ATI LPN
Study Guide for Fundamentals of Nursing Care: Concepts, Connections & Skills
Chapter 21 : Physical Assessment Questions
Question 1 of 5
You know that when assessing the pulse there is more than one characteristic you should assess. Which of the following best identifies the characteristics you must assess?
Correct Answer: A
Rationale: Pulse assessment includes rate (beats per minute), Rhythm (regular or irregular), and strength (force of the pulse).
Question 2 of 5
You are caring for a patient with mitral valve stenosis. You plan to assess the mitral valve during your initial assessment. Where will you be best able to auscultate the mitral valve?
Correct Answer: C
Rationale: The mitral valve is best heard at the apex of the left ventricle, typically in the 5th intercostal space, midclavicular line.
Question 3 of 5
When you assessed the radial pulse and the apical pulse of one of your patients, you noted that one of the pulses was slower than the other one. Which one of the following describes the assessment finding that you obtained?
Correct Answer: C
Rationale: A pulse deficit occurs when the radial pulse is slower than the apical pulse due to weak or missed peripheral pulses.
Question 4 of 5
Another nurse working on your floor reports that one of the patients has an apical pulse of 87 bpm and a pulse deficit of 9. You know that means the patient's radial pulse was
Correct Answer: C
Rationale: Pulse deficit is the difference between apical and radial pulse rates; 87 bpm (apical) - 9 = 78 bpm (radial).
Question 5 of 5
You are preparing to perform an initial shift assessment. You know that the correct order in which you should perform the five techniques for objective assessment (except for the abdomen) is
Correct Answer: B
Rationale: The correct order for assessment (except abdomen) is observation, auscultation, palpation, percussion, and olfaction to avoid altering findings.