A nurse is assessing a 10-year-old child's radial pulse. What is the appropriate technique for counting the pulse?
Use the index and middle fingers to palpate the pulse.
Use the thumb to apply pressure to the radial artery.
Apply strong pressure to detect the pulse rhythm.
Count the pulse for 10 seconds and multiply by 6.
The Correct Answer is A
A. Correct. Using the index and middle fingers to palpate the pulse provides a more accurate assessment of the radial pulse.
B. Incorrect. Using the thumb to apply pressure to the radial artery can inadvertently compress the artery, leading to an inaccurate pulse reading.
C. Incorrect. Applying strong pressure may interfere with the pulse assessment and is not necessary for detecting the pulse rhythm.
D. Incorrect. Counting the pulse for 10 seconds and multiplying by 6 is a valid method, but using the index and middle fingers for palpation is preferred for accuracy.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Correct. Having the child stand against a wall and marking their height with a pen provides an accurate measurement of height in children who are able to stand.
B. Incorrect. Instructing the child to lie down on the examination table is not the appropriate method for measuring height in a standing child.
C. Incorrect. Using a tape measure to measure the distance from head to toe is not as accurate as having the child stand against a wall for measurement.
D. Incorrect. Estimating height based on age and weight is not a reliable method for obtaining an accurate measurement.
Correct Answer is B
Explanation
A. Incorrect. Counting respirations immediately after eating may not provide an accurate measurement, as activity or digestion can influence respiratory rate.
B. Correct. Observing chest movement for a full minute allows for an accurate assessment of respiratory rate in children.
C. Incorrect. While using a stopwatch may be helpful, it is not necessary to ensure an accurate respiratory rate measurement in this context.
D. Incorrect. Asking the child to take deep breaths may not reflect their natural respiratory rate and could lead to an inaccurate assessment.
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