vital signs test
A nurse is preparing an in-service about vital signs for a group of newly hired assistive personnel. Which of the following information should the nurse include about measuring body temperature?
Oral temperature is easily accessible despite a client's position
A nurse is caring for a client who has an increase in cardiac afterload. Which of the following findings should the nurse expect?
Increase in blood pressure
A nurse is discussing the use of a client's thigh for blood pressure measurement with an assistive personnel (AP). Which of the following information should the nurse include?
Use the thigh to obtain blood pressure when a client has severe edema in their arms
A nurse is reviewing the vital signs of four clients. The nurse should identify that which of the following clients has a vital sign outside of the expected reference range?
A 23-year-old client who runs marathons and has a blood pressure of 82/54 mm Hg
A nurse is reviewing the vital signs for a group of clients obtained by an assistive personnel. The nurse should identify that which of the following clients requires a follow-up assessment due to bradycardia?
A young adult who has a radial pulse of 56/min
A nurse is teaching a group of newly licensed nurses about vital sign measurements. Which of the following factors should the nurse include in the teaching?
Body temperature is typically lower in older adults
A charge nurse is providing an in-service for a group of nurses about cardiac output. Which of the following statements should the nurse include?
Cardiac output is the amount of blood flow through the heart in 1 minute
A nurse is preparing an in-service about factors affecting respiratory rate for a group of assistive personnel. Which of the following information should the nurse include?
Fever can increase a client's respiratory rate
A nurse is reviewing blood flow through the heart with a group of assistive personnel. The nurse should identify that blood flows to which of the following parts of the heart as it leaves the right ventricle?
Pulmonary artery
A nurse is caring for a recently admitted client and as part of the plan of care, two nurses obtained simultaneous pulse rates. The client's auscultated apical pulse was 106/min and the palpated radial pulse was 93/min. The nurse should document the findings as which of the following?
Pulse deficit of 13/min
A nurse is reviewing the vital signs obtained by an assistive personnel at 1200. For which of the following clients should the nurse plan to interview?
Toddler who has a respiratory rate of 44/min
A nurse is evaluating the effectiveness of interventions used for clients who had alterations in vital signs. Which of the following clients' vital signs indicate that interventions were effective? (SATA)
- A preschooler who was exhibiting tachypnea 2 hr postoperative and now has alterations in vital signs -An older client who has bradycardia while sleeping and now an apical pulse rate of 66/min - A young adult who had hypotension after receiving an opioid analgesic and now has a blood pressure of 98/68 mm Hg
