ATI RN
Vital Signs Assessment Chapter 7 Questions
Question 1 of 5
Mr. Patel is a 64-year-old man who was told by another care provider that his liver is enlarged. Although he is a life-long smoker, he has never used drugs or alcohol and has no knowledge of liver disease. Indeed, on examination, a liver edge is palpable 4 centimeters below the costal arch. Which of the following would you do next?
Correct Answer: C
Rationale: A liver edge palpable this far below the costal arch should not be ignored. Ultrasound and laboratory investigation are reasonable if the liver is actually enlarged. Mr. Patel has developed emphysema with flattening of the diaphragms. This pushes a normal-sized liver below the costal arch so that it appears to be enlarged. A liver span should be determined by percussing down the chest wall until dullness is heard. A measurement is then made between this point and the lower border of the liver to determine its span; 6–12 centimeters in the mid-clavicular line is normal. Percussion is the only way to assess liver size on examination, and in this case it saved the patient much inconvenience and expense.
Question 2 of 5
The nurse is performing a musculoskeletal assessment and notes that the patient has a decreased range of motion in the knee joint. What is the most likely cause of this finding?
Correct Answer: A
Rationale: Decreased range of motion in the knee joint is often a result of osteoarthritis, a condition characterized by the degeneration of joint cartilage.
Question 3 of 5
A tender, painful swelling of the scrotum should suggest which of the following?
Correct Answer: D
Rationale: A tender, painful swelling of the scrotum can be a medical emergency. All of these conditions should be considered, as well as acute orchitis.
Question 4 of 5
The patient is lying in bed under a ceiling fan. Which technique is the nurse using when the fan produces heat loss?
Correct Answer: C
Rationale: A ceiling fan moves air over the patient, causing heat loss via convection , where warm air around the body is replaced by cooler moving air. Radiation involves heat emission without contact, not fan-driven. Conduction requires direct contact (e.g., cold pack), not air movement. Evaporation involves moisture loss, not primarily fan-related here. Choice C is correct because convection matches the mechanism of air circulation enhancing heat dissipation, a principle nurses apply in thermoregulation strategies to cool patients effectively in clinical settings.
Question 5 of 5
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.