Regarding the blood pressure in children, the diastolic pressure is assessed by the auscultation of a:

murmur or swishing sound that increases with depression of the cuff.

clear tapping that gradually grows louder

louder knocking sound that occurs with each heartbeat.

sudden change or muffling of the sound.

Answer and Explanation

The Correct Answer is D

A.   A murmur or swishing sound does not correspond to the diastolic pressure; it is more indicative of turbulent blood flow.
B.   Clear tapping sounds are heard at systolic pressure but do not indicate diastolic pressure.
C.   Knocking sounds are associated with systolic pressure, not diastolic.
D.   The muffling sound heard after the first Korotkoff sounds indicates the diastolic pressure in children and some adults, which is the correct method for assessing the diastolic reading.

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Correct Answer is A

Explanation

A. Performing a quick focused assessment at the beginning of each shift allows the nurse to identify any immediate needs or changes in the patient's condition, ensuring timely and appropriate care. This practice helps in maintaining continuity of care and promptly addressing any issues that may arise during the shift.
B. While a comprehensive assessment is typically performed upon admission to the unit, a quick focused assessment is not specifically required at this time. The initial comprehensive assessment will cover all necessary information.
C. At discharge, the focus is on providing discharge instructions and ensuring the patient understands their care plan after leaving the facility. A quick focused assessment is not typically performed at this time.
D. While it is important to check on the patient in the morning, a quick focused assessment is not specifically required at this time. The beginning of each shift is a more critical time to perform this assessment to ensure continuity of care.

A. Within the expected reference range B. Elevated blood pressure C. Hypertension stage 1 D. Hypertension stage 2

Correct Answer is B

Explanation

A. A blood pressure of 124/84 mm Hg is slightly elevated and falls into the "elevated blood pressure" category.
B. Elevated blood pressure (120-129 systolic and less than 80 diastolic) is considered a risk factor for developing hypertension.
C. Hypertension stage 1 begins at 130/80 mm Hg, not at 124/84 mm Hg.
D. Hypertension stage 2 requires a reading of 140/90 mm Hg or higher.

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Regarding the blood pressure in children, the diastolic pressure is assessed by the auscultation of a:

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

It is the responsibility of the nurse to perform a quick focused assessment of the patient upon:

Correct Answer is A

Explanation

A nurse is reinforcing teaching with a client who has a family history of hypertension. The nurse should inform the client that his blood pressure reading of 124/84 mm Hg places him in which of the following categories?

Correct Answer is B

Explanation

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