Taking Vital Signs – Nursing Practice Test Questions
- Posted by Brian Stocker MA
- Date January 29, 2012
- Comments 9 comments
Scenario
John, a 78 year old man with Dementia has been assigned to you. He fell out of his bed and sprained his wrist. He is diabetic and suffers from left-sided weakness due to a stroke. He requires total care and assistance with everything he does. He has dentures. He can no longer walk alone, feed himself, bathe or dress himself, and he is incontinent of urine and stool. His vital signs are to be monitored q 4 hrs.
Practice Questions Set 1
1. The taking of John’s vital signs includes
a. Temperature, blood pressure, respirations. and pulse
b. blood pressure, respirations, pulse and ROM
c. temperature, I&O, respirations, pulse and blood pressure
d. All of the above
2. When taking John’s blood pressure, you should make certain that
a. The cuff is the correct size
b. John is lying on his left side
c. The cuff is positioned dependent to his elbow
d. The cuff is pumped to at least 20 mm above his baseline b/p
3. The most accurate temperature is obtained when taken
a. Under the arm
b. Rectally
c. At the groin
In the ear
4. When counting the pulse rate, you may use the pulse at what points?
a. The carotid artery
b. The radial artery
c. The apical area of the heart via the chest using a stethoscope
d. All of the above
Set 1 – Answer Key
1. A
The four components of the vital sign assessment are temperature, blood pressure, pulse, and respirations.
2. A
If the cuff is not the proper width for your patient you will get a false reading on your blood pressure check.
3. B
The rectal temperature is taken within the body cavity and therefore yields the temperature which is closest to the actual body temperature.
4. D
The pulse can accurately be counted using any of these areas, although for most initial assessments the radial pulse is used.
Practice Questions – Set 2
5. While assessing John’s temperature, you note that it is 101.2 degrees. What is your FIRST action?
a. Notify your supervisor
b. Call the doctor
c. Wait the appropriate amount of time and take the temperature again
d. Have a co-worker check your work.
6. You can count respirations while
a. Taking John’s b/p
b. Counting John’s pulse
c. Taking his temperature
d. None of the above
7. When assessing John’s respirations you should
a. Count the number of times his chest rises and falls in one minute
b. Auscultate his chest
c. Observe whether John is breathing easily or seems to be having difficulty
d. All of the above
8. If John’s 3 year old granddaughter was visiting and was watching you take her grandfather’s vital signs and became curious about how you would take hers, you might explain to her that
a. You would do it on the arm but with a smaller cuff
b. You would do it on her thigh but with a smaller cuff
c. You would do it on her ankle using a smaller cuff
d. All of the above.
Answer Key – Set 2
5. C
Always double-check your vital signs to make certain there is a valid problem.
6. B
Count his respirations while taking his pulse.
7. D
The respiratory assessment should ALWAYS include the number of respirations, the quality of them and accompanying breath sounds.
8. D
A child of this age could have her b/p assessed on any of the above mentioned areas using a child’s cuff.
common Mistakes answering Vitals Signs Questions
Using Incorrect Units
Using the wrong units (e.g., using Celsius instead of Fahrenheit).
Tip Always double-check the units required and make sure your answer is consistent.
Wrong Technique
Using the wrong technique (e.g., incorrect placement of the blood pressure cuff or not placing the thermometer correctly).
Tip Review the proper techniques for each type of measurement and practice them to ensure accuracy.
Misreading Instruments
Misreading the scale on an instrument, such as a sphygmomanometer or thermometer.
Tip Slow down! Take your time to read the instruments carefully and make sure you understand how to interpret the readings.
Recording Data Errors
Writing down the wrong values or switching values (e.g., recording systolic and diastolic blood pressure values incorrectly).
Tip Always Double-check before turning in your answers.
Not Considering Patient Factors:
Remember to consider factors that can affect vital signs such as, recent physical activity, stress, or illness.
Tip What factors can influence vital signs? Be sure to include these when interpreting results.
Know the Normal Ranges
Make sure you know the normal ranges for vital signs for different age groups and conditions.
Tip Memorize the normal ranges for vital signs and understand how they can vary based on age, sex, and health status.
Not Following Protocol
Always follow the correct procedural steps and protocols (e.g., failing to wait an appropriate amount of time before retaking a blood pressure reading).
Tip Learn and follow standard protocols for taking each vital sign.
Date Published: Sunday, January 29th, 2012
Date Modified: Friday, July 5th, 2024
9 Comments
Hi,
Really it is a nice blog, I would like to tell you that you have given me much knowledge about it.
thank you for my information it was very helpful.
HIE
Thanks you have helped me preparing for the exams
Thank you for you help to remember I am certified nursing Asistant
Thank you
U have helped me to learn more about vital signs
Thanks this was very useful.
I have learned new things from your questions! thanks!
thanks for the post!
D.
THANK YOU FOR YOUR HELP, I HAVE LEARN NEW IDEA TODAY