Which of the following actions by the new nurse requires immediate intervention by the experienced nurse?
Does not let patient know that nurse is assessing respirations.
Auscultating heart sounds using bell of stethoscope.
Assessing both carotid pulse sites at the same time.
Cleaning stethoscope between patient assessments.
The Correct Answer is C
Choice A rationale
It is a common practice for nurses to assess a patient’s respirations without explicitly stating so. This is because patients may alter their breathing pattern if they know it’s being observed.
Choice B rationale
Auscultating heart sounds using the bell of the stethoscope is a standard practice in nursing. The bell of the stethoscope is used specifically to listen to low-frequency sounds such as heart murmurs.
Choice C rationale
Assessing both carotid pulse sites at the same time is dangerous and should be avoided. This action can lead to reduced blood flow to the brain, possibly causing the patient to faint or experience a decrease in cerebral blood flow.
Choice D rationale
Cleaning the stethoscope between patient assessments is a recommended practice to prevent the spread of infections.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
Discrimination refers to the unjust or prejudicial treatment of different categories of people, especially on the grounds of race, age, or sex. In this case, the physician is refusing to use a translator and only provides materials in English to patients who may not understand the language. This action can be seen as discriminatory because it denies these patients the same level of care that English-speaking patients receive.
Choice B rationale
Ethnocentrism is the belief in the inherent superiority of one’s own ethnic group or culture. While the physician’s actions may seem ethnocentric, as they are not considering the cultural needs of their patients, the scenario does not provide enough information to definitively label the behavior as such.
Choice C rationale
Stereotyping involves generalized and oversimplified beliefs about a particular group. The physician’s actions do not necessarily indicate that they are stereotyping their patients, but rather that they are not providing equitable care.
Choice D rationale
Acculturation is the process of adopting the cultural traits or social patterns of another group. The physician’s actions do not demonstrate acculturation. Instead, they show a lack of willingness to accommodate the cultural and linguistic needs of their patients.
Correct Answer is A
Explanation
Choice A rationale
During systole, the ventricles contract to pump blood out of the heart to the body and lungs.
Choice B rationale
The ventricles relax during diastole, not systole.
Choice C rationale
The atria also contract during systole, but this occurs just before ventricular systole.
Choice D rationale
This choice is incorrect because both the ventricles and the atria contract during systole.
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