Name three factors that can falsely elevate a blood pressure reading.

• A. Having a calm, rested state; arm supported; correct cuff size.
• B. Recent caffeine or nicotine use, recent heavy activity, arm not supported or above heart level, and incorrect cuff size.
• C. Recent hydration; cold environment; full night sleep; correct cuff size.
• D. Eating a meal; lying down; regular breathing; appropriate cuff width.

Answer: (B)

When measuring blood pressure, readings can look higher than the true resting value if certain conditions aren’t ideal. Three common factors that can falsely elevate the number are: recent caffeine or nicotine use, recent heavy physical activity, and improper cuff technique. Caffeine and nicotine stimulate the sympathetic nervous system and cause blood vessels to constrict, which raises BP temporarily. After strenuous activity, cardiac output and vascular resistance are elevated, so a measurement taken soon after can be higher than baseline. With cuff technique, the arm should be supported and held at heart level, and the cuff must fit properly. A cuff that’s too small narrows the artery more and yields a higher reading, and an arm that isn’t supported or isn’t at heart level can introduce body-position-related errors. By ensuring no stimulants for a short period, allowing rest before measurement, and using proper arm position and cuff size, you get a reading that more accurately reflects the patient’s true resting blood pressure.