ATI RN
Assessing Vital Signs Questions
Question 1 of 5
A nurse is conducting a health assessment. How will the information collected from the patient be used?
Correct Answer: A
Rationale: Health assessment data forms the basis for the nursing process , per the answer key, guiding diagnosis, planning, and care. Illustrating competence or facilitating caring are secondary benefits, not primary uses. Medical care involves physicians, not nursing focus. Nurses rely on this systematic approach, per Taylor, to prioritize patient needs and interventions effectively.
Question 2 of 5
Which of the following is true of the HPV vaccine?
Correct Answer: D
Rationale: The correct answer is D because the HPV vaccine can protect against anogenital lesions by preventing infection with certain HPV types. This is supported by clinical evidence and research. Choice A is incorrect because the vaccine can be administered at any age, not just within 3 years of first intercourse. Choice B is incorrect as the HPV vaccine covers against specific HPV types, not all. Choice C is incorrect as the vaccine is primarily used for prevention, not as adjuvant therapy in cervical cancer.
Question 3 of 5
A 21-year-old college senior presents to your clinic, complaining of shortness of breath and a nonproductive nocturnal cough. She states she used to feel this way only with extreme exercise, but lately she has felt this way continuously. She denies any other upper respiratory symptoms, chest pain, gastrointestinal symptoms, or urinary tract symptoms. Her past medical history is significant only for seasonal allergies. On examination, auscultation of her chest shows decreased air movement and a high-pitched whistling on expiration in all lobes. Percussion reveals resonant lungs.
Correct Answer: C
Rationale: The correct answer is C: Asthma. The key clues in the scenario are the patient's age, nocturnal cough, continuous shortness of breath, history of seasonal allergies, and physical exam findings of wheezing on expiration in all lobes. These are classic signs of asthma. Asthma is a chronic inflammatory condition of the airways characterized by reversible airflow obstruction, leading to symptoms such as cough, shortness of breath, and wheezing. The patient's history of seasonal allergies further supports the diagnosis of asthma, as allergies are a common trigger for asthma exacerbations. Now, let's discuss why the other choices are incorrect: A: Spontaneous pneumothorax typically presents with sudden-onset chest pain and shortness of breath, not a gradual onset as described in the scenario. B: Chronic obstructive pulmonary disease (COPD) is more common in older individuals with a history of smoking. The absence of smoking history and the patient's age make COPD
Question 4 of 5
You are at your family reunion playing football when your uncle takes a hit to his right lateral thorax and is in pain. He asks you if you think he has a rib fracture. You are in a very remote area. What would your next step be?
Correct Answer: C
Rationale: The correct answer is C: Press on his sternum and spine simultaneously. This action is known as the sternum and spine test, which helps determine if there is rib fracture. It is important to examine for instability and crepitus, which are indicative of rib fractures. This step is crucial in assessing the severity of the injury and deciding on the next course of action. Calling a medevac helicopter (A) or driving him to the city (B) without proper assessment can worsen the injury. Examining for tenderness over the injured area (D) is not specific for rib fractures and may not provide enough information to make a proper decision.
Question 5 of 5
A patient repeatedly seems to have difficulty coming up with a word. He says, 'I was on my way to work, and when I got there, the thing that you step into that goes up in the air was so full that I decided to take the stairs.' The nurse will note on his chart that he is using or experiencing:
Correct Answer: C
Rationale: The correct answer is C: Circumlocution. Circumlocution refers to the use of indirect or roundabout ways of expressing oneself, often due to difficulty in finding the right word. In this case, the patient struggles to recall the word "elevator" and instead describes it as "the thing that you step into that goes up in the air." This behavior is characteristic of circumlocution. Blocking (A) refers to a sudden interruption in train of thought or speech production, which is not evident in this scenario. Neologism (B) is the creation of new words or phrases, which is not demonstrated here. Circumstantiality (D) involves unnecessary and excessive detail in conversation, which is not the primary issue in this case.