ATI VItal Signs Test
A nurse is planning care for a client who is experiencing tachycardia. Which of the
following interventions should the nurse plan
... [Show More] to make?
a) instruct the client to increase exercise
b) instruct the client to consume no more than four caffeinated beverages per day
c) encourage the client to practice relaxation techniques each day
d) encourage the client to engage in pattern paced breathing by panting - c) encourage
the client to practice relaxation techniques each day
A nurse is teaching a group of AP about techniques used to obtain BP. For which of the
following clients should the nurse to instruct the AP to obtain an electronic BP
measurement?
a) a client who has a BP lower than the expected reference range
b) a school-age client
c) a client recovering from extensive abdominal surgery
d) a client who has stabilized BP measurements - d) a client who has stabilized BP
measurements
A nurse is observing an AP obtain vital signs from an adult client. Which of the following
actions by the AP requires follow up by the nurse?
a) the AP pulls the pinna up and back when obtaining a tympanic temperature
b) the AP informs the client when they are counting the respirations
c) the AP gently presses down with the pads of two or three fingers over the radial pulse
site
d) the AP selects a blood pressure cuff that is 40% the circumference of the client's arm
- b) the AP informs the client when they are counting the respirations
A charge nurse in a clinic is preparing an in-service about blood pressure
measurements for a group of staff members. Which of the following should the nurse
include?
a) A client diagnosed with an elevated BP when the measurement is greater than
130/80 mm Hg
b) A client us experiencing a hypertensive crisis when their BP is greater than 150/90
mm Hg
c) A client who has a BP of 128/86 mm Hg has stage I hypertension
d) A client who has a blood pressure of 162/102 mm Hg has stage II hypertension - d) A
client who has a blood pressure of 162/102 mm Hg has stage II hypertension
A charge nurse is reviewing documentation of vital signs by a newly licensed nurse.
Which of the following pieces of documentation is correct?
a) pulse 52/min
b) RR 24
c) SaO2 97% right index finger, room air
d) BP 132/86 mm Hg - c) SaO2 97% right index finger, room air
A nurse is assessing a three month old infant during a well-child visit. Which of the
following actions should the nurse take when assessing the apical pulse?
ATI VItal Signs Test
a) count the number of beats heard in 15 seconds and multiply by 4
b) notify the provider if the apical pulse rate is greater than 110/min
c) place the stethoscope over the 4th intercostal space to the left of the sternum
d) auscultate the apical pulse for an S4 heart sound - c) place the stethoscope over the
4th intercostal space to the left of the sternum
A nurse is caring for a group of clients. Which of the following clients is experiencing an
alteration in their RR that requires intervention?
a) an adolescent who has a RR of 20/min
b) an older adult with RR of 16/min
c) an infant with RR of 52/min
d) a school-age child who has a RR of 14/min - d) a school-age child who has a RR of
14/min
A nurse is planning care for a group of clients. For which of the following clients should
the nurse direct an AP to obtain a rectal temperature?
a) a toddler who has diarrhea
b) a client who is 1 day post op from hemorrhoid surgery
c) an infant who is receiving IV fluids
d) a client who is diaphoretic and frequently chewing ice to relieve dry mouth - d) a
client who is diaphoretic and frequently chewing ice to relieve dry mouth
A nurse is reviewing the vitals for a group of clients obtained by an AP. The nurse
should identify that which of the following clients requires a follow-up assessment due to
bradycardia?
a) a school-age child who has an apical pulse of 78/min
b) a young adult who has a radial pulse of 56/min
c) an adolescent who has a radial pulse of 76/min
d) an older adult with apical pulse of 62/min - b) a young adult who has a radial pulse of
56/min [Show Less]