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Author Question: The student nurse is preparing to take the client's apical pulse. Where does the registered nurse ... (Read 75 times)

joesmith1212

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The student nurse is preparing to take the client's apical pulse. Where does the registered nurse instruct the student nurse to place the stethoscope?
 
  a. Along the left midclavicular line at the second to third intercostals space
  b. Along the left midclavicular line at the third to fourth intercostal space
  c. Along the left midclavicular line at the fourth to fifth intercostal space
  d. Along the left midclavicular line at the fifth to sixth intercostal space

Question 2

A paraplegic client is in the hospital for an electrolyte imbalance. At which level of prevention is the client receiving care?
 
  a. Primary prevention level
  b. Secondary prevention level
  c. Tertiary prevention level
  d. Health promotion level



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bdobbins

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Answer to Question 1

C
An apical pulse should be assessed at the client's point of maximal impulse (PMI). The PMI is located at the fourth to fifth intercostal space at the left midclavicular line.
Along the left midclavicular line at the second to third intercostals space is not the correct placement for auscultating a client's apical pulse.
The PMI is higher and more medial in children younger than 8 years of age. This client is not identified as being a child.
Along the left midclavicular line at the fifth to sixth intercostal space is not the correct placement for auscultating a client's apical pulse.

Answer to Question 2

B
The secondary prevention level focuses on early detection of disease once pathogenesis has oc-curred, so that prompt treatment can be initiated to halt disease and limit disability.
The primary prevention level focuses on health promotion and specific protection measures such as immunizations, and the reduction of risk factors such as smoking.
The tertiary prevention level focuses on minimizing residual disability.
Health promotion is a focus of the primary prevention level.





 

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