A nurse palpates the pulse of a client and documents the following: 6/6/12 pulse 85 and regular, 3+ and equal in radial, popliteal, and dorsalis pedis. What does the number "+3" represent?

Pulse deficit

Pulse rhythm

Pulse rate

Pulse amplitude

Answer and Explanation

The Correct Answer is D

The number "+3" in this documentation represents the pulse amplitude. Pulse amplitude refers to the strength or force of the pulse and is typically measured on a scale of 0 to 4+. A "+3" pulse is considered to be full or strong, indicating good blood ﬂow to the area being palpated.

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Correct Answer is B

Explanation

When selecting interventions for a care plan, the nurse should consider several principles. One important principle is that actions should address the underlying cause (etiology) of the nursing diagnosis. By addressing the root cause of the problem, interventions can be more eﬀective in achieving the desired outcomes. There is not necessarily one "best" intervention for each goal or outcome, as diﬀerent clients may have diﬀerent needs and respond diﬀerently to interventions. Interventions can include both "doing" actions and monitoring, and both independent and collaborative interventions may be appropriate depending on the situation.

A. This was an older client. B. The unit has a new wheelchair. C. The UAP had just returned from an extended leave of absence. D. It was the client's first time out of bed after surgery.

Correct Answer is D

Explanation

It would be inappropriate to delegate the unsupervised task of transferring a client from bed to chair to an unlicensed assistant (UAP) if it was the client's first time out of bed after surgery. In this situation, the client may have specific needs or limitations that require the expertise and assessment of a licensed healthcare provider. The nurse should supervise the transfer to ensure that it is performed safely and appropriately for the client's condition.

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A nurse palpates the pulse of a client and documents the following: 6/6/12 pulse 85 and regular, 3+ and equal in radial, popliteal, and dorsalis pedis. What does the number "+3" represent?

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Which of the following principles does the nurse use in selecting interventions for the care plan?

Correct Answer is B

Explanation

An unlicensed assistant (UAP) has previously performed client transfers safely (bed to chair) on many occasions. It would be inappropriate to delegate this unsupervised task to the UAP under which condition?

Correct Answer is D

Explanation

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