Hartman's Nursing Assistant Care Chapter 7 - 2026 Nursing
Assistant Exam Questions and Answers (Vital Signs & Basic
Care) - 130 Questions with Answers
Page 1
,Q1. A nursing assistant is measuring a patient's blood pressure using a stethoscope
and an aneroid sphygmomanometer. The patient's arm is positioned below heart
level. How will this position affect the blood pressure reading, and what is the
underlying physiological principle?
A. The reading will be falsely low due to decreased hydrostatic pressure in the brachial
artery.
B. The reading will be falsely high due to increased hydrostatic pressure from the
column of blood.
C. The reading will be unaffected because the cuff pressure compensates for position.
D. The reading will be falsely low because the cuff is too far from the heart.
Correct Answer: B. The reading will be falsely high due to increased hydrostatic
pressure from the column of blood.
Rationale: When the arm is below heart level, hydrostatic pressure from the blood column
adds to arterial pressure, causing a falsely high reading. This is due to gravity increasing
the pressure in dependent vessels. The other options misidentify the direction of the error
or the underlying mechanism.
Why Wrong:
A - Incorrect: Hydrostatic pressure increases, not decreases, when the limb is
dependent.
C - Incorrect: Position does affect readings; the cuff does not compensate for
hydrostatic effects.
D - Incorrect: The distance from the heart is not the primary factor; it is the vertical
height relative to the heart.
Reference: Hartman's Nursing Assistant Care, 2026, Ch. 7, Vital Signs: Blood Pressure
Q2. A patient has a temperature of 101.8°F (38.8°C) measured orally. Which
physiological process is primarily responsible for the elevated temperature, and how
does this affect the nursing assistant's care priorities?
A. Increased heat loss through vasodilation; the assistant should apply cold
compresses.
B. Increased heat production from shivering; the assistant should provide extra
blankets.
C. Activation of the immune response resetting the hypothalamic set point; the
assistant should monitor for dehydration and report the fever.
D. Decreased metabolic rate reducing heat production; the assistant should encourage
activity.
Correct Answer: C. Activation of the immune response resetting the hypothalamic set
point; the assistant should monitor for dehydration and report the fever.
Page 2
,Rationale: Fever is caused by pyrogens resetting the hypothalamic set point, leading to
increased heat production and conservation. The nursing assistant's role is to monitor the
patient, ensure hydration, and report the fever. Options A and B describe thermoregulatory
responses but not the primary cause; D is opposite.
Why Wrong:
A - Incorrect: Vasodilation promotes heat loss but is not the cause of fever; cold
compresses may cause shivering.
B - Incorrect: Shivering is a response to the new set point, not the primary cause; extra
blankets may be needed but not the priority.
D - Incorrect: Metabolic rate typically increases, not decreases, during fever.
Reference: Hartman's Nursing Assistant Care, 2026, Ch. 7, Vital Signs: Temperature
Q3. When measuring a patient's radial pulse for 30 seconds and multiplying by 2,
what assumption is made, and under what condition is this method inappropriate?
A. The pulse is regular; inappropriate for irregular rhythms.
B. The pulse is strong; inappropriate for weak pulses.
C. The patient is at rest; inappropriate after exercise.
D. The pulse is within normal range; inappropriate for bradycardia.
Correct Answer: A. The pulse is regular; inappropriate for irregular rhythms.
Rationale: Multiplying a 30-second count by 2 assumes a regular rhythm; if the rhythm is
irregular, this method may miss variations. The correct practice is to count for a full
minute when irregularities are detected. The other options do not directly invalidate the
30-second method.
Why Wrong:
B - Incorrect: Pulse strength does not affect the accuracy of the count in a 30-second
interval.
C - Incorrect: Rest is important for baseline, but the method is not inappropriate solely
after exercise.
D - Incorrect: The rate does not determine the appropriateness; regularity does.
Reference: Hartman's Nursing Assistant Care, 2026, Ch. 7, Vital Signs: Pulse
Q4. A nursing assistant is assisting a patient with a bedpan. Which action best
prevents skin breakdown and promotes patient comfort?
A. Place the bedpan under the patient with the open end toward the foot of the bed.
B. Raise the head of the bed to 30 degrees and ask the patient to bear down.
C. Use a fracture bedpan for all patients to minimize lifting.
D. Position the patient supine with legs extended and place the bedpan flat.
Correct Answer: B. Raise the head of the bed to 30 degrees and ask the patient to
bear down.
