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.
Position of the client.
Unit of measurement.
Location of blood pressure cuff.
The Correct Answer is D
The correct answer is choice d. Location of blood pressure cuff.
Choice A rationale: The systolic blood pressure of 102 mm Hg is within a normal range and does not require clarification.
Choice B rationale: The position of the client, “sitting up in a chair,” is clearly documented and does not need further clarification.
Choice C rationale: The unit of measurement, “mm Hg,” is the standard unit for blood pressure and is correctly documented.
Choice D rationale: The location of the blood pressure cuff is not specified in the documentation. It is important to document whether the blood pressure was taken on the left or right arm, or another location, to ensure accuracy and consistency in future measurements.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale:
SDOH are not determined by an individual's ethnic background. SDOH encompass a wide range of factors beyond ethnicity that affect an individual's well-being, including social, economic, and environmental factors.
Choice B rationale:
SDOH are conditions in an individual's environment that affect their well-being. This is the correct answer. Social Determinants of Health (SDOH) refer to the conditions in which people are born, grow, live, work, and age, and how these conditions impact their physical and mental well-being. These conditions include factors such as income, education, employment, social support, and access to healthcare.
Choice C rationale:
Identifying SDOH does not increase disparities in healthcare. In fact, recognizing and addressing SDOH can help reduce health disparities by providing more equitable access to resources and services for underserved populations.
Choice D rationale:
While psychological factors can be important determinants of health, they are not typically considered part of the social determinants of health. SDOH primarily focus on external factors related to an individual's environment and socioeconomic conditions.
Correct Answer is B
Explanation
Choice A rationale:
Encouraging family members to call the client is a valuable emotional and social support, but it may not be as effective in reducing social isolation for a client at the end of life. While communication with loved ones is important, it may not fully address the client's need for personal interaction.
Choice C rationale:
Instructing the client to join an online support group can be a useful intervention to reduce social isolation, especially in cases where physical interaction is limited. However, it may not be as effective for all clients, as comfort with technology and online groups can vary. Additionally, it should be one of several strategies used to address social isolation.
Choice D rationale:
Asking the client's friends to text the client is a positive gesture, but it may not be as effective as scheduling home visits with the client. Text messages may not provide the same level of personal interaction and emotional support that physical visits can offer.
Choice B rationale:
Scheduling home visits with the client is the most effective intervention to reduce social isolation in a client at the end of life. It allows for in-person interaction, emotional support, and the opportunity to address the client's physical and emotional needs directly. Face-to-face contact can significantly improve the client's sense of connectedness and reduce feelings of isolation.
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