When performing blood pressure measurements to assess for orthostatic hypotension, which action should the nurse implement first?
Record the client's pulse rate and rhythm.
Assist the client to stand at the bedside.
Apply the blood pressure cuff securely.
Position the client supine for a few minutes.
The Correct Answer is D
Choice A reason: Recording the client's pulse rate and rhythm is part of the assessment, but it is not the first action to take when assessing for orthostatic hypotension.
Choice B reason: Assisting the client to stand is part of the assessment process, but it should be done after the initial blood pressure and pulse have been measured while the client is supine.
Choice C reason: Applying the blood pressure cuff securely is necessary for an accurate reading, but it is not the first step in the process of assessing for orthostatic hypotension.
Choice D reason: The first action is to position the client supine for a few minutes before taking the initial blood pressure and pulse measurements, as this provides a baseline for comparison when the client stands.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: While using multiple people can increase safety, it is not the primary purpose of the log rolling technique.
Choice B reason: The log rolling technique is specifically designed to maintain straight spinal alignment, especially in patients with suspected spinal injuries, to prevent further injury.
Choice C reason: Reducing skin damage is a benefit of proper patient handling, but it is not the main reason for using the log rolling technique.
Choice D reason: Decreasing the risk of back injury to nurses is important, but the primary purpose of the log rolling technique is to protect the patient's spinal integrity.
Correct Answer is B
Explanation
Choice A reason: Analogies can be useful for explaining concepts but may not provide the hands-on practice needed for managing confrontational situations.
Choice B reason: Role-playing is an effective strategy for practicing communication skills, as it allows staff to simulate and navigate difficult conversations in a controlled environment.
Choice C reason: Return demonstration is typically used for teaching psychomotor skills and may not be as effective for communication training.
Choice D reason: Journaling is a reflective practice but does not offer the interactive experience needed to prepare for real-life scenarios involving angry family members.
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