A nurse is preparing to palpate a client's systolic blood pressure using the brachial artery. After applying the blood pressure cuff to the client's arm, identify the sequence of steps the nurse should follow. (Arrange the steps, placing them in the order of performance. Use all the steps.)
Palpate the brachial pulse site.
Discontinue palpation of the brachial pulse.
Inflate the blood pressure cuff to 30 mm Hg beyond where the brachial pulse was last felt.
Deflate the blood pressure cuff slowly until the brachial pulse is detected.
The Correct Answer is A, C, B, D
First, the nurse should palpate the brachial pulse site to locate the artery. Next, the nurse should inflate the blood pressure cuff to 30 mm Hg beyond where the brachial pulse was last felt. The nurse should then discontinue palpation of the brachial pulse and deflate the blood pressure cuff slowly until the brachial pulse is detected. This is the point at which the systolic blood pressure can be read.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
If a client reports pain and informs the nurse that pain medications are not an option for managing their pain, the nurse can offer non-pharmacological interventions such as a back massage to help relieve the client's pain. This is an appropriate response by the nurse.
a. Telling the client that the pain medication will work if they just give it a chance is not an appropriate response as it dismisses the client's concerns and preferences.
b. The nurse should not recommend that the client take any herbal remedies without first consulting with the healthcare provider.
d. Asking the client why they think pain medication is not going to help them may be appropriate in some situations, but it is not necessarily the best initial response. The nurse should first offer non- pharmacological interventions to help relieve the client's pain.
Correct Answer is C
Explanation
The correct answer is that the client can apply lotion to their feet if they avoid the area between their toes. Moisturizing the feet can help prevent dry skin and cracking, which are common problems for people with diabetes. However, it is important to avoid applying lotion between the toes, as this can create a moist environment that promotes the growth of fungus and bacteria¹.
Options a, b and d are not correct statements by the client that indicate an understanding of proper foot care for diabetes. Using a pumice stone to soften calluses on the feet, going barefoot just in the house and using a heating pad when feet are cold are not recommended practices for people with diabetes.
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