The nurse prepares to assess the client's radial pulse. Which statement made by the nurse reflects a correct understanding of the procedure? "I will:

count the radial pulse for two minutes."

put my fingers on the "pinky" finger side of the wrist."

use my thumb to count the pulse."

count the pulse for 30 seconds and multiply the number by two

Answer and Explanation

The Correct Answer is D

D. Counting the radial pulse for 30 seconds and then multiplying the count by two gives an estimate of the client's heart rate per minute (bpm). This method is efficient and commonly used in clinical practice, especially if the client's pulse is regular.

A. Counting the radial pulse for two minutes is unnecessarily long and not standard practice. Typically, the radial pulse is counted for either 30 seconds or 60 seconds (one minute) to determine the client's heart rate. Multiplying the count by two for a 30-second count or directly using the count for a 60- second count provides the client's beats per minute (bpm).

B. The radial pulse is assessed by palpating the radial artery on the thumb side (or lateral side) of the client's wrist. The nurse places the index and middle fingers gently over the radial artery and applies light pressure to feel the pulse rhythm and rate.

C. Using the thumb to count the pulse is not recommended because the thumb has its own pulse, which could interfere with accurately assessing the client's radial pulse.

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Correct Answer is ["A","B","C","D","E"]

Explanation

A. Previous experiences with pain can significantly influence how individuals perceive and respond to pain in the future. Positive experiences may lead to better coping strategies, while negative experiences could increase fear and anxiety associated with pain.

B. Cultural beliefs, norms, and practices surrounding pain vary widely across different societies. Culture shapes how individuals express pain, interpret pain severity, and seek treatment. For instance, some cultures may encourage stoicism in the face of pain, while others may emphasize the importance of verbalizing discomfort.

C. Socioeconomic status can impact access to healthcare resources, including pain management options. Higher SES individuals may have better access to healthcare facilities, medications, and therapies, whereas lower SES individuals may face barriers to adequate pain relief due to financial constraints or limited healthcare services.

D. Emotional states such as anxiety, depression, stress, and fear can significantly influence the perception and experience of pain. These emotions can amplify pain perception and interfere with pain management strategies. Conversely, positive emotions and a sense of well-being may help reduce the intensity of pain.

E. Age-related factors can affect how pain is perceived and managed. Children and older adults, for example, may experience pain differently due to developmental stages, cognitive abilities, and physiological changes. Pain assessment and management approaches need to be tailored accordingly to address age-specific considerations.

A. strain all of the client's urine. B. inflate a blood pressure cuff 20 mmHg above systolic measurement. C. lightly percuss the client's cheek. D. obtain a baseline height and weight.

Correct Answer is C

Explanation

C. Chvostek's sign is assessed by tapping or lightly percussing the facial nerve (facial muscles) at the angle of the jaw, just in front of the earlobe. A positive Chvostek's sign is indicated by facial twitching, especially around the mouth, nose, and eye, in response to this percussion. It indicates neuromuscular irritability due to low calcium levels.

A. Straining urine is typically done to collect urine for analysis or to detect urinary stones. It does not relate to the assessment of neuromuscular irritability, which is what Chvostek's sign evaluates.

B. This option does not pertain to assessing Chvostek's sign either. Inflating a blood pressure cuff above systolic measurement is a technique used to assess for Trousseau's sign, which is another clinical indicator of hypocalcemia but involves different physiological mechanisms than Chvostek's sign.

D. This option is unrelated to assessing Chvostek's sign or hypocalcemia. Baseline height and weight are typically obtained for nutritional assessment, growth monitoring, or as part of a general health assessment. They do not help in evaluating neuromuscular irritability associated with calcium levels.

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The nurse prepares to assess the client's radial pulse. Which statement made by the nurse reflects a correct understanding of the procedure? "I will:

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse notes that various factors influence a client's pain. Which of the following factors could be influencers of pain? (SELECT ALL THAT APPLY)

Correct Answer is ["A","B","C","D","E"]

Explanation

The nurse is caring for a client with a total calcium level of 7.0 mg/dL. To assess for Chvostek's sign, the nurse would:

Correct Answer is C

Explanation

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