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 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 rnurse ris rcaring rfor ra rgroup rof rclients. rWhich rof rthe rfollowing rclients ris rexperiencing
ran ralteration rin rtheir rRR rthat rrequires rintervention?
a) an radolescent rwho rhas ra rRR rof r20/min
b) an rolder radult rwith rRR rof r16/min
c) an rinfant rwith rRR rof r52/min
d) a rschool-age rchild rwho rhas ra rRR rof r14/min r- rd) ra rschool-age rchild rwho rhas ra
rRR rof r14/min
A rnurse ris rplanning rcare rfor ra rgroup rof rclients. rFor rwhich rof rthe rfollowing rclients
rshould rthe rnurse rdirect ran rAP rto robtain ra rrectal rtemperature?
a) a rtoddler rwho rhas rdiarrhea
b) a rclient rwho ris r1 rday rpost rop rfrom rhemorrhoid rsurgery
c) an rinfant rwho ris rreceiving rIV rfluids
d) a rclient rwho ris rdiaphoretic rand rfrequently rchewing rice rto rrelieve rdry rmouth r-
rd) ra rclient rwho ris rdiaphoretic rand rfrequently rchewing rice rto rrelieve rdry rmouth
A rnurse ris rreviewing rthe rvitals rfor ra rgroup rof rclients robtained rby ran rAP. rThe rnurse
rshould ridentify rthat rwhich rof rthe rfollowing rclients rrequires ra rfollow-up rassessment
rdue rto rbradycardia?
a) a rschool-age rchild rwho rhas ran rapical rpulse rof r78/min
b) a ryoung radult rwho rhas ra rradial rpulse rof r56/min
c) an radolescent rwho rhas ra rradial rpulse rof r76/min
d) an rolder radult rwith rapical rpulse rof r62/min r- rb) ra ryoung radult rwho rhas ra rradial
rpulse rof r56/min
A rnurse ris rteaching ra rgroup rof rnewly rlicensed rnurses rabout rvital rsign rmeasurements.
rWhich rof rthe rfollowing rfactors rshould rthe rnurse rinclude rin rthe rteaching?
a) anxiety rcan rcause ra rdecrease rin rRR
b) body rtemperature ris rtypically rlower rin rolde radults
c) caffeine rcan rcause ra rtemporary rdecrease rin rpulse rrate rin radolescents
d) BP rcan rslightly rdecrease rimmediately rfollowing rthe ruse rof rnicotine r- rb)
rbody rtemperature ris rtypically rlower rin rolder radults
A rnurse ris robtaining rvital rsigns rfor ra rgroup rof rclients. rWhich rof rthe rfollowing rfindings
rrequires rintervention?
a) a r17 ryear rold rwho rhas ra rRR rof r16/min
b) a ryoung radult rwho rhas ra rpulse rrate rof r98/min
c) an r11 ryear rold rwho rhas ra rRR rof r34/min
d) an rolder radult rwho rhas ra rpulse rrate rof r62/min r- rc) ran r11 ryear rold rwho rhas ra
rRR rof r34/min
A nurse is planning care for a client who is experiencing tachycardia. Which of the
following interventions should the nurse plan 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 rnurse ris rcaring rfor ra rgroup rof rclients. rWhich rof rthe rfollowing rclients ris rexperiencing
ran ralteration rin rtheir rRR rthat rrequires rintervention?
a) an radolescent rwho rhas ra rRR rof r20/min
b) an rolder radult rwith rRR rof r16/min
c) an rinfant rwith rRR rof r52/min
d) a rschool-age rchild rwho rhas ra rRR rof r14/min r- rd) ra rschool-age rchild rwho rhas ra
rRR rof r14/min
A rnurse ris rplanning rcare rfor ra rgroup rof rclients. rFor rwhich rof rthe rfollowing rclients
rshould rthe rnurse rdirect ran rAP rto robtain ra rrectal rtemperature?
a) a rtoddler rwho rhas rdiarrhea
b) a rclient rwho ris r1 rday rpost rop rfrom rhemorrhoid rsurgery
c) an rinfant rwho ris rreceiving rIV rfluids
d) a rclient rwho ris rdiaphoretic rand rfrequently rchewing rice rto rrelieve rdry rmouth r-
rd) ra rclient rwho ris rdiaphoretic rand rfrequently rchewing rice rto rrelieve rdry rmouth
A rnurse ris rreviewing rthe rvitals rfor ra rgroup rof rclients robtained rby ran rAP. rThe rnurse
rshould ridentify rthat rwhich rof rthe rfollowing rclients rrequires ra rfollow-up rassessment
rdue rto rbradycardia?
a) a rschool-age rchild rwho rhas ran rapical rpulse rof r78/min
b) a ryoung radult rwho rhas ra rradial rpulse rof r56/min
c) an radolescent rwho rhas ra rradial rpulse rof r76/min
d) an rolder radult rwith rapical rpulse rof r62/min r- rb) ra ryoung radult rwho rhas ra rradial
rpulse rof r56/min
A rnurse ris rteaching ra rgroup rof rnewly rlicensed rnurses rabout rvital rsign rmeasurements.
rWhich rof rthe rfollowing rfactors rshould rthe rnurse rinclude rin rthe rteaching?
a) anxiety rcan rcause ra rdecrease rin rRR
b) body rtemperature ris rtypically rlower rin rolde radults
c) caffeine rcan rcause ra rtemporary rdecrease rin rpulse rrate rin radolescents
d) BP rcan rslightly rdecrease rimmediately rfollowing rthe ruse rof rnicotine r- rb)
rbody rtemperature ris rtypically rlower rin rolder radults
A rnurse ris robtaining rvital rsigns rfor ra rgroup rof rclients. rWhich rof rthe rfollowing rfindings
rrequires rintervention?
a) a r17 ryear rold rwho rhas ra rRR rof r16/min
b) a ryoung radult rwho rhas ra rpulse rrate rof r98/min
c) an r11 ryear rold rwho rhas ra rRR rof r34/min
d) an rolder radult rwho rhas ra rpulse rrate rof r62/min r- rc) ran r11 ryear rold rwho rhas ra
rRR rof r34/min
