ATI RN
Vital Signs Assessment Nursing Questions
Question 1 of 5
Which of the following assessments is most indicative of adequate peripheral circulation?
Correct Answer: B
Rationale: The correct answer is B: Capillary refill time less than 2 seconds. This assessment is indicative of adequate peripheral circulation because it measures how quickly blood refills in the capillaries after they have been compressed. A capillary refill time of less than 2 seconds indicates normal circulation, as it demonstrates that blood is flowing efficiently to the extremities. Rationale: A: Pallor in the extremities indicates poor circulation and reduced blood flow, which is not indicative of adequate peripheral circulation. C: Cool skin temperature in the lower extremities suggests vasoconstriction and reduced blood flow, not adequate circulation. D: Diminished dorsalis pedis pulse indicates a weak or absent pulse in the foot, which is a sign of impaired circulation and not indicative of adequate peripheral circulation.
Question 2 of 5
A patient recently admitted to an acute care hospital is referred to physical therapy. The physical therapist documents the following clinical signs: pallor, cyanosis, and cool skin. These clinical signs are MOST consistent with:
Correct Answer: B
Rationale: The clinical signs of pallor, cyanosis, and cool skin are indicative of poor oxygenation and circulation, which are commonly seen in anemia. Anemia leads to reduced oxygen-carrying capacity, resulting in pallor and cyanosis. Cool skin is a result of decreased blood flow. Cor pulmonale is related to right heart failure due to lung disease, not directly related to the signs described. Hypertension typically presents with elevated blood pressure, not the signs mentioned. Diaphoresis refers to excessive sweating, which is not associated with the described clinical signs. Therefore, the correct answer is B (anemia) based on the patient's presentation.
Question 3 of 5
A physical therapist reviews the medical record of a patient diagnosed with Parkinson's disease. Which clinical finding would the therapist MOST likely observe?
Correct Answer: A
Rationale: The correct answer is A: Hypertonicity. In Parkinson's disease, there is a loss of dopamine-producing cells, leading to increased muscle tone or hypertonicity. This results in stiffness and rigidity of muscles, making movements slow and difficult. Hypotonicity (B) refers to decreased muscle tone and is not typically seen in Parkinson's. Hyperreflexia (C) is an exaggerated reflex response, which is not a common feature of Parkinson's. Hyporeflexia (D) is reduced reflex response, which is not typically associated with Parkinson's disease. Hence, the most likely clinical finding in a patient with Parkinson's disease would be hypertonicity.
Question 4 of 5
A physical therapist uses an incentive spirometer with a patient post-thoracic surgery. The PRIMARY purpose of this intervention is to:
Correct Answer: D
Rationale: The correct answer is D: Prevent pulmonary complications. Using an incentive spirometer post-thoracic surgery helps prevent atelectasis and pneumonia by promoting lung expansion, improving ventilation, and clearing secretions. This intervention aids in maintaining lung function and preventing respiratory complications. A: Promote relaxation - While using an incentive spirometer may induce relaxation as a side effect, the primary purpose is not relaxation but rather to prevent pulmonary complications. B: Improve inspiratory muscle strength - Although using an incentive spirometer can help improve inspiratory muscle strength, the primary purpose is to prevent pulmonary complications. C: Reduce pain during breathing - While using an incentive spirometer may indirectly reduce pain by promoting optimal lung function, the primary purpose is to prevent pulmonary complications.
Question 5 of 5
A physical therapist works with a patient who has a deep partial-thickness burn on the upper extremity. Which dressing would be MOST appropriate for this type of wound?
Correct Answer: B
Rationale: The correct answer is B: Silver sulfadiazine dressing. This choice is correct because silver sulfadiazine has antimicrobial properties that can help prevent infection in deep partial-thickness burns. It also provides a moist environment for wound healing. A: Hydrocolloid dressing is not ideal for deep partial-thickness burns as it may not provide enough antimicrobial protection. C: Gauze dressing with saline is not the best choice as it can dry out the wound and may not provide adequate protection against infection. D: Transparent film dressing is not suitable for deep partial-thickness burns as it does not provide the necessary antimicrobial properties and may not allow proper wound healing.