A nurse is collecting data from an infant.
Which of the following sites is the most reliable location to check the infant’s pulse?
Carotid.
Dorsalis pedis.
Temporal.
Apical.
The Correct Answer is D
Choice A rationale
The carotid pulse is not the most reliable location to check an infant’s pulse because it can be difficult to locate and can cause discomfort to the infant.
Choice B rationale
The dorsalis pedis pulse is not the most reliable location to check an infant’s pulse because it can be difficult to locate in small infants.
Choice C rationale
The temporal pulse is not the most reliable location to check an infant’s pulse because it can be affected by external factors such as temperature and can be difficult to locate in small infants.
Choice D rationale
The apical pulse is the most reliable location to check an infant’s pulse. It is located at the apex of the heart and can be easily heard using a stethoscope. It provides the most accurate assessment of the heart rate.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
The FACES scale is a valid tool for assessing pain in children aged 3 years and older. It uses a series of faces to help the child express their level of pain.
Choice B rationale
The Visual Analog Scale is typically used for adults and older children who can understand the concept of ranking their pain on a scale from 0 to 10. It may not be suitable for a 3-year-old child.
Choice C rationale
A color tool may not be effective for a 3-year-old child as they may not yet fully understand the concept of associating colors with different levels of pain.
Choice D rationale
A numeric scale is typically used for adults and older children who can understand the concept of ranking their pain on a scale from 0 to 10. It may not be suitable for a 3-year-old child.
Correct Answer is B
Explanation
Choice A rationale
Adjusting the harness straps every day is not recommended. The straps should be adjusted only as directed by the healthcare provider or orthopedic specialist to ensure proper positioning and effectiveness of the Pavlik harness.
Choice B rationale
This is the correct answer. Checking the baby’s skin three times a day is important to prevent skin irritation or breakdown under the harness.
Choice C rationale
Massaging lotion on the skin around the harness clasps is not recommended as it can cause skin irritation.
Choice D rationale
The diaper should be placed under the harness to prevent soiling and maintain the effectiveness of the harness.
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