323-Chapter 20- Vital Signs

Which blood pressure reading would be seen in an adult with hypotension? -Systolic BP below 110 mm Hg -Diastolic BP above 60 mm Hg -Systolic BP below 90 mm Hg -Diastolic BP below 60 mm Hg

Systolic BP below 90 mm Hg- A systolic BP below 90 mm Hg indicates hypotension.

The temperature of a 3-year-old child with bilateral otitis externa is best taken with which thermometer? -Tympanic -Axillary -Oral -Temporal artery

Temporal artery- The temporal artery reading is most accurate and easiest to use in young children.

Which site for taking an infant's body temperature is considered to give the most accurate results? -Axilla -Tympanic membrane -Sublingual -Temporal artery

Temporal artery- The temporal artery temperature and rectal methods provide the most accurate reflection of core infant temperatures.

A safe and accurate method of recording the temperature of a 6-month-old infant is with which thermometer? -Rectal -Temporal artery -Axillary -Tympanic

Temporal artery- The temporal artery thermometer is recommended for infants and is safer than rectal methods.

Which of the following pulses is palpated on either side of the eyes? -Apical -Brachial -Carotid -Radial -Temporal

Temporal- The temporal pulses are located on the side of the head at eye level.

Which of the following sites are typically used to obtain a pulse on young children and infants and is heard with a stethoscope? -The carotid artery -The apical heart rate -The radial artery -The brachial pulse

The apical heart rate- The apical heart rate, or the heartbeat at the apex of the heart, is heard with a stethoscope. It is used for infants and young children because the radial pulse is difficult to palpate in young patients.

When documenting a temperature reading on the patient chart, what abbreviation should be used to indicate the site of an oral reading? -T -A -TA -The site does not have to be indicated

The site does not have to be indicated- When obtaining an oral temperature, you do not have to indicate the site when documenting the reading in the patient's health record. However, if you use an alternative site, you should write (or put in the correct window in the EHR) the following identifiers after recording the temperature: (T) for tympanic, (A) for axillary, or (TA) for temporal artery.

What are the effects of using a blood pressure cuff that is one size larger than appropriate? -The systolic and diastolic can be lowered by as much as 5 mm Hg. -The BP can be elevated by up to 6 mm Hg. -The systolic will be elevated by up to 5 mm Hg, and the diastolic will remain the same. -The diastolic will be lowered by up to 5 mm Hg, and the systolic will remain the same.

The systolic and diastolic can be lowered by as much as 5 mm Hg.- To obtain a correct blood pressure reading, the proper-sized cuff must be used. The systolic and diastolic blood pressures can be lowered by as much as 5 mm Hg if the cuff is one size larger than appropriate; the blood pressure can be elevated by up to 6 mm Hg if the cuff is one size smaller.

When measuring a pulse, which of the following is not one of the three important characteristics? -Rate -Rhythm -Volume -Tone

Tone- When measuring a pulse, you must note three important characteristics: rate, rhythm, and volume. These characteristics vary with the size and elasticity of the artery and the strength and regularity of the heart's contractions.

Which of the following systems requires the shortest length of time to obtain an accurate temperature reading? -Digital thermometer -Tympanic thermometer -Temporal artery scanner -Axillary thermometer

Tympanic thermometer- Tympanic measurement systems obtain accurate readings in less than 2 seconds. Digital thermometers sound a beep when the process is complete (10 to 60 seconds). Temporal artery scanners record an accurate temperature in about 3 seconds.

The diastolic BP is heard during which Korotkoff phase? -I -II -III -IV -V

V- Phase V is the last phase, in which the last sound is heard, the diastolic reading.

Dr. Xu is concerned that an elderly patient may be experiencing orthostatic hypotension. How would you check this patient's BP? -Instruct the patient to lie flat on her back while you take the BP. -Have the patient sit up on the side of the bed for 5 minutes before recording the BP. -With the cuff in place, take the BP with the patient lying down and then immediately after she stands. -Take the BP bilaterally 2 minutes apart.

With the cuff in place, take the BP with the patient lying down and then immediately after she stands.- Orthostatic hypotension is diagnosed if a significant drop in BP occurs when the patient moves from a lying down position to standing.

