ATI RN
Assess Vital Signs Questions
Question 1 of 5
When auscultating the lungs of an adult patient, the nurse notes that low-pitched, soft breath sounds are heard over the posterior lower lobes, with inspiration being longer than expiration. The nurse interprets that these sounds are:
Correct Answer: C
Rationale: The correct answer is C: Vesicular breath sounds and normal in that location. Vesicular breath sounds are low-pitched, soft sounds heard over most of the lung fields. In this case, they are heard over the posterior lower lobes, which is a normal location for vesicular sounds. The longer inspiration than expiration is also characteristic of vesicular breath sounds. A: Normally auscultated over the trachea - This is incorrect as breath sounds over the trachea are typically harsh and high-pitched. B: Bronchial breath sounds and normal in that location - Bronchial breath sounds are harsh, loud sounds heard over the trachea and are not normal in the posterior lower lobes. D: Bronchovesicular breath sounds and normal in that location - Bronchovesicular breath sounds are a mix of bronchial and vesicular sounds, and they are not normally auscultated in the posterior lower lobes.
Question 2 of 5
The nurse is reviewing risk factors for breast cancer. Which of these women have risk factors that place them at a higher risk for breast cancer?
Correct Answer: D
Rationale: Answer D is correct because having a first-degree relative (mother) with breast cancer is a significant risk factor for developing breast cancer. This increases the individual's risk compared to the general population. Choice A (37-year-old who is slightly overweight) is not a direct risk factor for breast cancer. Choice B (42-year-old who has had ovarian cancer) is not a known risk factor for breast cancer, although there is a link between ovarian and breast cancer. Choice C (45-year-old who has never been pregnant) is a risk factor for breast cancer but not as significant as having a family history of the disease.
Question 3 of 5
In assessing a 70-year-old man, the nurse finds the following: blood pressure 140/100 mm Hg; heart rate 104 beats per minute and slightly irregular; and the split S2 heart sound. Which of these findings can be explained by expected hemodynamic changes related to age?
Correct Answer: B
Rationale: Correct Answer: B - Increase in systolic blood pressure Rationale: 1. Age-related vascular changes lead to decreased arterial compliance. 2. Decreased arterial compliance results in increased systolic blood pressure. 3. This explains the elevated systolic blood pressure in the 70-year-old man. Other Choices: A. Increase in resting heart rate - Not typically age-related; may indicate other issues. C. Decrease in diastolic blood pressure - Usually remains stable or slightly increases with age. D. Increase in diastolic blood pressure - Not a common age-related change; may indicate other underlying conditions.
Question 4 of 5
The nurse is using a Doppler device. This tool is primarily used to:
Correct Answer: B
Rationale: The correct answer is B: Detect faint pulses. A Doppler device is used to detect and amplify weak pulses, making it an essential tool in assessing blood flow and circulation. It uses sound waves to detect movement, such as blood flow through vessels, and converts them into audible signals. This helps healthcare providers identify and monitor pulses in various parts of the body. A, C, and D are incorrect choices because: A: Assess joint range of motion. This is typically done using physical assessment techniques, such as observation and measurement, not with a Doppler device. C: Magnify low-pitched sounds. Doppler devices do not magnify sounds but rather detect and amplify specific types of movement-related signals. D: Examine the retina. Retinal examination is usually performed using specialized instruments like ophthalmoscopes, not Doppler devices.
Question 5 of 5
The nurse is reviewing the blood supply to the arm. The major artery supplying the arm is the _____ artery.
Correct Answer: C
Rationale: The correct answer is C: Brachial artery. The brachial artery is the major artery supplying the arm, running from the shoulder to the elbow. It is a continuation of the axillary artery and provides blood to the entire arm. The ulnar and radial arteries are branches of the brachial artery, supplying the forearm and hand. The deep palmar artery is a branch of the radial artery, supplying the palm of the hand. Therefore, the brachial artery is the correct choice as it is the main artery directly supplying the arm.