A nurse is providing teaching about blood pressure measurement to a client who has hypertension. Which of the following instructions should the nurse include?
Use an electronic device.
Inflate the cuff to 140/90 mmHg.
Place the cuff on the upper arm.
Measure blood pressure after exercise.
The Correct Answer is C
Choice A reason: Using an electronic device is not a reliable method for measuring blood pressure because it may give inaccurate readings due to movement, noise, or battery issues. An electronic device should be calibrated regularly and compared with a manual device.
Choice B reason: Inflating the cuff to 140/90 mmHg is not a correct procedure for measuring blood pressure because it may cause discomfort and false readings. The cuff should be inflated to about 20 to 30 mmHg above the expected systolic pressure or until the pulse disappears.
Choice C reason: Placing the cuff on the upper arm is a correct procedure for measuring blood pressure because it ensures that the cuff is at the same level as the heart and that the brachial artery is compressed. The cuff should be snug and fit around 80% of the arm circumference.
Choice D reason: Measuring blood pressure after exercise is not a good time for measuring blood pressure because it may reflect a temporary increase due to physical activity. Blood pressure should be measured after resting for at least 5 minutes in a quiet and comfortable environment.

Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: Thawing frozen meat on the counter is not a good practice for food poisoning prevention because it can allow bacteria to grow rapidly on the surface of the meat. Thawing frozen meat should be done in the refrigerator, in cold water, or in the microwave.
Choice B reason: Reusing leftover marinade as sauce is not a good practice for food poisoning prevention because it can contaminate cooked food with raw meat juices that may contain bacteria. Leftover marinade should be discarded or boiled for at least one minute before using as sauce.
Choice C reason: Apple pie is a good choice for food poisoning prevention because it is unlikely to contain harmful bacteria or toxins. Apple pie is made from cooked apples, sugar, flour, and butter, which are low-risk ingredients for food poisoning. Apple pie should be stored in the refrigerator or freezer after cooling to prevent spoilage.
Choice D reason: Cooked rice is not a good choice for food poisoning prevention because it can harbor a bacterium called Bacillus cereus, which can produce toxins that cause vomiting and diarrhea. Cooked rice should be cooled quickly and stored in the refrigerator for no more than one day or in the freezer for longer periods. Cooked rice should be reheated thoroughly before eating.

Correct Answer is A
Explanation
Choice A reason: Serum creatinine 3.5 mg/dL is high and indicates the need for further assessment. Creatinine is a waste product of muscle metabolism that is filtered by the kidneys. High creatinine levels can indicate kidney damage or impaired renal function.
Choice B reason: Hematocrit 45% is within the normal range (37-47% for women, 40-50% for men), and it does not indicate the need for further assessment. Hematocrit is the percentage of red blood cells in the blood. Low hematocrit levels can indicate anemia, bleeding, or hemolysis.
Choice C reason: Blood urea nitrogen 18 mg/dL is within the normal range (7-20), and it does not indicate the need for further assessment. Blood urea nitrogen is a waste product of protein metabolism that is filtered by the kidneys. High blood urea nitrogen levels can indicate dehydration, kidney damage, or high protein intake.
Choice D reason: Sodium 140 mEq/L is within the normal range (135-145), and it does not indicate the need for further assessment. Sodium is an electrolyte that helps maintain fluid balance, blood pressure, and nerve impulses. Low or high sodium levels can cause confusion, seizures, or coma.

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