A newborn is observed in the nursery with periodic episodes of not breathing. This is called: -bradypnea. -apnea. -hyperpnea. -rales.

apnea- Apnea means without breathing.

Mrs. Anderson's oral temperature is 99°F. Dr. Xu requests that you record it in Celsius. What would that be? -32.6°C -37.8°C -35.8°C -37.2°C

-37.2°C- Fahrenheit temperatures are converted to Celsius using the following formula: °C = (°F - 32) x 5/9.

How long should the pulse be counted for the most accurate results? -15 seconds -30 seconds -45 seconds -1 minute

1 minute- Taking the pulse for a full 60 seconds allows for the most accurate recording.

Your office uses thermometers that record temperatures in Celsius, but the mother of a young child doesn't understand what 38.6°C means. Convert the temperature into Fahrenheit for her. -99°F -103.2°F -101.5°F -100.8°F

101.5°F- The conversion formula is °F = (°C x 1.8) + 32.

Mr. Garcia weighs 250 lb. You are expected to record this weight in kilograms. It is equal to________ kg. -113.6 -550 -555.5 -122.3

113.6- To convert pounds to kilograms, divide the weight in pounds by 2.2.

Sammy Feaver, age 6, weighs 21.4 kg. His mother asks you how much that is in pounds. You respond: -12.4. -51. -47.1. -9.7.

47.1- To convert kilograms to pounds, multiply the number of kilograms by 2.2.

Which of the following pulse rates are typically found on well-conditioned athletes? -50 to 60 beats per minute -60 to 70 beats per minute -70 to 80 beats per minute -80 to 90 beats per minute

50 to 60 beats per minute- Well-conditioned athletes tend to have pulse rates of 50 to 60 beats per minute because consistent aerobic exercise strengthens the heart muscle (the myocardium) so that each heart contraction ejects an increased volume of blood into the arterial system. It usually is faster in women (70 to 80 beats per minute) than in men (60 to 70 beats per minute). Children tend to have more rapid pulse rates than adults.

An aural thermometer should not be used if the patient has: -chest pain. -bilateral impacted cerumen. -tachycardia. -pierced ears.

bilateral impacted cerumen.- Impacted cerumen in both ears would act as an obstruction, preventing the thermometer from reading the temperature of the tympanic membrane.

Mrs. Anderson's BP reading is 132/74 mm Hg. Her pulse pressure would be: -42. -58. -14. -26.

58.- The pulse pressure is the difference between the systolic and diastolic readings.

What would be considered a normal pulse for an average-sized 37-year-old patient in good health? -50 to 60 beats per minute -60 to 70 beats per minute -50 to 70 beats per minute -60 to 80 beats per minute

60 to 80 beats per minute- The average adult pulse rate is 80 beats per minute.

The temperature diurnal variation is typically: -95.6° to 98.3° F -96.7° to 99° F -97.2° to 102° F -98.2° to 98.1°° F

96.7° to 99° F- Diurnal rhythm varies from 97.6°F to 99°F (36.4°C to 37.2°C); the average daily temperature is 98.6°F (37°C). Body temperature is lowest in the morning and highest in the late afternoon.

When compared to the average patient, the expected resting pulse of a marathon runner would be: -increased. -decreased. -the same. -dependent on age.

decreased.- Conditioned athletes typically have slower resting pulse rates.

As a blood pressure cuff is deflated, the last tapping sound heard is the __________ pressure. -mean arterial -systolic -diastolic -pulse

diastolic- The diastolic pressure is the last detected sound when the BP is taken.

Your patient is having difficulty breathing. The medical term for this is: -orthopnea. -hyperpnea. -apnea. -dyspnea.

dyspnea- Dyspnea is difficulty breathing.

The internal functions of the body are constantly adapting and changing to keep the body in balance. Maintenance of this complex process is called: -diurnal rhythms. -homeostasis. -bounding back. -intermittent relief.

homeostasis.- Homeostasis works to keep all functions of the body within normal range.

If a patient is diagnosed with secondary hypertension, this means that the: -condition has worsened from essential hypertension. -patient has the most serious form of hypertension. -patient has the most common form of hypertension. -hypertension is associated with another disease.

hypertension is associated with another disease.- Secondary hypertension occurs when a disease process has caused it, such as kidney disease.

