ATI RN
Vital Signs Assessment Questions
Question 1 of 5
The nurse is conducting a patient interview. Which statement made by the patient should the nurse more fully explore during the interview?
Correct Answer: C
Rationale: The correct answer is C: "I never did too good in school." This statement indicates potential underlying issues like learning disabilities or lack of education, affecting the patient's understanding of health information. The nurse should explore this further to assess the patient's health literacy. Choices A, B, and D are less critical as they do not directly impact the patient's health status or the interview process.
Question 2 of 5
The nurse is preparing to perform a physical assessment. Which statement is true about the physical assessment? The inspection phase:
Correct Answer: B
Rationale: The correct answer is B: Takes time and reveals a surprising amount of information. During the inspection phase of a physical assessment, the nurse carefully observes the patient's appearance, behavior, and movements. This phase is crucial as it provides valuable visual information about the patient's overall health status, potential abnormalities, and clues for further assessment. By taking time and paying attention to detail during inspection, the nurse can gather significant data that can guide the rest of the assessment process. The other choices are incorrect because: A) Inspecting usually yields valuable information, C) Discomfort is not a typical characteristic of the inspection phase, and D) Inspection requires thorough observation, not just a quick glance before palpation.
Question 3 of 5
When using an otoscope to examine a patient, the nurse:
Correct Answer: C
Rationale: The correct answer is C because when using an otoscope, the nurse should direct light onto the tympanic membrane (eardrum) to visualize its condition. This helps in assessing ear health and identifying any abnormalities or infections. Choice A is incorrect as an otoscope is not used to visualize sinuses. Choice B is incorrect as it refers to examining inner ear structures which is beyond the scope of an otoscope. Choice D is incorrect as external lesions are not typically assessed using an otoscope.
Question 4 of 5
The nurse is examining a patient who is complaining of "feeling cold." Which is a mechanism of heat loss in the body?
Correct Answer: B
Rationale: The correct answer is B: Radiation. Heat loss through radiation occurs when the body emits infrared radiation to the surrounding environment. This is a passive process and can account for a significant amount of heat loss. Exercise (choice A) generates heat due to muscle activity, leading to increased body temperature. Metabolism (choice C) is the process by which the body converts food into energy and does not directly result in heat loss. Food digestion (choice D) also contributes to metabolic processes and energy production, rather than heat loss.
Question 5 of 5
The nurse has collected the following information on a patient: palpated blood pressure–180 mm Hg; auscultated blood pressure–170/100 mm Hg; apical pulse–60 beats per minute; radial pulse–70 beats per minute. What is the patient's pulse pressure?
Correct Answer: B
Rationale: The pulse pressure is calculated by subtracting the diastolic blood pressure from the systolic blood pressure. In this case, the systolic blood pressure is 170 mm Hg and the diastolic blood pressure is 100 mm Hg. Therefore, 170 - 100 = 70 mm Hg, which is the patient's pulse pressure. A: 10 - Incorrect. This value is too low for the pulse pressure given the systolic and diastolic blood pressure readings. C: 80 - Incorrect. This value is too high for the pulse pressure given the systolic and diastolic blood pressure readings. D: 100 - Incorrect. This value is equal to the diastolic blood pressure, not the pulse pressure.