Page 3
, Rationale: Raising the head of the bed to 30 degrees (Fowler's position) uses gravity to
help with elimination and reduces pressure on the sacrum. The open end of the bedpan
should be toward the patient's back, not the foot. Fracture bedpans are for patients who
cannot lift their hips, not all patients.
Why Wrong:
A - Incorrect: The open end should be positioned toward the patient's back (buttocks).
C - Incorrect: Fracture bedpans are not universally appropriate; they are for specific
mobility limitations.
D - Incorrect: Supine with legs extended does not facilitate elimination and increases
pressure.
Reference: Hartman's Nursing Assistant Care, 2026, Ch. 7, Basic Care: Bedpan
Q5. A patient has an irregular radial pulse. The nursing assistant counts the pulse for
a full 60 seconds and obtains a rate of 72. Which additional assessment is most critical
to perform?
A. Measure the pulse in the opposite arm to compare.
B. Count the apical pulse for a full minute and compare to the radial pulse.
C. Recheck the radial pulse after 5 minutes of rest.
D. Document the rate and rhythm and report to the nurse.
Correct Answer: B. Count the apical pulse for a full minute and compare to the radial
pulse.
Rationale: For an irregular pulse, the apical-radial pulse deficit should be assessed to
determine if all heartbeats are reaching the periphery. This is a critical nursing assistant
skill. Comparing arms is for equality, not irregularity; rechecking after rest is not the
priority.
Why Wrong:
A - Incorrect: Comparing arms assesses for perfusion differences, not irregularity.
C - Incorrect: Rechecking may be done but does not provide the definitive assessment
needed.
D - Incorrect: Documentation is important but the apical-radial assessment is more
critical.
Reference: Hartman's Nursing Assistant Care, 2026, Ch. 7, Vital Signs: Pulse
Q6. Which of the following is the most accurate method for measuring a patient's
respiratory rate, and what is the primary reason for using this method?
A. Count for 15 seconds and multiply by 4; it is quicker and equally accurate.
B. Count for 30 seconds and multiply by 2; it balances speed and accuracy.
C. Count for a full 60 seconds; it is the most accurate method.
D. Observe the chest rise and fall for 10 seconds and estimate; it avoids patient
Page 4
Assistant Exam Questions and Answers (Vital Signs & Basic
Care) - 130 Questions with Answers
Page 1
,Q1. A nursing assistant is measuring a patient's blood pressure using a stethoscope
and an aneroid sphygmomanometer. The patient's arm is positioned below heart
level. How will this position affect the blood pressure reading, and what is the
underlying physiological principle?
A. The reading will be falsely low due to decreased hydrostatic pressure in the brachial
artery.
B. The reading will be falsely high due to increased hydrostatic pressure from the
column of blood.
C. The reading will be unaffected because the cuff pressure compensates for position.
D. The reading will be falsely low because the cuff is too far from the heart.
Correct Answer: B. The reading will be falsely high due to increased hydrostatic
pressure from the column of blood.
Rationale: When the arm is below heart level, hydrostatic pressure from the blood column
adds to arterial pressure, causing a falsely high reading. This is due to gravity increasing
the pressure in dependent vessels. The other options misidentify the direction of the error
or the underlying mechanism.
Why Wrong:
A - Incorrect: Hydrostatic pressure increases, not decreases, when the limb is
dependent.
C - Incorrect: Position does affect readings; the cuff does not compensate for
hydrostatic effects.
D - Incorrect: The distance from the heart is not the primary factor; it is the vertical
height relative to the heart.
Reference: Hartman's Nursing Assistant Care, 2026, Ch. 7, Vital Signs: Blood Pressure
Q2. A patient has a temperature of 101.8°F (38.8°C) measured orally. Which
physiological process is primarily responsible for the elevated temperature, and how
does this affect the nursing assistant's care priorities?
A. Increased heat loss through vasodilation; the assistant should apply cold
compresses.
B. Increased heat production from shivering; the assistant should provide extra
blankets.
C. Activation of the immune response resetting the hypothalamic set point; the
assistant should monitor for dehydration and report the fever.
D. Decreased metabolic rate reducing heat production; the assistant should encourage
activity.
Correct Answer: C. Activation of the immune response resetting the hypothalamic set
point; the assistant should monitor for dehydration and report the fever.
