ATI RN
CNS Vital Signs Assessment Questions
Question 1 of 5
In assessing the carotid arteries of an older patient with cardiovascular disease, the nurse would:
Correct Answer: B
Rationale: The correct answer is B. Listening with the bell of the stethoscope allows the nurse to assess for bruits, abnormal sounds indicating turbulent blood flow in carotid arteries, which could indicate potential blockages or narrowing. Palpating the artery in the upper one third of the neck (A) is not recommended as it could potentially dislodge plaque and cause a stroke. Simultaneously palpating both arteries (C) is not necessary for this assessment. Instructing the patient to take slow deep breaths (D) is not relevant to assessing the carotid arteries for bruits.
Question 2 of 5
Which vein(s) is(are) responsible for most of the venous return in the arm?
Correct Answer: D
Rationale: The correct answer is D: Superficial. The superficial veins, like the basilic and cephalic veins, are responsible for most of the venous return in the arm due to their larger size and proximity to the surface. These veins run parallel to major arteries, assisting in venous return through the pumping action of nearby muscles. Deep veins are important but less significant in venous return compared to superficial veins in the arm. Ulnar and subclavian veins are not primarily responsible for venous return in the arm.
Question 3 of 5
When assessing a patient's pulse, the nurse notes that the amplitude is weaker during inspiration and stronger during expiration. When the nurse measures the blood pressure, the reading decreases 20 mm Hg during inspiration and increases with expiration. This patient is experiencing pulsus:
Correct Answer: D
Rationale: Step-by-step rationale for why the correct answer is D (Paradoxus): 1. Pulsus paradoxus is characterized by a decrease in pulse strength during inspiration and an increase during expiration, as seen in the patient's pulse assessment. 2. The blood pressure reading decreasing by 20 mm Hg during inspiration is indicative of pulsus paradoxus, as it reflects an exaggeration of the normal inspiratory drop in blood pressure. 3. Pulsus paradoxus is commonly associated with conditions like cardiac tamponade and severe asthma, which can cause this paradoxical pulse and blood pressure pattern. Summary of why the other choices are incorrect: A. Alternans: Alternating strong and weak pulse amplitudes, not related to the respiratory cycle. B. Bisferiens: Pulse with double systolic peaks, not related to respiratory cycle changes. C. Bigeminus: A pattern of every other heartbeat occurring prematurely, not related to respiratory cycle influences.
Question 4 of 5
A 23-year-old graduate student comes to your clinic for evaluation of a urethral discharge. As the provider, you need to get a sexual history. Which one of the following questions is inappropriate for eliciting the information?
Correct Answer: D
Rationale: Correct Answer: D Rationale: 1. Inquiring about the number of sexual partners in the last 6 months is not appropriate as it can be seen as judgmental and might make the patient uncomfortable. 2. The focus should be on gathering relevant information about the patient's sexual practices and behaviors without passing judgment. 3. Questions A, B, and C are relevant and appropriate for eliciting information about the patient's sexual history without making assumptions or causing discomfort. 4. Asking about sexual activity, types of partners, and recent intimate physical contact are essential in assessing the risk factors and providing appropriate care.
Question 5 of 5
A middle-aged man comes in because he has noticed multiple small, blood-red, raised lesions over his anterior chest and abdomen for the past several months. They are not painful and he has not noted any bleeding or bruising. He is concerned this may be consistent with a dangerous condition. What should you do?
Correct Answer: D
Rationale: The correct answer is D: Do a skin biopsy in the office. This is the most appropriate action to take in this scenario as the presence of multiple small, blood-red, raised lesions without pain or bleeding warrants further investigation to determine the underlying cause. A skin biopsy would provide histological information about the nature of the lesions, helping to differentiate between various skin conditions such as angiomas, petechiae or purpura. This would guide the appropriate management and rule out any serious underlying conditions. Choice A (Reassure him that there is nothing to worry about) is incorrect as the appearance of these lesions warrants further investigation rather than immediate reassurance. Choice B (Do laboratory work to check for platelet problems) is not the most appropriate initial step without first obtaining more specific information about the nature of the lesions. Choice C (Obtain an extensive history regarding blood problems and bleeding disorders) may be necessary later but is not the initial step in this case.