Practice Question
A nurse is checking the apical pulse of a client who is taking several cardiovascular medications. Which of the following actions should the nurse take?
Answer Choices:
Correct Answer:
Count the apical pulsations for a full minute
Rationale:
♦️ The nurse should count the apical pulse for a full minute to obtain an accurate assessment, especially in clients on cardiovascular medications that may affect heart rate and rhythm.
♦️ Using the diaphragm of the stethoscope is appropriate for heart sounds, but the focus is on counting duration for accuracy, not the type of stethoscope part.
♦️ Pressing the stethoscope too firmly can distort sounds and cause discomfort.
♦️ A Doppler device is used when pulse sounds are difficult to hear but is not the first choice.
♦️ Accurate pulse assessment helps in monitoring for adverse medication effects such as bradycardia.
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This question is from ATI LPN Fundamentals Exam 3 which contains 40 questions.
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Question Details
- Category: LPN Nursing Exam(s)
- Subcategory: LPN ATI Exams
- Domain: Fundamentals of Nursing
- Answer Choices: 4