ATI RN
ATI Vital Signs Assessment Questions
Question 1 of 5
A 50-year-old man with a history of heavy alcohol use presents with abdominal pain, jaundice, and ascites. His serum bilirubin is elevated, and liver function tests show elevated AST and ALT. What is the most likely diagnosis?
Correct Answer: B
Rationale: The most likely diagnosis for a 50-year-old man with a history of heavy alcohol use presenting with abdominal pain, jaundice, and ascites, along with elevated serum bilirubin, AST, and ALT, is cirrhosis. Cirrhosis is a chronic condition characterized by liver damage and scarring, commonly caused by long-term alcohol abuse. The elevated liver function tests and jaundice are indicative of liver dysfunction, while ascites is a common complication of cirrhosis due to portal hypertension. Chronic pancreatitis (choice A) typically presents with pancreatic enzyme abnormalities, not liver dysfunction. Hepatitis (choice C) may present with elevated liver enzymes but is less likely in a patient with a history of heavy alcohol use. Gallstones (choice D) can cause jaundice but are less likely to be the primary cause of liver dysfunction in this case.
Question 2 of 5
The nurse is assessing a patient's pupils and notes that the pupils constrict when exposed to light but do not constrict when focused on a near object. What does this finding suggest?
Correct Answer: C
Rationale: The correct answer is C: Failure of the accommodation reflex. When the pupils constrict in response to light but do not constrict when focused on a near object, it indicates a failure of the accommodation reflex. This reflex is responsible for adjusting the shape of the lens to focus on near objects. In this scenario, the pupils are reacting to light (normal pupillary response) but not adjusting properly for near vision, ruling out A. Failure of the consensual light reflex (B) would result in both pupils failing to constrict when exposed to light. Increased intracranial pressure (D) would typically present with other neurological signs and symptoms.
Question 3 of 5
The nurse is assessing a patient's lungs and hears wheezing on expiration. What condition is most likely associated with this finding?
Correct Answer: A
Rationale: The correct answer is A: Asthma. Wheezing on expiration is a classic finding in asthma due to airway constriction. During expiration in asthma, the narrowed airways cause turbulent airflow, leading to the characteristic high-pitched wheezing sound. Asthma is a chronic inflammatory condition of the airways that results in reversible airflow obstruction. Pneumonia (B) typically presents with crackles on auscultation, not wheezing. Pulmonary edema (C) is associated with crackles and possibly wheezing on inspiration. COPD (D) may present with wheezing on both inspiration and expiration, but it is less likely than asthma to present with wheezing on expiration alone.
Question 4 of 5
During a cardiovascular assessment, the nurse auscultates a murmur that occurs during diastole. What is the most likely cause of this finding?
Correct Answer: B
Rationale: The correct answer is B: Mitral stenosis. During diastole, the mitral valve should be closed, allowing blood to flow from the left atrium to the left ventricle. A murmur during diastole indicates turbulent blood flow across a stenotic mitral valve. Mitral stenosis causes decreased flow from the left atrium to the left ventricle during diastole, leading to increased pressure in the left atrium and the pulmonary circulation. Aortic regurgitation (A) would present with a murmur during diastole, but it is typically heard in early diastole. Tricuspid regurgitation (C) would present with a murmur during systole. Systolic heart failure (D) is not associated with a diastolic murmur.
Question 5 of 5
The nurse is assessing a patient's cranial nerve function and asks the patient to raise both eyebrows. Which cranial nerve is being tested?
Correct Answer: B
Rationale: Step-by-step rationale: 1. Choice B, Cranial nerve VII (facial nerve), is correct. This nerve innervates the muscles responsible for facial expressions, including raising the eyebrows. 2. Cranial nerve III (choice A) controls eye movements, not eyebrow elevation. 3. Cranial nerve IX (choice C) is involved in swallowing and taste sensation, not eyebrow movement. 4. Cranial nerve X (choice D) is responsible for various functions including regulating the heart and digestive system, not eyebrow movement. Summary: Choice B is correct as the facial nerve controls the muscles involved in raising the eyebrows. Choices A, C, and D are incorrect as they are not specifically associated with eyebrow movement.