Page 2
,Rationale: Fever is caused by pyrogens resetting the hypothalamic set point, leading to
increased heat production and conservation. The nursing assistant's role is to monitor the
patient, ensure hydration, and report the fever. Options A and B describe thermoregulatory
responses but not the primary cause; D is opposite.
Why Wrong:
A - Incorrect: Vasodilation promotes heat loss but is not the cause of fever; cold
compresses may cause shivering.
B - Incorrect: Shivering is a response to the new set point, not the primary cause; extra
blankets may be needed but not the priority.
D - Incorrect: Metabolic rate typically increases, not decreases, during fever.
Reference: Hartman's Nursing Assistant Care, 2026, Ch. 7, Vital Signs: Temperature
Q3. When measuring a patient's radial pulse for 30 seconds and multiplying by 2,
what assumption is made, and under what condition is this method inappropriate?
A. The pulse is regular; inappropriate for irregular rhythms.
B. The pulse is strong; inappropriate for weak pulses.
C. The patient is at rest; inappropriate after exercise.
D. The pulse is within normal range; inappropriate for bradycardia.
Correct Answer: A. The pulse is regular; inappropriate for irregular rhythms.
Rationale: Multiplying a 30-second count by 2 assumes a regular rhythm; if the rhythm is
irregular, this method may miss variations. The correct practice is to count for a full
minute when irregularities are detected. The other options do not directly invalidate the
30-second method.
Why Wrong:
B - Incorrect: Pulse strength does not affect the accuracy of the count in a 30-second
interval.
C - Incorrect: Rest is important for baseline, but the method is not inappropriate solely
after exercise.
D - Incorrect: The rate does not determine the appropriateness; regularity does.
Reference: Hartman's Nursing Assistant Care, 2026, Ch. 7, Vital Signs: Pulse
Q4. A nursing assistant is assisting a patient with a bedpan. Which action best
prevents skin breakdown and promotes patient comfort?
A. Place the bedpan under the patient with the open end toward the foot of the bed.
B. Raise the head of the bed to 30 degrees and ask the patient to bear down.
C. Use a fracture bedpan for all patients to minimize lifting.
D. Position the patient supine with legs extended and place the bedpan flat.
Correct Answer: B. Raise the head of the bed to 30 degrees and ask the patient to
bear down.
Page 3
, Rationale: Raising the head of the bed to 30 degrees (Fowler's position) uses gravity to
help with elimination and reduces pressure on the sacrum. The open end of the bedpan
should be toward the patient's back, not the foot. Fracture bedpans are for patients who
cannot lift their hips, not all patients.
Why Wrong:
A - Incorrect: The open end should be positioned toward the patient's back (buttocks).
C - Incorrect: Fracture bedpans are not universally appropriate; they are for specific
mobility limitations.
D - Incorrect: Supine with legs extended does not facilitate elimination and increases
pressure.
Reference: Hartman's Nursing Assistant Care, 2026, Ch. 7, Basic Care: Bedpan
Q5. A patient has an irregular radial pulse. The nursing assistant counts the pulse for
a full 60 seconds and obtains a rate of 72. Which additional assessment is most critical
to perform?
A. Measure the pulse in the opposite arm to compare.
B. Count the apical pulse for a full minute and compare to the radial pulse.
C. Recheck the radial pulse after 5 minutes of rest.
D. Document the rate and rhythm and report to the nurse.
Correct Answer: B. Count the apical pulse for a full minute and compare to the radial
pulse.
Rationale: For an irregular pulse, the apical-radial pulse deficit should be assessed to
determine if all heartbeats are reaching the periphery. This is a critical nursing assistant
skill. Comparing arms is for equality, not irregularity; rechecking after rest is not the
priority.
Why Wrong:
A - Incorrect: Comparing arms assesses for perfusion differences, not irregularity.
C - Incorrect: Rechecking may be done but does not provide the definitive assessment
needed.
D - Incorrect: Documentation is important but the apical-radial assessment is more
critical.
Reference: Hartman's Nursing Assistant Care, 2026, Ch. 7, Vital Signs: Pulse
Q6. Which of the following is the most accurate method for measuring a patient's
respiratory rate, and what is the primary reason for using this method?
A. Count for 15 seconds and multiply by 4; it is quicker and equally accurate.
B. Count for 30 seconds and multiply by 2; it balances speed and accuracy.
C. Count for a full 60 seconds; it is the most accurate method.
D. Observe the chest rise and fall for 10 seconds and estimate; it avoids patient
Page 4
