ATI RN
Vital Signs Assessment Chapter 7 Questions
Question 1 of 5
When listening to heart sounds, the nurse knows the valve closures that can be heard best at the base of the heart are:
Correct Answer: C
Rationale: The second heart sound (S2) occurs with the closure of the semilunar (aortic and pulmonic) valves and signals the end of systole. Although it is heard over all the precordium, the S2 is loudest at the base of the heart.
Question 2 of 5
G.R. is a 75-year-old male who presents to the emergency department with chest pain, palpitations, and appears pale and diaphoretic. As the history and physical are completed, the following problems emerge. Please label them first-, second-, or third-level priority problems. b. Serum potassium 2.7 mmol/L (low), Glucose 225 mg/dL (high)
Correct Answer: A
Rationale: Low potassium and high glucose levels are critical and require immediate attention, making this a first-level priority.
Question 3 of 5
During an assessment, the nurse knows that expected assessment findings in the normal adult lung include the presence of:
Correct Answer: C
Rationale: Normal lung findings include symmetric chest expansion, resonant percussion tones, vesicular breath sounds over the peripheral lung fields, muffled voice sounds, and no adventitious sounds.
Question 4 of 5
The nurse is performing a respiratory assessment and notes decreased tactile fremitus over the left lower lung field. What does this finding most likely indicate?
Correct Answer: B
Rationale: Decreased tactile fremitus is commonly associated with pleural effusion due to fluid accumulation.
Question 5 of 5
The nurse is performing a musculoskeletal assessment and notes that the patient has a decreased range of motion in the knee joint. What is the most likely cause of this finding?
Correct Answer: A
Rationale: Decreased range of motion in the knee joint is often a result of osteoarthritis, a condition characterized by the degeneration of joint cartilage.