ATI RN
Vital Signs Assessment Questions
Question 1 of 5
The nurse is conducting a pain assessment. Which question best evaluates the quality of the patient's pain?
Correct Answer: B
Rationale: The correct answer is B: What does the pain feel like? This question is best for evaluating the quality of pain because it helps determine the characteristics and nature of the pain, such as sharp, dull, throbbing, burning, etc. Understanding the specific qualities of pain can provide valuable insights into possible causes and appropriate interventions. A: When did the pain start? This question assesses the onset of pain, not its quality. C: What makes the pain better or worse? This question evaluates exacerbating or alleviating factors, not the quality of pain. D: Where is the pain located? This question assesses the location of pain, not its quality.
Question 2 of 5
The following information is best placed in which category? 'The patient had a stent placed in the left anterior descending artery (LAD) in 1999.'
Correct Answer: A
Rationale: The correct answer is A: Adult illnesses. The information about a stent placed in an artery relates to a medical procedure for a cardiovascular condition, which falls under adult illnesses. This category encompasses conditions and treatments related to the health of adults. Surgeries (B) would be too broad and not specific to the medical context provided. Obstetrics/gynecology (C) focuses on women's reproductive health and pregnancy-related issues, which are not relevant here. Psychiatric (D) pertains to mental health and psychological disorders, which is also not applicable to the given information.
Question 3 of 5
The nurse is performing a neurological assessment and notes a positive Romberg test. What does this finding indicate?
Correct Answer: B
Rationale: The Romberg test assesses balance and postural stability. A positive Romberg test indicates a deficit in proprioception, which is commonly seen in cerebellar ataxia or vestibular dysfunction. The cerebellum and vestibular system play crucial roles in maintaining balance and coordination. Cranial nerve dysfunction (A) does not directly affect balance. Peripheral neuropathy (C) primarily affects sensation and motor function, not balance. Increased intracranial pressure (D) may present with other neurological signs, but not specifically a positive Romberg test. Therefore, the correct answer is B.
Question 4 of 5
Which assessment technique is used to evaluate for the presence of fluid in the abdominal cavity?
Correct Answer: B
Rationale: The correct answer is B: Shifting dullness. This technique involves percussing the abdomen to determine if there is a change from tympanic to dull sound while the patient changes positions. This change in sound indicates the presence of fluid in the abdominal cavity, known as ascites. Rebound tenderness (A) is used to assess for peritoneal irritation, not fluid. Light palpation (C) is used to assess superficial abdominal tenderness and masses, not fluid. Deep palpation (D) is used to assess for deeper abdominal masses or organ enlargement, not fluid.
Question 5 of 5
A 60-year-old man presents with difficulty swallowing. He reports that the difficulty has been present for several months and is associated with weight loss. He has a history of smoking and heavy alcohol use. On examination, he has a palpable mass in the upper abdomen. Which of the following is the most likely cause of his symptoms?
Correct Answer: A
Rationale: The most likely cause of the man's symptoms is esophageal cancer (Choice A) due to his age, symptoms of dysphagia and weight loss, history of smoking and heavy alcohol use, and the presence of a palpable mass in the upper abdomen on examination. Esophageal cancer commonly presents with difficulty swallowing, weight loss, and risk factors such as smoking and alcohol use. The palpable mass indicates a more advanced disease stage. Choice B (Achalasia) is less likely due to the presence of a palpable mass, which is not typical of achalasia. Choice C (Gastroesophageal reflux disease) typically presents with heartburn and regurgitation rather than dysphagia and weight loss. Choice D (Peptic ulcer disease) is less likely as it does not typically cause a palpable mass or significant weight loss.