ATI RN
Vital Signs Assessment Questions
Question 1 of 5
Which of the following is the medically acute inpatient cardiac rehabilitation phase?
Correct Answer: A
Rationale: The correct answer is A: Phase 1. This phase is the medically acute inpatient cardiac rehabilitation phase focused on initial evaluation, stabilization, and education post-cardiac event. Phase 2 involves early outpatient exercise and education, Phase 3 is the maintenance phase, and Phase 4 is long-term independent exercise. Phase 1 is crucial for monitoring and managing acute cardiac issues, making it the correct choice.
Question 2 of 5
A patient is at the clinic to have her blood pressure checked. She has been coming to the clinic weekly since she changed medications 2 months ago. The nurse should:
Correct Answer: A
Rationale: The correct answer is A because collecting a follow-up data base allows the nurse to assess any changes in the patient's health status since her last visit, including evaluating the effectiveness of the new medication on her blood pressure. This step is essential to ensure the patient's ongoing care is appropriate and effective. Option B is incorrect because asking the patient to read her health record may not provide a comprehensive update on her current health status. Option C is incorrect as the patient's health history may have changed within the 2-month period, necessitating a reassessment. Option D is incorrect as obtaining a complete health history before checking her blood pressure may delay the assessment and may not be necessary for a routine follow-up visit.
Question 3 of 5
A young man is concerned about a hard mass he has just noticed in the midline of his palate. On examination, it is indeed hard and in the midline. There are no mucosal abnormalities associated with this lesion. He is experiencing no other symptoms. What will you tell him is the most likely diagnosis?
Correct Answer: B
Rationale: The most likely diagnosis for a hard mass in the midline of the palate with no associated mucosal abnormalities is Torus palatinus (Choice B). This is a benign bony growth that typically occurs in the midline of the hard palate. The absence of mucosal abnormalities and the hard nature of the mass are indicative of a bony growth rather than a soft tissue lesion like leukoplakia (Choice A), thrush (Choice C), or Kaposi's sarcoma (Choice D). Leukoplakia is a white patch that cannot be scraped off, thrush is a fungal infection causing creamy white lesions, and Kaposi's sarcoma usually presents as purplish lesions in immunocompromised individuals. In this case, the hard midline mass without mucosal changes points towards Torus palatinus as the most likely diagnosis.
Question 4 of 5
Which of the following is consistent with obturator sign?
Correct Answer: B
Rationale: The obturator sign is a test for appendicitis. B is correct because it describes the characteristic pain felt in the right hypogastric region when the right hip and knee are flexed and internally rotated, indicating irritation of the obturator muscle due to an inflamed appendix. A is incorrect as it describes rebound tenderness in a different location. C is incorrect as it describes pain with thigh extension or flexion, not internal rotation. D is incorrect as it describes pain that affects breathing, not related to obturator muscle irritation.
Question 5 of 5
A patient with a head injury opens the eyes to painful stimulation, mumbles incoherently when stimulated, and does not respond to a verbal command to move but localizes to painful stimulus. The nurse records the patient's Glasgow Coma Scale score as:
Correct Answer: B
Rationale: The correct answer is B: 11. According to the Glasgow Coma Scale (GCS), this patient scores 4 for eye opening (to painful stimulus), 3 for verbal response (mumbles incoherently), and 4 for motor response (localizes to painful stimulus), totaling 11. This indicates moderate brain injury. Choice A (9) is incorrect because the patient localizes to pain, indicating a higher level of responsiveness than a GCS score of 9. Choice C (13) and D (15) are also incorrect as the patient's responses do not align with a higher GCS score due to the patient's inability to follow verbal commands effectively.