Persistent readings of 90/60 mm Hg or lower usually are considered: -hypotension. -orthostatic hypotension. -stage 1 hypertension. -stage 2 hypertension.

hypotension.- Hypotension is an abnormally low blood pressure, which may be caused by emotional or traumatic shock; hemorrhage; central nervous system (CNS) disorders; and chronic wasting diseases. Persistent readings of 90/60 mm Hg or lower usually are considered hypotensive.

If a patient is anxious, the medical assistant would expect the pulse to be: -increased. -decreased. -the same. -dependent on age.

increased- Tachycardia can occur with anxiety.

The process of chemical and physical change in the body that produces heat is called: -homeostasis. -metabolism. -dyspnea. -pyrexia.

metabolism.- Metabolism is the process of chemical and physical change in the body that produces heat. Homeostasis is internal adaptation and change in response to environmental factors; multiple functions that attempt to keep the body's functions in balance. Dyspnea is difficult or painful breathing. Pyrexia is a febrile condition or fever.

One reason to not use a tympanic thermometer is: -patient has small ears. -otitis externa. -difficulty hearing. -smoking.

otitis externa.- Otitis externa causes pain when the ear is manipulated, so using an aural thermometer would be uncomfortable for the patient.

The medical term for an oral temperature above 100.5°F is: -hyperpnea. -pyrexia. -pyuria. -empyema.

pyrexia- Pyrexia is the medical term for fever.

A common pediatric pulse arrhythmia that varies with breathing is called: -intermittent pulse. -apnea. -sinus arrhythmia. -thready.

sinus arrhythmia.- Sinus arrhythmia is a normal variation of the pulse rate that accompanies respirations in young children.

Stertorous breathing often is described as sounding similar to: -snoring. -wheezing. -gasping. -rales.

snoring- Stertorous breathing is very labored and creates a raspy, snoring sound.

The instrument used to measure the blood pressure is the: -stethoscope. -sphygmomanometer. -spirometer. -analog dial.

sphygmomanometer.- The sphygmomanometer measures BP.

The instrument that measures the volume of inspired and expired air is called a(n): -audiometer. -spirometer. -breathing machine. -CPAP.

spirometer- A spirometer is used to measure breathing volumes.

As a blood pressure cuff is deflated, the first tapping sound is the ______ pressure. -mean arterial -systolic -diastolic -pulse

systolic- The first sound heard is the systolic reading.

While taking vital signs on Mrs. Anderson, you note a difference between her radial and apical pulses. This problem is known as: -the pulse pressure. -arrhythmia. -the intermittent pulse. -the pulse deficit.

the pulse deficit.- If the radial pulse is lower than the apical pulse, the patient may have peripheral vascular disease.

Which of the following symptoms may indicate that the patient has hypertension? -Epistaxis -Headache -Vertigo -Angina -All are correct

All are correct- Complications of hypertension may include nosebleeds, headache, dizziness, and chest pain.

Aural temperatures are recommended for adults, when possible, because the: -tympanic membrane shares the blood supply of the hypothalamus. -ear canal is a protected cavity. -risk of spreading communicable diseases is reduced. -All are correct

All are correct- The aural temperature is an accurate, safe, and efficient method of taking the temperature of older children and adults.

Which of the following pulses is auscultated with a stethoscope? -Apical -Brachial -Temporal -Radial -Carotid

Apical- Apical pulses are heard through a stethoscope.

An infant's pulse typically is taken by which method? -Auscultating over the apex of the heart -Palpating the brachial artery -Palpating the carotid artery -Auscultating the brachial artery

Auscultating over the apex of the heart- Auscultating the apical pulse is the most accurate method of measuring the pulse of an infant.

When you are taking a radial pulse, where should you position the arm relation to the level of the heart? -Above or at the same level -Below or at the same level -Only at the same level -It does not matter as long as the patient is comfortable

Below or at the same level- The arm should be placed at the same level or lower than the heart to obtain the most accurate reading.

