ATI RN
Vital Signs Assessment Chapter 7 Questions
Question 1 of 9
A pregnant woman states, 'I just know labor will be so painful that I won't be able to stand it. I know it sounds awful, but I really dread going into labor.' The nurse responds by stating, 'Oh, don't worry about labor so much. I have been through it, and although it is painful, many good medications are available to decrease the pain.' Which statement is true regarding this response? The nurse's reply was a:
Correct Answer: B
Rationale: By providing false assurance or reassurance, this courage builder relieves the woman's anxiety and gives the nurse the false sense of having provided comfort. However, for the woman, providing false assurance or reassurance actually closes off communication, trivializes her anxiety, and effectively denies any further talk of it.
Question 2 of 9
A nurse is conducting a health assessment for an African American patient. What should the nurse consider in terms of cultural sensitivity?
Correct Answer: C
Rationale: Cultural risk factors and racial variations , per the answer key, guide sensitive assessments (e.g., hypertension in African Americans). Uniformity , race questions , or emotional needs miss this focus. Nurses, per Taylor, adapt care culturally.
Question 3 of 9
The nurse is performing a respiratory assessment and notes decreased tactile fremitus over the left lower lung field. What does this finding most likely indicate?
Correct Answer: B
Rationale: Decreased tactile fremitus is commonly associated with pleural effusion due to fluid accumulation.
Question 4 of 9
During an assessment of a 20-year-old Asian patient, the nurse notices that he has dry, flaky cerumen in his canal. What is the significance of this finding? This finding:
Correct Answer: C
Rationale: Asians and Native Americans are more likely to have dry cerumen, whereas Blacks and Whites usually have wet cerumen.
Question 5 of 9
A nurse is assessing a client's pulse rate and observes an irregular rhythm with skipped beats. What action should the nurse take?
Correct Answer: C
Rationale: Irregular rhythm with skipped beats suggests a potential arrhythmia, requiring provider notification for evaluation. It's not normal . Waiting an hour delays care. Deep breathing doesn't address cardiac issues. Choice C is correct, per the explanation, reflecting nursing's duty to escalate abnormal findings promptly for patient safety.
Question 6 of 9
Which of the following pathologic conditions would result in release of ADH by the posterior pituitary?
Correct Answer: A
Rationale: Hemorrhage triggers ADH release to conserve water and raise BP, per the answer key. Allergies , obesity , and asthma don't directly stimulate ADH. Nurses understand this hormonal response to hypovolemia, critical for managing shock or fluid loss scenarios.
Question 7 of 9
Which of the following is true of human papilloma virus (HPV) infection?
Correct Answer: B
Rationale: HPV is the most common STI in the United States and is by far the most common cause of cervical cancers. The sensitivity of the liquid-based cytology is between 61% and 95% and specificity is from 78% to 82%. While HPV affects almost 50% of the population at some point, many of these infections resolve spontaneously.
Question 8 of 9
The nurse is caring for a newborn infant in the hospital nursery and notices that the infant is breathing rapidly but is pink, warm, and dry. Which normal respiratory rate will the nurse consider when planning care for this newborn?
Correct Answer: A
Rationale: Newborn respiratory rate is 30-60 breaths/min; rapid breathing within this is normal if pink, warm, dry. Lower ranges (B, C, D) apply to older ages. Choice A is correct, per neonatal norms, guiding care planning.
Question 9 of 9
The nurse is assessing the vital signs of a 3-year-old patient who appears to have an irregular respiratory pattern. How should the nurse assess this child's respirations?
Correct Answer: A
Rationale: For irregular respiratory patterns, respirations should be counted for a full minute to ensure accuracy.