ATI RN
ATI Vital Signs Assessment Questions
Question 1 of 5
Which of these techniques uses the sense of touch to assess texture, temperature, moisture, and swelling?
Correct Answer: A
Rationale: The correct answer is A: Palpation. Palpation is the technique of using the sense of touch to assess various aspects such as texture, temperature, moisture, and swelling. It involves feeling the body with the hands to gather information about the underlying structures. Inspection (B) is the visual examination, not tactile. Percussion (C) is tapping on the body to listen for sounds, not assessing through touch. Auscultation (D) is listening to sounds within the body using a stethoscope, not related to touch assessment.
Question 2 of 5
When evaluating the temperature of older adults, the nurse should remember which aspect about an older adult's body temperature?
Correct Answer: A
Rationale: The correct answer is A because older adults tend to have a lower baseline body temperature compared to younger adults. This is due to age-related changes in metabolism and decreased efficiency of thermoregulation. As people age, their metabolic rate decreases, leading to less heat production. Additionally, older adults may have impaired ability to adapt to temperature changes. Choice B is incorrect because young children typically have higher body temperatures than older adults. Choice C is incorrect as body temperature may vary slightly with different types of thermometers but the overall trend of lower temperature in older adults remains. Choice D is incorrect as while older adults may have decreased heat control mechanisms, their body temperature still tends to be lower rather than widely varying.
Question 3 of 5
A patient is seen in the clinic for complaints of "fainting episodes that started last week." How should the nurse proceed with the examination?
Correct Answer: C
Rationale: Rationale: 1. Recording blood pressure in lying, sitting, and standing positions helps assess for orthostatic hypotension. 2. Orthostatic hypotension can cause fainting episodes when changing positions. 3. Lying, sitting, and standing readings provide a comprehensive evaluation of blood pressure changes. 4. It helps in identifying if there is a significant drop in blood pressure from lying to standing. 5. This approach aligns with best practices in diagnosing syncope and fainting episodes. Summary of Other Choices: A. Taking blood pressure in arms and thighs is not relevant to assessing orthostatic changes. B. Only taking blood pressure in a lying position does not provide a complete evaluation of potential orthostatic issues. D. Averaging lying and sitting positions may miss important changes when transitioning to a standing position.
Question 4 of 5
The nurse is bathing an 80-year-old man and notices that his skin is wrinkled, thin, lax, and dry. This finding would be related to which factor in the older adult?
Correct Answer: D
Rationale: The correct answer is D because as individuals age, there is a natural decline in elastin production and a reduction in subcutaneous fat, leading to thin, lax, and dry skin. Increased vascularity (choice A) would not cause the described skin changes. Increased sweat and sebaceous glands (choice B) typically occur during puberty, not in older adults. An increase in elastin and a decrease in subcutaneous fat (choice C) would not result in the specific skin characteristics mentioned. Therefore, choice D is the most appropriate explanation for the observed skin changes in the elderly man.
Question 5 of 5
The nurse notices that a patient has a solid, elevated, circumscribed lesion that is less than 1 cm in diameter. When documenting this finding, the nurse reports this as a:
Correct Answer: D
Rationale: Step-by-step rationale: 1. A papule is a solid, elevated lesion less than 1 cm in diameter, fitting the description. 2. A bulla is a large vesicle greater than 1 cm, not fitting the size criteria in the question. 3. A wheal is a raised, erythematous, edematous papule or plaque, not solid as described. 4. A nodule is a solid, raised lesion larger than 1 cm, not fitting the size criteria in the question. In summary, the correct answer is D (Papule) because it accurately describes the size and characteristics of the lesion in question, while the other options do not match the given description.