A nurse is preparing to measure an infant’s vital signs.

Which of the following sites should the nurse use to assess the heart rate?

Carotid artery

Brachial artery

Apex of the heart

Radial artery .

Answer and Explanation

The Correct Answer is C

Choice C rationale
The apex of the heart is the most appropriate site to assess an infant’s heart rate. In infants, the apical pulse provides the most accurate assessment of heart rate. The apical pulse is located at the fifth intercostal space at the midclavicular line.
Choice A rationale
The carotid artery is not typically used to assess an infant’s heart rate. This site is more commonly used in adults and older children.
Choice B rationale
The brachial artery can be used to assess an infant’s heart rate, but it is typically used for blood pressure measurements rather than heart rate assessments.
Choice D rationale
The radial artery is not typically used to assess an infant’s heart rate. This site is more commonly used in adults and older children.

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Correct Answer is {"A":{"answers":"A"},"B":{"answers":"A"},"C":{"answers":"B"},"D":{"answers":"A"}}

Explanation

WBC count: This finding is not consistent with either sickle cell anemia or hemophilia. Both conditions do not typically cause an increase in white blood cell count.
Temperature: This finding is not consistent with either sickle cell anemia or hemophilia. Neither condition is associated with an elevated body temperature unless there is a concurrent infection.
Bleeding: This finding is consistent with hemophilia. Hemophilia is a bleeding disorder where the blood does not clot properly. This can lead to spontaneous bleeding as well as bleeding following injuries or surgery.
Reported pain: This finding is consistent with sickle cell anemia. Sickle cell anemia can cause episodes of pain when sickle-shaped red blood cells block blood flow through tiny blood vessels to your chest, abdomen and joints. Pain can also occur in your bones.

A. Pulmonic stenosis, ventricular septal defect, overriding aorta, right ventricular hypertrophy. B. Aortic stenosis, atrial septal defect, overriding aorta, left ventricular hypertrophy. C. Pulmonary stenosis, ventricular septal defect, aortic hypertrophy, left ventricular hypertrophy. D. Aortic stenosis, ventricular septal defect, overriding aorta, right ventricular hypertrophy.

Correct Answer is A

Explanation

Choice A rationale
Tetralogy of Fallot is a congenital heart defect that includes four specific heart abnormalities: pulmonic stenosis, ventricular septal defect, overriding aorta, and right ventricular hypertrophy.
Choice B rationale
This choice incorrectly identifies aortic stenosis and atrial septal defect as components of Tetralogy of Fallot. In fact, the condition involves pulmonic stenosis and a ventricular septal defect.
Choice C rationale
This choice incorrectly identifies pulmonary stenosis and aortic hypertrophy as components of Tetralogy of Fallot. In fact, the condition involves pulmonic stenosis and right ventricular hypertrophy.
Choice D rationale
This choice incorrectly identifies aortic stenosis as a component of Tetralogy of Fallot. In fact, the condition involves pulmonic stenosis.

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A nurse is preparing to measure an infant’s vital signs. Which of the following sites should the nurse use to assess the heart rate?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is {"A":{"answers":"A"},"B":{"answers":"A"},"C":{"answers":"B"},"D":{"answers":"A"}}

Explanation

Can you identify the structural anomalies that make up Tetralogy of Fallot?

Correct Answer is A

Explanation

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A nurse is preparing to measure an infant’s vital signs.

Which of the following sites should the nurse use to assess the heart rate?