Chapter 6: Vital Signs and Pain Assessment

Question 1

The heart rate of a pregnant woman may increase to a level at term that is _____ higher than normal.

Select one:

a. 5% to 10%
b. 10% to 30%
c. 40% to 60%
d. 60% to 80%
e. 80% to 100%

Answer 1

b. 10% to 30%

Question 2

The difference in blood pressure readings between the right and left arms is considered normal up to _____ mm Hg.

Select one:

a. 5
b. 10
c. 20
d. 25
e. 30

Answer 2

b. 10

Question 3

The value of the use of scales for patients to rate their pain intensity is that:

Select one:

a. the emotional responses are factored in.
b. correlation with others’ expectations is achieved.
c. the patient’s response to therapy can be documented.
d. subjective responses are eliminated.
e. the patient’s perception is minimized.

Answer 3

c. the patient’s response to therapy can be documented.

Question 4

Systolic hypertension in the adult less than 60 years of age is generally defined as pressure in excess of:

Select one:

a. 120 + the patient’s age.
b. 140
c. 160
d. 180
e. 200

Answer 4

b. 140

Question 5

Which of the following statements is true regarding tympanic membrane temperature?

Select one:
a. It is taken by placing an infrared probe anterior to the ear.

b. The probe is placed in the external auditory canal to occlude it.
c. Temperatures taken with a tympanic thermometer never vary from those taken by the oral or rectal route.
d. It is an accurate measurement of body temperature because the tympanic membrane shares its blood supply with the hypothalamus.
e. It is taken by placing an infrared probe posterior to the ear.

Answer 5

d. It is an accurate measurement of body temperature because the tympanic membrane shares its blood supply with the hypothalamus.

The tympanic membrane shares its blood supply with the hypothalamus and is therefore an accurate measurement of body temperature. Tympanic thermometer probes are gently placed at the external opening of the ear canal, but not in the canal, and they should not occlude the canal.

Question 6

Postural hypotension is defined as which of the following when the patient stands compared with a sitting or supine reading?

Select one:
a. Blood pressure drop of more than 20 mm Hg in systolic and 10 mm Hg drop in diastolic

b. Pulse rate decrease with a systolic pressure increase of at least 15 mm Hg
c. Diastolic pressure increase of more than 5 mm Hg and no pulse rate changes
d. Pulse rate decrease and diastolic pressure decrease of more than 5 mm Hg

e. Decrease in pulse pressure
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Answer 6

. Blood pressure drop of more than 20 mm Hg in systolic and 10 mm Hg drop in diastolic

Postural hypotension (orthostatic hypotension) represents a significant decrease in systolic pressure (greater than 20 mm Hg) and a 10 mm Hg drop in diastolic pressure as a patient changes from a sitting to a standing position. An increase in heart rate often occurs as well.

Question 7

A 5-year-old is complaining of nondescriptive “belly pain.” Your next action should be to ask him to:
Select one:
a. point a finger to the spot that hurts.
b. draw a circle around the area that hurts.
c. use a metaphor to describe the pain.
d. identify what makes the pain worse.
e. allow him to use a “pain-o-meter.”

Answer 7

a. point a finger to the spot that hurts.