ATI RN
Chapter 12 Vital Signs Assessment Questions
Question 1 of 5
The differential diagnosis of trigger finger includes which of the following?
Correct Answer: D
Rationale: The correct answer is D because trigger finger can be caused by Dupuytren's disease, ganglion of the tendon sheath, or rheumatoid arthritis. Dupuytren's disease can lead to the formation of nodules in the palm that can affect finger movement. Ganglion of the tendon sheath can cause tendon swelling and lead to triggering of the finger. Rheumatoid arthritis can result in inflammation of the tendon sheaths, causing trigger finger. Therefore, all of the above conditions are part of the differential diagnosis for trigger finger. Choices A, B, and C are incorrect individually because trigger finger can be associated with each condition separately.
Question 2 of 5
In Erb's palsy, what part of the brachial plexus is affected?
Correct Answer: D
Rationale: In Erb's palsy, the upper trunk (C5-C6) of the brachial plexus is affected. This leads to weakness or paralysis of the shoulder and elbow muscles. The C5-C6 nerve roots are commonly injured during childbirth trauma. The other choices are incorrect because Erb's palsy specifically involves the upper trunk, not the lower trunk (C8-T1), both upper and lower trunks, or the middle trunk (C7). Therefore, the correct answer is D.
Question 3 of 5
If a burn patient is splinted in a comfortable position for grafted burns to heal, the patient is at risk for which of the following complications?
Correct Answer: D
Rationale: The correct answer is D: Wound contracture. When a burn patient is splinted in a comfortable position for grafted burns to heal, there is a risk of wound contracture due to prolonged immobility. Wound contracture refers to the tightening and shrinking of the skin and underlying tissues, leading to restricted joint movement and functional impairment. This complication can result in long-term disability and decreased quality of life for the patient. Choices A, B, and C are incorrect: A: Tendon rupture is not a typical complication of splinting a burn patient in a comfortable position. B: Skin breakdown may occur if the splint is too tight or if there is excessive pressure on certain areas, but it is not the primary risk associated with this scenario. C: Mechanical falls are unrelated to the positioning of the burn patient for graft healing.
Question 4 of 5
When considering priority setting of problems, the nurse keeps in mind that second-level priority problems include which of these aspects?
Correct Answer: C
Rationale: The correct answer is C: Abnormal laboratory values. Second-level priority problems are those that require attention after addressing first-level problems but before third-level problems. Abnormal laboratory values fall into this category because they may indicate a potential for worsening health conditions if left untreated. Low self-esteem (choice A) is typically a third-level priority, lack of knowledge (choice B) can usually be addressed as a lower priority, and severely abnormal vital signs (choice D) are considered first-level priorities due to their immediate threat to the patient's well-being.
Question 5 of 5
The nurse is performing a physical assessment on a newly admitted patient. An example of objective information obtained during the physical assessment includes the:
Correct Answer: D
Rationale: The correct answer is D because a 2.5 cm scar on the right lower forearm is an observable and measurable physical finding. Objective information in a physical assessment is data that can be directly observed or measured by the healthcare provider. Scars are physical characteristics that can be visually confirmed, making them objective. Choices A, B, and C are subjective information as they rely on the patient's report or history, which may be influenced by memory, perception, or interpretation. Therefore, they are not considered objective data.