Which condition would lead the RN to choose the dorsalis pedis pulse as the site for further assessing the client's status?
1. Altered level of consciousness
2. Decreased urine output
3. Irregular radial pulse
4. Toes cool to touch
Correct Answer: 4
Rationale 1: To assess an altered level of consciousness, the nurse would most likely assess the client's apical pulse.
Rationale 2: To assess for decreased urine output, the nurse would most likely assess the apical pulse.
Rationale 3: For an irregular radial pulse, the nurse would most likely assess the apical pulse.
Rationale 4: The dorsalis pedis pulse site is in the foot, so this is the ideal site to assess the pulse for toes that are cool to touch.
You might also like to view...
The nurse observes hirsutism in a female client. What does the nurse do next?
a. Assess for deepening of the voice. b. Assess personal hygiene habits. c. Document the finding. d. Prepare the client for a biopsy.
Which questions are appropriate for the nurse to ask during a cultural assessment of a patient new to the clinic? Note: Credit will be given only if all correct and no incorrect choices are selected. Select all that apply
1. What genetic and other biological differences affect caregiving? 2. Which family member must be consulted for decisions about care? 3. What type of health provider is the most appropriate? 4. Does the patient have beliefs or traditions that might impact the care plan? 5. Are communications patterns established?
The nurse is planning care for a client from a non-English-speaking culture. Which of the following cultural factors will influence the client's responses to the nurse? (Select all that apply.)
1. How a person acts 2. Communication pattern 3. Socioeconomic background 4. Thinking process 5. Interpretation of other's characteristics 6. Family structure
For very small children, or children who need the drug administered intravenously but cannot tolerate extra fluids, a special delivery system such as a(n) ________ may be used.
Fill in the blank(s) with the appropriate word(s).