A nurse is preparing to check a client's blood pressure. Which of the following actions should the nurse take?
Use a cuff with a width that is about 60% of the client's arm circumference.
Release the pressure on the client's arm 5 to 6 mm per second.
Apply the cuff above the client's antecubital fossa
Have the client sit with his arm resting above the level of his heart.
Correct Answer : A,B
A cuff that is too narrow or too wide can result in inaccurate blood pressure readings. The cuff should be snug but not tight and cover about 80% of the arm length. The pressure should be released at a rate of 2 to 3 mm per second to avoid missing auscultatory gaps or causing discomfort to the client.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. "I will put some lubricant on the flat end of the suppository.": It is generally not necessary to use lubricant on the suppository. If lubrication is needed, it should be applied sparingly to the rounded end, not the flat end.
B. "I will lie on my left side to insert the suppository.": The recommended position for inserting a vaginal suppository is usually lying on your back with your knees bent or standing with one foot elevated, not lying on the left side.
C. “I can discontinue the medications once my symptoms are gone.": This is incorrect. It is important to complete the full course of medication to ensure the infection is fully treated, even if symptoms improve before finishing the medication.
D. "I will place the suppository as far inside my vagina as I can reach.”: This statement is correct. The suppository should be inserted high into the vagina to ensure it is placed correctly and will dissolve properly to treat the infection.
Correct Answer is C
Explanation
Sleep deprivation is a condition that occurs when a person does not get enough quality sleep or has a disrupted sleep pattern. Sleep deprivation can affect a person's physical, mental, and emotional health. One of the effects of sleep deprivation is decreased judgment, which means that a person may have difficulty making decisions, solving problems, and concentrating. The nurse should recognize this finding as an indication that the client has sleep deprivation and intervene accordingly.
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