A nurse is reinforcing teaching with the spouse of a client about how to take a blood pressure. Which of the following actions by the spouse indicates a need for further instruction?
Wrap the blood pressure cuff snugly around the arm.
Place the client's arm above the level of the heart.
Center the cuff bladder over the brachial artery.
Check the instrument gauge to ensure the reading starts at zero.
The Correct Answer is B
A. Wrap the blood pressure cuff snugly around the arm. Wrapping the cuff snugly ensures an accurate blood pressure reading. This statement does not indicate a need for further instruction.
B. Place the client's arm above the level of the heart. The arm should be at the level of the heart, not above. Placing the arm above the heart can result in falsely low blood pressure readings. This action indicates a need for further instruction.
C. Center the cuff bladder over the brachial artery. Proper placement of the cuff bladder over the brachial artery is necessary for an accurate reading. This statement does not indicate a need for further instruction.
D. Check the instrument gauge to ensure the reading starts at zero. Ensuring the gauge starts at zero before taking a reading is necessary to prevent errors. This statement does not indicate a need for further instruction.
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Related Questions
Correct Answer is C
Explanation
A. "I can drink wine in moderation." Moderate wine consumption (particularly red wine) is often considered acceptable as part of the Mediterranean diet. This statement does not indicate a need for further teaching.
B. "I will limit my intake of eggs." Eggs can be consumed in moderation on the Mediterranean diet, typically no more than a few times a week. This statement reflects an understanding of the diet and does not indicate a need for further teaching.
C. "I will limit my intake of red meat to two times per week." The Mediterranean diet recommends limiting red meat consumption, but typically to less than two times per week. This statement indicates a need for further teaching as it suggests a higher frequency than recommended.
D. "I should cook with olive oil." Olive oil is a key component of the Mediterranean diet, replacing butter and other fats. This statement reflects correct understanding and does not indicate a need for further teaching.
Correct Answer is ["A","C"]
Explanation
A. Monitor your blood pressure on a regular basis: Regular monitoring of blood pressure is important for clients taking lisinopril to ensure the medication is effectively controlling hypertension.
B. Your cholesterol levels must be monitored monthly while taking this medication: Lisinopril does not typically require monthly cholesterol monitoring. This instruction is more relevant for statins or other lipid-lowering agents.
C. Report the development of a persistent dry cough.: A dry cough is a common side effect of ACE inhibitors like lisinopril. Clients should report this side effect as it may necessitate discontinuing the medication.
D. Your diet should include plenty of potassium-rich foods daily: Lisinopril can increase potassium levels, potentially causing hyperkalemia. Clients should be advised to avoid excessive potassium intake, not to increase it.
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