ATI RN
Neurological Vital Signs Assessment Questions
Question 1 of 5
The nurse is assessing an older adult. Which action is most appropriate?
Correct Answer: B
Rationale: The correct answer is B: Minimize position changes during the exam. This is the most appropriate action because older adults may have mobility issues, so minimizing position changes helps prevent discomfort and potential injury. Speaking loudly (choice C) is not necessary unless the patient has hearing impairments. Completing the exam in one session (choice A) may be overwhelming and tiring for the patient. Performing a quick exam (choice D) may compromise the thoroughness of the assessment.
Question 2 of 5
The nurse is preparing to measure the vital signs of a 6-month-old infant. Which action by the nurse is correct?
Correct Answer: A
Rationale: The correct answer is A because in infants, it is recommended to measure respirations first, followed by pulse and temperature. Infants have irregular breathing patterns, so measuring respirations first allows for the most accurate reading. Pulse and temperature can be affected by handling the infant, so they should be measured after respirations. Choice B is incorrect because vital signs in infants are typically measured at the same frequency as in adults, unless there are specific concerns or conditions. Choice C is incorrect because involving the parent in the procedure and encouraging the infant to handle the equipment may not be appropriate or necessary for measuring vital signs accurately. Choice D is incorrect because it is not necessary to perform a physical examination before measuring vital signs in an infant. It is important to follow the standard sequence of measuring respirations, then pulse, and temperature for accurate readings.
Question 3 of 5
A 22-year-old woman comes to the clinic because of severe sunburn and states, 'I was out in the sun for just a couple of minutes.' The nurse begins a medication review with her, paying special attention to which medication class?
Correct Answer: B
Rationale: The correct answer is B: Tetracyclines for acne. Tetracyclines are known to cause photosensitivity, increasing the risk of sunburn with minimal sun exposure. The nurse should review this medication class as the patient's severe sunburn may be a side effect. Nonsteroidal anti-inflammatory drugs (Choice A) are not directly related to photosensitivity. Proton pump inhibitors (Choice C) are used for reducing stomach acid, not linked to sunburn. Thyroid replacement hormone (Choice D) does not typically cause sunburn as a side effect. Therefore, the focus on tetracyclines is crucial in this scenario.
Question 4 of 5
A mother has noticed that her son, who has been to a new babysitter, has some blisters and scabs on his face and buttocks. On examination, the nurse notices moist, thin-roofed vesicles with a thin erythematous base and suspects:
Correct Answer: B
Rationale: The correct answer is B: Impetigo. Impetigo presents with moist, thin-roofed vesicles with a thin erythematous base, commonly found on the face and buttocks. The vesicles rupture, forming honey-colored crusts. The history of a new babysitter suggests exposure to skin infections. Eczema (choice A) presents with dry, scaly patches. Herpes zoster (choice C) presents with grouped vesicles along a dermatome. Diaper dermatitis (choice D) presents with erythema and scaling in the diaper area. The key features in this case match impetigo, making it the correct choice.
Question 5 of 5
The nurse is reviewing the function of the cranial nerves (CNs). Which CN is responsible for conducting nerve impulses to the brain from the organ of Corti?
Correct Answer: C
Rationale: The correct answer is C: VIII (Vestibulocochlear nerve). This cranial nerve is responsible for conducting nerve impulses to the brain from the organ of Corti, which is located in the cochlea of the inner ear. The vestibulocochlear nerve is specifically involved in transmitting auditory information to the brain. A: CN I (Olfactory nerve) is responsible for the sense of smell, not related to the organ of Corti. B: CN III (Oculomotor nerve) controls eye movements. D: CN XI (Accessory nerve) is responsible for controlling muscles of the neck and shoulders, not related to auditory functions. In summary, choice C is correct because the Vestibulocochlear nerve is specifically responsible for transmitting auditory information from the organ of Corti to the brain, while the other choices are not related to this specific function.