The nurse is caring for a patient with chronic lower back pain. The nurse knows

that the most reliable indicator of pain in this client is:

The patient is reporting "6/10" pain.

The patient is refusing to get out of bed.

The patient is refusing to eat breakfast.

The patient's heart rate is 90 beats per minute.

A

Which of the following actions should the nurse take to ensure an accurate blood

pressure (BP) reading?

Ensure the width of the BP cuff is equal to 80% of the arm circumference.

Ensure the client's back is supported and feet are flat on the ground.

Take two BP readings 20 seconds apart.

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