ATI RN
Health Assessment Vital Signs Quizlet Questions
Question 1 of 5
During a musculoskeletal assessment, the nurse observes swelling and redness over a joint. What is the nurse's next action?
Correct Answer: A
Rationale: The correct answer is A: Assess the range of motion of the joint. This is the next action because swelling and redness over a joint can indicate inflammation or injury, which may affect the joint's mobility. Assessing the range of motion will help determine the extent of the issue and guide further interventions. Applying heat (B) may worsen inflammation, documenting as normal (C) is inappropriate given the abnormal findings, and referring for further evaluation (D) can be considered after assessing the range of motion to provide more specific information to the healthcare provider.
Question 2 of 5
A physical therapist completes a respiratory examination on a patient diagnosed with chronic obstructive pulmonary disease (COPD). Which finding would the therapist MOST likely observe?
Correct Answer: D
Rationale: The correct answer is D: Increased total lung capacity. In COPD, there is typically air trapping due to decreased elasticity of the lungs and increased residual volume. This results in an increased total lung capacity as the lungs are hyperinflated. A: Decreased residual volume is incorrect because in COPD, there is air trapping leading to increased residual volume. B: Increased expiratory flow rates is incorrect because in COPD, there is airflow limitation causing decreased expiratory flow rates. C: Decreased functional residual capacity is incorrect because in COPD, there is air trapping leading to increased functional residual capacity.
Question 3 of 5
A physical therapist instructs a patient on the proper use of a walker. Which sequence of steps is MOST appropriate for a patient with a partial weight-bearing status?
Correct Answer: A
Rationale: The correct answer is A because when a patient has a partial weight-bearing status, they should first advance the walker to provide support, then advance the affected leg to ensure stability, and finally advance the unaffected leg to complete the step. This sequence ensures that the patient maintains balance and support throughout the movement. Choice B is incorrect because advancing the unaffected leg first may lead to instability. Choice C is incorrect as advancing the unaffected leg before the walker does not provide proper support. Choice D is incorrect as advancing the affected leg first without walker support can risk falls.
Question 4 of 5
During a neurological assessment, the nurse observes that the patient has difficulty with heel-to-toe walking. What does this finding suggest?
Correct Answer: B
Rationale: The correct answer is B: Cerebellar dysfunction. Heel-to-toe walking, also known as tandem gait, is a test of cerebellar function. The cerebellum is responsible for coordinating movement and balance, so difficulty with this task indicates dysfunction in the cerebellum. Cranial nerve deficit (A) typically presents with abnormalities in facial sensation or muscle weakness. Vestibular impairment (C) is associated with dizziness and balance issues, but not specifically heel-to-toe walking. Spinal cord injury (D) would manifest as motor or sensory deficits below the level of injury, not specifically affecting heel-to-toe walking.
Question 5 of 5
Which heart sound is most commonly associated with heart failure?
Correct Answer: C
Rationale: The correct answer is C: S3. In heart failure, S3 heart sound is often heard due to rapid ventricular filling during early diastole. This sound is associated with volume overload and impaired left ventricular function. S1 and S2 are normal heart sounds, while S4 is associated with stiff ventricles and is commonly heard in conditions like hypertension or aortic stenosis. Therefore, S3 is the most commonly associated heart sound with heart failure due to its specific characteristics in this condition.