To differentiate an actual high reading from a misread caused by an auscultatory gap, you should:

• A. Ignore gaps and proceed
• B. Inflate cuff to 200 mmHg and read once
• C. Use only auscultation without palpation
• D. Palpate the artery to confirm cuff occlusion, use multiple readings, and ensure proper deflation

Answer: (D)

An auscultatory gap can make the reading appear misleading because Korotkoff sounds may be absent for a range of cuff pressures, so relying on listening alone can fail to reflect the true systolic pressure. Palpating the artery to confirm cuff occlusion gives an independent check of when the cuff pressure actually exceeds systolic pressure, regardless of whether sounds are heard. Taking multiple readings helps average out variation and reveals whether a single measurement is an outlier or part of a consistent pattern, which is essential when a gap might distort one reading. Proper deflation prevents missing the onset of sounds or overshooting, further reducing the chance of mistaking a gap for a truly high reading. Together, these steps provide a more accurate assessment and help distinguish a real elevated blood pressure from a misread caused by an auscultatory gap.