ATI RN
Health Assessment Vital Signs Quizlet Questions
Question 1 of 5
When auscultating for bowel sounds, the nurse should:
Correct Answer: C
Rationale: The correct answer is C: Use the diaphragm of the stethoscope. The diaphragm is the appropriate part of the stethoscope for listening to bowel sounds due to its ability to pick up higher frequency sounds. Bowel sounds are best heard with a higher frequency range, which the diaphragm is designed to capture. Using the bell of the stethoscope (choice A) is not ideal for bowel sounds as it is better suited for low-frequency sounds like heart murmurs. Ensuring the patient is standing upright (choice B) is unnecessary for auscultating bowel sounds. Avoiding pressing the stethoscope too firmly (choice D) is a good practice to prevent unnecessary noise interference, but it is not directly related to the optimal choice of stethoscope component for bowel sounds.
Question 2 of 5
The nurse is helping another nurse to take a blood pressure reading on a patient's thigh. Which action is correct regarding thigh pressure?
Correct Answer: C
Rationale: The correct answer is C. When the blood pressure in the arm is high in an adolescent, it should be compared with thigh pressure. This is because in certain conditions like coarctation of the aorta, there can be a significant difference in blood pressure between the arms and thighs. By comparing arm and thigh pressures, the nurse can assess for potential underlying cardiovascular issues. A: Auscultating the popliteal or femoral vessels is not necessary for obtaining thigh pressure as the correct method is comparing arm and thigh pressures. B: The position for measuring thigh pressure is not specified, and the focus should be on comparing arm and thigh pressures. D: The difference in pressure between the arm and thigh is not solely due to distance from the heart and vessel size; it can be indicative of cardiovascular abnormalities.
Question 3 of 5
During an examination, the nurse finds that a patient has excessive dryness of the skin. The best term to describe this condition is:
Correct Answer: A
Rationale: Step 1: Identify the patient's symptom - excessive dryness of the skin. Step 2: Recall the term for this condition - xerosis, characterized by dry skin. Step 3: Eliminate other choices - pruritus means itching, alopecia refers to hair loss, seborrhea is excessive oiliness. Step 4: Confirm xerosis as the best fit due to matching symptomatology. Step 5: Choose option A as the correct answer for precise description of the patient's condition.
Question 4 of 5
A patient has had a 'terrible itch' for several months that he has been continuously scratching. On examination, the nurse might expect to find:
Correct Answer: D
Rationale: The correct answer is D: Lichenification. Lichenification is a skin condition characterized by thickening and hardening of the skin due to chronic irritation or scratching. In this case, the patient's continuous scratching of the itch has led to lichenification. This is evident by the rough and leathery texture of the skin upon examination. A: A keloid is an overgrowth of scar tissue that can occur after a wound heals, not typically associated with chronic scratching. B: A fissure is a small, painful crack in the skin that can occur due to dryness or trauma, not a result of continuous scratching. C: Keratosis refers to various skin conditions characterized by thickening of the skin, but it is not specifically associated with chronic scratching like lichenification. In summary, lichenification is the most likely finding in this scenario due to the chronic scratching leading to skin thickening and hardening.
Question 5 of 5
A patient with a middle ear infection asks the nurse, 'What does the middle ear do?' The nurse responds by telling the patient that the middle ear functions to:
Correct Answer: C
Rationale: The correct answer is C: Conduct vibrations of sounds to the inner ear. The middle ear consists of the eardrum and three small bones that transmit sound vibrations from the eardrum to the inner ear. This process allows sound waves to be converted into electrical signals that can be interpreted by the brain. Choice A is incorrect because balance is primarily controlled by structures in the inner ear, not the middle ear. Choice B is incorrect as interpreting sounds happens in the inner ear and brain, not the middle ear. Choice D is incorrect because the middle ear does not increase the amplitude of sound; rather, it amplifies and transmits sound vibrations to the inner ear for further processing.