The patient has a history of orthostatic hypotension. What is the priority action of the nurse?

Always take the patient's blood pressure manually using a sphygmomanometer.

Monitor the patient's neurological status carefully for symptoms of a stroke.

Assist the patient to sit and stand slowly when getting out of bed.

Check the patient's blood pressure on a lower extremity using a thigh-sized cuff.

Answer and Explanation

The Correct Answer is C

A. Always take the patient's blood pressure manually using a sphygmomanometer. While manual BP measurements can be more accurate, they are not the priority intervention for orthostatic hypotension, which primarily involves position changes and fall prevention.
B. Monitor the patient's neurological status carefully for symptoms of a stroke. Orthostatic hypotension can cause dizziness or fainting, but it is not a direct cause of stroke. Neurological assessment is important if symptoms arise but is not the primary intervention.
C. Assist the patient to sit and stand slowly when getting out of bed. Orthostatic hypotension causes a sudden drop in blood pressure upon standing, increasing the risk of falls and syncope. The priority action is to help the patient transition slowly from lying to sitting and standing to allow the body to adjust.
D. Check the patient's blood pressure on a lower extremity using a thigh-sized cuff. Lower extremity BP measurements are not standard for managing orthostatic hypotension. Blood pressure should be checked in both lying, sitting, and standing positions to monitor for significant drops.

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Free Nursing Study Resources

Correct Answer is ["39.2"]

Explanation

Calculation:

The formula to convert Fahrenheit (°F) to Celsius (°C) is:

°C = (°F - 32) × 5/9

= (102.5 - 32) × 5/9

= (70.5) × 5/9

= 39.1666...

Rounding to the nearest tenth: 39.2 °C.

Therefore, 102.5 °F is equal to 39.2 °C.

A. Ask the patient to rate the pain on a 0-to-10 scale. B. Call the physician or health care provider immediately. C. Check the patency of the patient's intravenous line. D. Speak to the patient in a calming tone to reduce anxiety.

Correct Answer is A

Explanation

A. Ask the patient to rate the pain on a 0-to-10 scale. Pain is subjective, and the first step in pain management is assessment. Asking the patient to rate their pain helps determine the severity and whether adjustments to pain management are needed.
B. Call the physician or health care provider immediately. Contacting the provider may be necessary if the pain is uncontrolled, but the nurse must assess the pain level first before deciding if intervention is needed.
C. Check the patency of the patient's intravenous line. While an IV line is essential for PCA function, the priority is assessing the patient’s pain level before troubleshooting the equipment.
D. Speak to the patient in a calming tone to reduce anxiety. Although a calm demeanor is beneficial, it does not address the patient’s pain directly. Pain assessment is the first priority.

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The patient has a history of orthostatic hypotension. What is the priority action of the nurse?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Covert 102.5 Fahrenheit to C (round to tenths)

Correct Answer is ["39.2"]

Explanation

A patient has a morphine sulfate patient-controlled analgesia (PCA) to control postoperative pain. When the nurse enters the room, the patient complains of pain. The nurse's first response is which of the following?

Correct Answer is A

Explanation

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