ATI RN
Vital Signs Assessment Questions
Question 1 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 2 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 3 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.
Question 4 of 5
The nurse is examining a patient who tells the nurse, 'I sure sweat a lot, especially on my face and feet but it doesn't have an odor.' The nurse knows that this condition could be related to:
Correct Answer: A
Rationale: The correct answer is A: Eccrine glands. Eccrine glands are responsible for producing sweat that is mostly composed of water and salts. Excessive sweating on the face and feet without odor is characteristic of eccrine gland activity. Eccrine glands are distributed throughout the body and help regulate body temperature through sweat production. Apocrine glands, choice B, produce a thicker sweat that can lead to body odor. Choices C and D are related to the skin's outer layers and not directly associated with sweating.
Question 5 of 5
A 35-year-old pregnant woman comes to the clinic for a monthly appointment. During the assessment, the nurse notices that she has a brown patch of hyperpigmentation on her face. The nurse continues the skin assessment aware that another finding may be:
Correct Answer: C
Rationale: The correct answer is C: Chloasma. Chloasma, also known as melasma, is a common skin condition characterized by brown patches of hyperpigmentation on the face, particularly during pregnancy. This is due to hormonal changes that increase melanin production. Keratoses (A) are rough, scaly skin growths. Xerosis (B) is dry skin. Acrochordons (D) are skin tags. The nurse should be aware that chloasma is a common finding during pregnancy and continue the assessment accordingly.