Maryville NURS330 Chapter 10 Quiz Latest 2022 May

NURS330 Individual Assessment

Chapter 10 Quiz

Question 1A nurse is helping at a health fair at a local mall. What should the nurse keep in mind when taking blood pressures on a variety of people?

  After menopause, blood pressure readings in women are usually lower than those taken in men.

  The blood pressure of an African-American adult is usually higher than that of a non-Hispanic White adult of the same age.

  Blood pressure measurements in people who are overweight should be the same as those of people who are at a normal weight.

  A teenager’s blood pressure reading will be lower than that of an adult.

Question 2A 4-month-old child is at the clinic for a well-baby checkup and immunizations. Which of these actions is most appropriate when the nurse is assessing an infant’s vital signs?

  The infant’s radial pulse should be palpated, and the nurse should notice any fluctuations resulting from activity or exercise.

  The nurse should auscultate an apical rate for 1 minute and then assess for any normal irregularities, such as sinus dysrhythmia.

  The infant’s blood pressure should be assessed by using a stethoscope with a large diaphragm piece to hear the soft muffled Korotkoff sounds.

  The infant’s chest should be observed and the respiratory rate counted for 1 minute; the respiratory pattern may vary significantly.

Question 3The nurse will perform a palpated pressure before auscultating blood pressure. What is the reason for this?

  More clearly hear the Korotkoff sounds.

  Detect the presence of an auscultatory gap.

  Avoid missing a falsely elevated blood pressure.

  More readily identify phase IV of the Korotkoff sounds.

Question 4When assessing the pulse of a 6-year-old boy, the nurse notices that his heart rate varies with his respiratory cycle, speeding up at the peak of inspiration and slowing to normal with expiration. What action should the nurse take next?

  Notify the physician.

  Record this finding as normal.

  Check the child’s blood pressure and note any variation with respiration.

  Document that this child has bradycardia and continue with the assessment.

 Question 5When auscultating the blood pressure of a 25-year-old patient, the nurse notices that the phase I Korotkoff sounds begin at 200 mm Hg. At 100 mm Hg, the Korotkoff sounds muffle. At 92 mm Hg, the Korotkoff sounds disappear. How should the nurse record this patient’s blood pressure?

  200/92

  200/100

  100/200/92

  200/100/92

Question 6When considering the concepts r/t blood pressure, the nurse knows that the concept of mean arterial pressure (MAP) is best described by which statement?

  MAP is the pressure of the arterial pulse.

  MAP reflects the stroke volume of the heart.

  MAP is the pressure forcing blood into the tissues, averaged over the cardiac cycle.

  MAP is an average of the systolic and diastolic blood pressures and reflects tissue perfusion.

Question 7The nurse is helping another nurse take a blood pressure reading on a patient’s thigh. Which action is correct regarding thigh pressure?

  Either the popliteal or femoral vessels should be auscultated to obtain a thigh pressure.

  The best position to measure thigh pressure is the supine position with the knee slightly bent.

  If the blood pressure in the arm is high in an adolescent, then it should be compared with the thigh pressure.

  The thigh pressure is lower than the pressure in the arm, which is attributable to the distance away from the heart and the size of the popliteal vessels.

Question 8The nurse should measure rectal temperatures in which of these patients?

  Older adult

  Comatose adult

  School-age child

  Patient receiving oxygen by nasal cannula

Question 9The nurse is assessing the vital signs of a 20-year-old male marathon runner and documents the following vital signs: temperature–36° C; pulse–48 beats per minute; respirations–14 breaths per minute; blood pressure–104/68 mm Hg. Which statement is true concerning these results?

  The patient is experiencing tachycardia.

  These are normal vital signs for a healthy, athletic adult.

  The patient’s pulse rate is not normal—his physician should be notified.

  On the basis of these readings, the patient should return to the clinic in 1 week.

Question 10The nurse is assessing children in a pediatric clinic. Which statement is true regarding the measurement of blood pressure in children?

  Blood pressure guidelines for children are based on age.

  Phase II Korotkoff sounds are the best indicator of systolic blood pressure in children.

  Using a Doppler device is recommended for accurate blood pressure measurements until adolescence.

  The disappearance of phase V Korotkoff sounds can be used for the diastolic reading in children.