ATI Fundamentals | Vital Signs & Assessment Practice Pack 2026/2027
|Questions |Answers |Rationales
1. A nurse is assessing a client’s pulse and finds it to be irregular. What is the
most appropriate action for the nurse to take next?
A. Document the finding as normal.
B. Wait 15 minutes and reassess the client.
C. Assess the pulse for a full 60 seconds.
D. Use a Doppler ultrasound to find the pulse.
Answer: C
Rationale: If a pulse is irregular, it should be counted for a full minute to ensure an
accurate assessment of the rate and rhythm.
2. Which part of the brain is primarily responsible for regulating body
temperature?
A. Medulla oblongata
B. Hypothalamus
C. Cerebellum
D. Thalamus
Answer: B
Rationale: The hypothalamus acts as the body’s thermostat, maintaining the balance
between heat loss and heat production.
,3. When measuring blood pressure, what is the effect of using a cuff that is too
small for the client’s arm?
A. It results in a false high reading.
B. It results in a false low reading.
C. It has no effect on the accuracy.
D. It prevents the detection of Korotkoff sounds.
Answer: A
Rationale: A cuff that is too narrow or small will result in a false high blood pressure
reading because the pressure is not distributed evenly.
4. A nurse is assessing a client’s respirations and notes they are shallow and
extremely slow. Which term should the nurse use to document this finding?
A. Tachypnea
B. Hyperpnea
C. Bradypnea
D. Dyspnea
Answer: C
Rationale: Bradypnea refers to a respiratory rate that is regular but abnormally slow
(usually less than 12 breaths per minute in adults).
5. What is the standard procedure for assessing a client for orthostatic
hypotension?
A. Measure BP while the client is supine, sitting, and standing.
B. Measure BP only while the client is standing.
C. Measure BP while the client is prone.
D. Measure BP after the client exercises for 5 minutes.
Answer: A
Rationale: Orthostatic hypotension is assessed by measuring the BP and heart rate while
the client is lying down, then sitting, and finally standing.
, 6. Which of the following is considered a normal adult heart rate range?
A. 40 to 60 beats per minute
B. 100 to 120 beats per minute
C. 60 to 100 beats per minute
D. 50 to 90 beats per minute
Answer: C
Rationale: The typical normal resting heart rate for an adult is between 60 and 100 beats
per minute.
7. A client has a temperature of 102.2°F (39°C). Which of the following terms
describes this condition?
A. Hypothermia
B. Afebrile
C. Pyrexia
D. Normothermia
Answer: C
Rationale: Pyrexia is the medical term for fever, typically defined as a body temperature
above the usual range.
8. When assessing a client’s blood pressure, the nurse notes the first rhythmic
tapping sound. This represents which of the following?
A. Systolic pressure
B. Pulse deficit
C. Diastolic pressure
D. Mean arterial pressure
Answer: A
Rationale: The first Korotkoff sound corresponds to the systolic blood pressure, indicating
the peak pressure in the arteries.
|Questions |Answers |Rationales
1. A nurse is assessing a client’s pulse and finds it to be irregular. What is the
most appropriate action for the nurse to take next?
A. Document the finding as normal.
B. Wait 15 minutes and reassess the client.
C. Assess the pulse for a full 60 seconds.
D. Use a Doppler ultrasound to find the pulse.
Answer: C
Rationale: If a pulse is irregular, it should be counted for a full minute to ensure an
accurate assessment of the rate and rhythm.
2. Which part of the brain is primarily responsible for regulating body
temperature?
A. Medulla oblongata
B. Hypothalamus
C. Cerebellum
D. Thalamus
Answer: B
Rationale: The hypothalamus acts as the body’s thermostat, maintaining the balance
between heat loss and heat production.
,3. When measuring blood pressure, what is the effect of using a cuff that is too
small for the client’s arm?
A. It results in a false high reading.
B. It results in a false low reading.
C. It has no effect on the accuracy.
D. It prevents the detection of Korotkoff sounds.
Answer: A
Rationale: A cuff that is too narrow or small will result in a false high blood pressure
reading because the pressure is not distributed evenly.
4. A nurse is assessing a client’s respirations and notes they are shallow and
extremely slow. Which term should the nurse use to document this finding?
A. Tachypnea
B. Hyperpnea
C. Bradypnea
D. Dyspnea
Answer: C
Rationale: Bradypnea refers to a respiratory rate that is regular but abnormally slow
(usually less than 12 breaths per minute in adults).
5. What is the standard procedure for assessing a client for orthostatic
hypotension?
A. Measure BP while the client is supine, sitting, and standing.
B. Measure BP only while the client is standing.
C. Measure BP while the client is prone.
D. Measure BP after the client exercises for 5 minutes.
Answer: A
Rationale: Orthostatic hypotension is assessed by measuring the BP and heart rate while
the client is lying down, then sitting, and finally standing.
, 6. Which of the following is considered a normal adult heart rate range?
A. 40 to 60 beats per minute
B. 100 to 120 beats per minute
C. 60 to 100 beats per minute
D. 50 to 90 beats per minute
Answer: C
Rationale: The typical normal resting heart rate for an adult is between 60 and 100 beats
per minute.
7. A client has a temperature of 102.2°F (39°C). Which of the following terms
describes this condition?
A. Hypothermia
B. Afebrile
C. Pyrexia
D. Normothermia
Answer: C
Rationale: Pyrexia is the medical term for fever, typically defined as a body temperature
above the usual range.
8. When assessing a client’s blood pressure, the nurse notes the first rhythmic
tapping sound. This represents which of the following?
A. Systolic pressure
B. Pulse deficit
C. Diastolic pressure
D. Mean arterial pressure
Answer: A
Rationale: The first Korotkoff sound corresponds to the systolic blood pressure, indicating
the peak pressure in the arteries.
