ATI RN
Rn Vital Signs Assessment ATI Questions
Question 1 of 5
The nurse is reviewing the characteristics of breath sounds. Which statement about bronchovesicular breath sounds is true? Bronchovesicular breath sounds are:
Correct Answer: C
Rationale: Step 1: Bronchovesicular breath sounds are expected near the major airways. Step 2: Bronchovesicular sounds are heard over the 1st and 2nd intercostal spaces along the sternal border at the front and between the scapulae on the back. Step 3: The sounds are a combination of bronchial (heard over trachea and major bronchi) and vesicular (heard over peripheral lung fields) sounds. Step 4: The characteristics include moderate pitch and intensity, with equal inspiration and expiration. Step 5: Choice C is the correct answer as it accurately describes the expected location of bronchovesicular breath sounds near the major airways. Summary: A: Incorrect - Bronchovesicular breath sounds are not musical in quality. B: Incorrect - Bronchovesicular breath sounds are not usually caused by a pathologic disease. D: Incorrect - Bronchovesicular breath sounds are a combination of bronchial
Question 2 of 5
The sac that surrounds and protects the heart is called the:
Correct Answer: A
Rationale: The correct answer is A: Pericardium. The pericardium is the sac that surrounds and protects the heart. It consists of two layers - the outer fibrous pericardium and the inner serous pericardium. The fibrous pericardium provides structural support and protection, while the serous pericardium secretes fluid to reduce friction as the heart beats. Summary: B: Myocardium is the middle layer of the heart muscle responsible for pumping blood. C: Endocardium is the innermost layer of the heart lining the chambers and valves. D: Pleural space refers to the space between the lungs and the chest wall, not related to the heart.
Question 3 of 5
When listening to heart sounds, the nurse knows that the S1:
Correct Answer: C
Rationale: The correct answer is C because S1 coincides with the carotid artery pulse due to the closure of the atrioventricular valves (mitral and tricuspid). This occurs at the beginning of systole. A is incorrect as S1 is actually softer than S2 at the base of the heart. B is incorrect because S1 marks the beginning of systole, not diastole. D is incorrect as S1 is caused by the closure of the AV valves, not the semilunar valves.
Question 4 of 5
Jim is a 47-year-old man who is having difficulties with sexual function. He is recently separated from his wife of 20 years. He notes that he has early morning erections but otherwise cannot function. Which of the following is a likely cause for his problem?
Correct Answer: B
Rationale: The correct answer is B: Psychological issues. Jim's recent separation and inability to function sexually suggest a psychological cause, such as depression or anxiety. Early morning erections indicate physical capability, ruling out choices A, C, and D. Decreased testosterone levels (A) would not selectively affect sexual function, abnormal hypogastric arterial circulation (C) would lead to consistent erectile dysfunction, and impaired neural innervation (D) would affect all aspects of sexual function, not just specific situations. Therefore, psychological issues are the most likely cause for Jim's problem.
Question 5 of 5
During an assessment of an older adult, the nurse should expect to notice which finding as a normal physiologic change associated with the aging process?
Correct Answer: C
Rationale: The correct answer is C. As individuals age, their peripheral blood vessels tend to become more rigid, leading to an increase in systolic blood pressure. This is a normal physiologic change associated with aging due to the loss of elasticity in the blood vessels. This change is commonly seen in older adults and is a result of the natural aging process. Choice A is incorrect because hormonal changes in older adults do not typically cause vasodilation leading to a drop in blood pressure. Choice B is incorrect as progressive atrophy of intramuscular calf veins is not a normal physiologic change associated with aging. Choice D is also incorrect as narrowing of the inferior vena cava does not typically occur as a normal part of the aging process, leading to low blood flow and varicosities.