When assessing an older adult client with a history of cardiovascular disease, dyspnea, and peripheral edema, which method is best for the nurse to use to assess the client's pulse rate?
Palpate the radial pulses in both arms for a deficit.
Use the stethoscope to listen over the carotid artery.
Feel the volume of the dorsalis pedis and posterior tibialis pulses.
Auscultate the apical pulse at the point of maximal impulse.
The Correct Answer is D
A. Palpating the radial pulses might not detect irregularities in pulse rate or rhythm as effectively as auscultation at the apical site.
B. Listening over the carotid artery may be useful in certain situations but is not the preferred method for assessing overall pulse rate.
C. Feeling the dorsalis pedis and posterior tibialis pulses provides information about peripheral circulation but does not assess the overall heart rate.
D. Auscultating the apical pulse is the most accurate method to assess the pulse rate, especially in clients with cardiovascular disease, as it provides direct measurement of heart activity.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is {"A":{"answers":"A"},"B":{"answers":"A"},"C":{"answers":"A"},"D":{"answers":"A"},"E":{"answers":"B"},"F":{"answers":"A"},"G":{"answers":"B"}}
Explanation
Morning stiffness quickly resolves:
Rheumatoid Arthritis: Morning stiffness is a hallmark of rheumatoid arthritis, although it typically lasts more than just a brief period.
Small joints of the hand:
Rheumatoid Arthritis: Rheumatoid arthritis commonly affects the small joints of the hands and wrists, leading to pain, stiffness, and swelling.
Fatigue and fever:
Rheumatoid Arthritis: Systemic symptoms like fatigue and low-grade fever are often associated with rheumatoid arthritis due to its inflammatory nature.
Joint swelling:
Rheumatoid Arthritis: Swelling of the joints is a key symptom of rheumatoid arthritis, typically due to inflammation and fluid accumulation within the joint.
Heberden nodes:
Not Applicable: Heberden nodes are associated with osteoarthritis, not rheumatoid arthritis. These nodes occur at the distal interphalangeal joints.
Symmetrical involvement:
Rheumatoid Arthritis: One of the classic features of rheumatoid arthritis is symmetrical involvement of joints, particularly in the hands and wrists.
Pain increases with motion:
Rheumatoid Arthritis: Joint pain that increases with motion is a common symptom of rheumatoid arthritis, reflecting active inflammation in the joints.
Correct Answer is D
Explanation
A. Otitis media is an infection of the middle ear, and while it can affect hearing, it is not typically assessed using a tuning fork. Tuning forks are more useful for evaluating conductive hearing loss or bone conduction.
B. A tuning fork is generally not used to assess neurological pathology directly. Neurological conditions often require other diagnostic tools or tests to evaluate nerve function or reflexes.
C. Tinnitus is the perception of ringing in the ears and is usually assessed through patient reporting and audiometric testing. A tuning fork is not used to diagnose tinnitus, but it may be used to test hearing acuity.
D. A tuning fork is commonly used to assess for hearing loss, specifically conductive hearing loss. The fork helps test the function of bone and air conduction, which are important for determining the type of hearing impairment.
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