ATI RN
Vital Signs Assessment Questions
Question 1 of 5
Which of the following findings during a cardiovascular assessment indicates poor oxygenation?
Correct Answer: B
Rationale: The correct answer is B: Cyanosis of the lips and nail beds. Cyanosis indicates poor oxygenation due to the bluish discoloration of the lips and nail beds, suggesting insufficient oxygen in the blood. Capillary refill time less than 2 seconds (A) is a normal finding indicating good perfusion. Warm and pink extremities (C) also suggest good circulation. Bounding peripheral pulses (D) can be associated with increased cardiac output but do not directly indicate poor oxygenation.
Question 2 of 5
The nurse is auscultating heart sounds and notes a split S2 during inspiration. What does this finding indicate?
Correct Answer: A
Rationale: The correct answer is A: A normal finding. During inspiration, the intrathoracic pressure decreases, causing the pulmonary artery to fill more slowly than the aorta, resulting in a split S2. This is a physiological phenomenon known as a respiratory split, which is considered normal. Choices B, C, and D are incorrect because they do not correlate with the specific finding of a split S2 during inspiration. Mitral valve regurgitation and aortic stenosis typically present with different auscultatory findings, while heart failure may manifest with additional signs and symptoms beyond just a split S2.
Question 3 of 5
The following information is best placed in which category? 'The patient had a stent placed in the left anterior descending artery (LAD) in 1999.'
Correct Answer: A
Rationale: The correct answer is A: Adult illnesses. The information about a stent placed in an artery relates to a medical procedure for a cardiovascular condition, which falls under adult illnesses. This category encompasses conditions and treatments related to the health of adults. Surgeries (B) would be too broad and not specific to the medical context provided. Obstetrics/gynecology (C) focuses on women's reproductive health and pregnancy-related issues, which are not relevant here. Psychiatric (D) pertains to mental health and psychological disorders, which is also not applicable to the given information.
Question 4 of 5
The nurse is performing a neurological assessment and notes a positive Romberg test. What does this finding indicate?
Correct Answer: B
Rationale: The Romberg test assesses balance and postural stability. A positive Romberg test indicates a deficit in proprioception, which is commonly seen in cerebellar ataxia or vestibular dysfunction. The cerebellum and vestibular system play crucial roles in maintaining balance and coordination. Cranial nerve dysfunction (A) does not directly affect balance. Peripheral neuropathy (C) primarily affects sensation and motor function, not balance. Increased intracranial pressure (D) may present with other neurological signs, but not specifically a positive Romberg test. Therefore, the correct answer is B.
Question 5 of 5
Which assessment technique is used to evaluate for the presence of fluid in the abdominal cavity?
Correct Answer: B
Rationale: The correct answer is B: Shifting dullness. This technique involves percussing the abdomen to determine if there is a change from tympanic to dull sound while the patient changes positions. This change in sound indicates the presence of fluid in the abdominal cavity, known as ascites. Rebound tenderness (A) is used to assess for peritoneal irritation, not fluid. Light palpation (C) is used to assess superficial abdominal tenderness and masses, not fluid. Deep palpation (D) is used to assess for deeper abdominal masses or organ enlargement, not fluid.