entering the operating room. The client must have all questions answered and sign consent prior to sedation or anesthesia to ensure voluntary decision-making.

D. "Every so often, I think about whether or not to have this surgery.": This response suggests indecision and lack of informed readiness for the procedure. The nurse must notify the provider so further discussion can occur to address concerns and ensure the client’s consent is fully informed and voluntary.

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