ATI RN
PN Vital Signs Assessment Questions
Question 1 of 5
The nurse needs to obtain a radial pulse from a patient. What must the nurse do to obtain a correct measurement?
Correct Answer: A
Rationale: Radial pulse is palpated with the first two fingers along the thumb side groove , ensuring accuracy without thumb pressure interference. Little finger side (B, C) is incorrect anatomically. Thumb use (C, D) distorts readings. Choice A is correct, per nursing technique standards, for reliable radial pulse measurement.
Question 2 of 5
A heart rate measurement, or pulse, can be taken at which pulse point?
Correct Answer: D
Rationale: Pulse can be palpated at radial , brachial , dorsalis pedis , and other sites , depending on accessibility and need. All are valid, with radial most common, brachial for infants, and dorsalis pedis for circulation checks. Choice D is correct, per nursing assessment flexibility, allowing pulse detection across peripheral sites to monitor cardiac function.
Question 3 of 5
The nurse is caring for a patient who has an elevated temperature. The nurse understands that
Correct Answer: D
Rationale: Hyperthermia is excessive heat production , unlike fever (set-point shift, C). They differ . Heat loss isn't the issue. Choice D is correct, per nursing pathophysiology distinguishing hyperthermia's uncontrolled rise from fever's regulated response.
Question 4 of 5
The nurse is caring for a patient who complains of feeling light-headed and 'woozy.' The nurse checks the patient's pulse and finds that it is irregular. The patient's blood pressure is 100/72. It was 113/80 an hour earlier. What should the nurse do?
Correct Answer: A
Rationale: Light-headedness, irregular pulse, and BP drop (100/72 from 113/80) suggest arrhythmia or instability; calling the physician is urgent. Apical/radial delays action. Pressure or thumb won't clarify. Choice A is correct, per escalation protocol.
Question 5 of 5
A nurse is assessing a client's blood pressure and finds it to be different in the two arms. What action should the nurse take?
Correct Answer: C
Rationale: A BP difference between arms may indicate vascular issues; reporting to the provider is priority. It's not normal . Rechecking or arm raising doesn't address the cause. Choice C is correct, per the explanation, ensuring timely evaluation.