ATI RN
CNS Vital Signs Assessment Questions
Question 1 of 5
The nurse needs to take the temperature of a patient who had a cardiac arrest. Which route will the nurse use?
Correct Answer: C
Rationale: Post-cardiac arrest, tympanic provides a quick, non-invasive core temperature estimate, critical for monitoring hypothermia or hyperthermia in resuscitation. Oral risks inaccuracy post-arrest. Rectal is invasive and slow. Temporal is less reliable in emergencies. Choice C is correct, aligning with ACLS emphasis on rapid, safe temperature assessment.
Question 2 of 5
A blood pressure reading consists of a top number, or , and bottom number, or
Correct Answer: C
Rationale: BP readings show systolic (top, ventricular contraction) and diastolic (bottom, relaxation) pressures , in mmHg. Oxygen saturation and pulse are separate. Diastolic over systolic reverses order. Millimeters and mercury is the unit, not the terms. Choice C is correct, per standard BP notation (e.g., 120/80 mmHg), a foundational nursing concept for documenting cardiac workload.
Question 3 of 5
A patient returns to your postoperative unit following surgery for right shoulder rotator cuff repair. The licensed practical nurse (LPN) reports that she had difficulty obtaining the patient's heart rate from his right radial pulse. What is your best response?
Correct Answer: A
Rationale: Post-shoulder surgery, right radial pulse may be weak due to positioning or swelling; apical pulse ensures accuracy. Bilateral radial is redundant. Oximeter is less reliable for rate. Full pulse check is excessive. Choice A is correct, per nursing focus on apical accuracy post-surgery.
Question 4 of 5
The patient is being admitted to the emergency department with complaints of shortness of breath. The patient has had chronic lung disease for many years but still smokes. The nurse should
Correct Answer: B
Rationale: Chronic lung disease (e.g., COPD) risks CO2 retention; cautious oxygen avoids suppressing hypoxic drive. High oxygen is dangerous. Paper bag and CO2 worsen hypoxia. Choice B is correct, per respiratory nursing.
Question 5 of 5
A nurse is assessing a client's blood pressure. Which of the following should the nurse use to measure blood pressure accurately?
Correct Answer: D
Rationale: A sphygmomanometer and stethoscope measure BP accurately via Korotkoff sounds. Palpation assesses pulse, not BP. Lung sounds and skin color don't measure pressure. Choice D is correct, per the explanation, aligning with standard BP technique.