Your patient has been diagnosed with uncontrolled hypertension. How would you expect his pulse to feel? -Strong -Weak -Bounding -Normal

Bounding- Hypertension causes excessive pressure on blood vessel walls; therefore, the pulse would feel very strong.

The stethoscope typically is placed over which artery when the BP is taken? -Radial -Aorta -Brachial -Carotid

Brachial- Most commonly, BP readings are heard over the brachial artery in the antecubital space.

Which of the following pulses is palpated in the antecubital space? -Apical -Brachial -Carotid -Radial -Temporal

Brachial- The brachial pulse is found in the crevice of the elbow.

Which of the following pulses is palpated in the neck? -Apical -Brachial -Carotid -Radial -Temporal

Carotid- The carotid pulses are located on either side of the thyroid gland in the neck.

Gil's mother calls to make an appointment for her son. She reports that he has had an elevated temperature for 24 hours, ranging from 99°F to 102.8°F. Mrs. Harris is describing which type of fever? -Constant -Remittent -Intermittent -Continuous

Continuous-

Which of the following assessments is not referred to as a cardinal sign? -Temperature -Pulse and respiration -Blood pressure -Height, weight, and BMI

Height, weight, and BMI- Anthropometric measurements are not considered vital signs but usually are obtained at the same time as vital signs. These measurements include height, weight, body mass index (BMI), and other body measurements, such as fat composition and an infant's head circumference. The vital signs are the patient's temperature, pulse, respiration, and blood pressure.

The systolic BP is measured during which Korotkoff phase? -I -II -III -IV -V

I- Phase I is the first sound heard and is the systolic reading.

If a bedridden patient has chills and is shivering, what would you expect the body temperature to be? -Increased -Decreased -The same -It would depend on the patient's age.

Increased- Shivering causes an increase in body temperature because of the energy being released.

You are asking a patient about his reason for visiting the doctor. He says that he has had a fever for 2 days that comes and goes; sometimes his temperature is normal, but other times it is elevated. This is what type of fever? -Remittent -Pyrexic -Frequent -Intermittent

Intermittent- An intermittent fever comes and goes, fluctuating between normal and elevated levels.

The goal of hypertensive treatment is to keep the blood pressure below 130/80 mm Hg in patients with what disease or diseases? -Liver disease -Kidney complications -Diabetes mellitus -Liver disease and diabetes mellitus -Kidney complications and diabetes mellitus

Kidney complications and diabetes mellitus- Management of high blood pressure is more aggressive in patients with diabetes and/or kidney disease to prevent further complications.

Which of the following pulses is palpated behind the knee? -Apical -Brachial -Carotid -Radial -None are correct

None are correct- The popliteal pulses are palpated behind the knees.

Which of the following respiration characteristics frequently occurs in patients with congestive heart failure and COPD? -Orthopnea -Wheezing -Hyperventilation -Hyperpnea

Orthopnea- Orthopnea frequently occurs in patients with congestive heart failure (CHF) and COPD. Wheezing signals difficulty breathing in patients with asthma. Hyperpnea usually is accompanied by hyperventilation and often occurs when the patient is extremely anxious or in pain.

Which of the following pulses is palpated on top of the foot? -Apical -Brachial -Pedal -Radial -Temporal

Pedal- The pedal pulses are palpated across the arch of the foot.

How can you help patients feel comfortable about having their weight measured in the office? -Reassure them that their weight is at a healthy level. -Place the scale in a private area of the office. -Have them remain in their shoes and outer clothing. -Allow them to weigh themselves at home and bring the results.

Place the scale in a private area of the office.- Privacy is a significant factor when weighing patients.

Which of the following pulses is palpated on the wrist? -Apical -Brachial -Carotid -Radial -Temporal

Radial- The radial pulse is felt at the wrist.

Which of the following best describes a fever that fluctuates considerably (e.g., by more than 3 °) and never returns to the normal range? -Continuous fever -Intermittent fever -Remittent fever -Pyrexia

Remittent fever- Remittent fever fluctuates considerably (i.e., by more than 3 degrees) and never returns to the normal range. Continuous fever rises and falls only slightly during a 24-hour period. The temperature consistently remains above the patient's average normal temperature range and fluctuates less than 3 degrees. Intermittent fever comes and goes, alternating between elevated and normal levels.