A nurse is reviewing the documentation of a client's blood pressure by a newly licensed nurse. The documentation states, "Blood pressure 102/58 mm Hg. client sitting up in a chair." Which of the following information should the nurse clarify?
Systolic blood pressure
Location of blood pressure cuff
Unit of measurement
Position of the client
The Correct Answer is B
A. The systolic blood pressure is clearly stated as "102 mm Hg" in the documentation. There is no need for clarification regarding the systolic value.
B. It is essential to document the site where the blood pressure was taken, as this can affect the accuracy of the reading. Typically, the blood pressure is measured in the brachial artery in the upper arm. If the cuff was placed on a different site, such as the wrist or ankle, this should be noted in the documentation.
C. The unit of measurement for blood pressure is correctly indicated as "mm Hg" (millimeters of mercury). There is no need for clarification regarding the unit since it is standard and clear.
D. The position of the client is correctly documented as sitting up in a chair.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Using a designated interpreter ensures that communication is accurate and professional, minimizing the risk of misunderstandings. Facilities often have protocols for accessing interpreters who are trained to handle medical conversations, making this the safest choice.
B. While electronic translating services can be useful, they are not always reliable for medical situations. These services may lack the necessary context for medical terminology and nuances, and they may not ensure confidentiality or accuracy.
C. Involving the client’s partner as an interpreter can lead to issues of accuracy, bias, and confidentiality. The partner may not fully understand medical terminology, and there is a potential for miscommunication or emotional involvement that could affect the interpretation.
D. While this option may seem helpful, it is not ideal. Using a colleague as an interpreter can compromise the confidentiality and professionalism of the interaction. Additionally, the colleague may not have the training necessary to accurately convey medical information, and there might be a conflict of interest.
Correct Answer is D
Explanation
A. This involves providing information and teaching individuals about health-related topics to improve their knowledge, skills, and behaviors. However, this is a narrower term.
B. This involves preventing the occurrence of a disease or injury before it happens. While the nurse's advice is aimed at improving the client's health and reducing the risk of heart disease, it doesn't directly prevent the occurrence of the disease.
C. This approach considers the whole person, including physical, mental, emotional, and spiritual aspects. While a heart-healthy diet can contribute to overall well-being, it doesn't encompass all aspects of holistic health.
D. This involves creating conditions that enable people to lead healthy lives. While the nurse's advice can contribute to health promotion, it's not the primary focus of the interaction.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.
