What steps should be taken if the first BP reading is unusually high due to poor technique?

• A. Ignore and record as high
• B. Re-measure with correct technique, using an appropriate cuff size, proper arm position, and rest; record multiple readings
• C. Use a different device
• D. Only measure again if symptoms persist

Answer: (B)

Accurate blood pressure depends on proper technique, so an initial reading that seems unusually high should not be trusted if technique was off. The best next step is to re-measure using correct technique and settings. Have the patient rest for about five minutes, ensure they are seated with back supported and feet uncrossed, and place a properly sized cuff on a bare arm at heart level. The patient should avoid talking, and the cuff should be positioned over the brachial artery with a smooth, controlled deflation. Take at least two readings, separated by a minute or two, and document all results. Recording multiple measurements and using the average helps distinguish true hypertension from a one-time artifact caused by poor technique. If the readings remain high after proper technique, further assessment and follow-up are warranted.