Nursing practice questions with comprehensive rationales
NurseDive Free Nursing Practice Question
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?
A. Systolic blood pressure.
The systolic blood pressure of 102 mm Hg is within a normal range and does not require clarification.
B. Position of the client.
The position of the client, “sitting up in a chair,” is clearly documented and does not need further clarification.
C. Unit of measurement.
The unit of measurement, “mm Hg,” is the standard unit for blood pressure and is correctly documented.
D. Location of blood pressure cuff.
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.
This question is an excerpt from Nurse Dive's nursing test bank - ATI custom fundamentals final proctored exam fall 2023. Take the full exam now
Full Explanation
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.
Similar Questions
A nurse is discussing a client's needs at an interdisciplinary team conference.
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Which of the nursing competencies is the nurse demonstrating?
A. Collaborator.
B. Case manager.
C. Nurse manager.
D. Advocate.
Full Explanation
A nurse is preparing to administer furosemide 40 mg IV. Available is furosemide 10 mg/1 mL. How many mL should the nurse administer per dose?
Full Explanation
To calculate the correct dose in milliliters (mL), you can use the formula: Desired Dose (in mg) = Available Dose (in mg/mL) * Volume (in mL)
Desired Dose (in mg) = 40 mg Available Dose (in mg/mL) = 10 mg/1 mL Now, plug these values into the formula: Volume (in mL) = 40 mg / 10 mg/1 mL Volume (in mL) = 4 mL.
The nurse should administer 4 mL of furosemide per dose.
A nurse is preparing an in-service about communication for a group of staff nurses.
Which of the following information should the nurse include when discussing the electronic mode of communication?
A. Providers can send prescriptions to a pharmacy on an unencrypted device.
B. Electronic communication includes video conference calls with clients.
C. Electronic communication does not have a risk of privacy violations.
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