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6_PD_Introduction to PE: General Survey & Vital Signs

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p.11

What condition is associated with a paradoxical pulse? A) Pure aortic regurgitation B) Cardiac tamponade C) Hypertrophic obstructive cardiomyopathy D) Premature contractions E) Severe aortic stenosis

Select an answer

p.11

Explanation

No explanation provided.

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p.11
Pulse Rate Assessment

What condition is associated with a paradoxical pulse?
A) Pure aortic regurgitation
B) Cardiac tamponade
C) Hypertrophic obstructive cardiomyopathy
D) Premature contractions
E) Severe aortic stenosis

B) Cardiac tamponade
Explanation: Paradoxical pulse is an abnormal pulse pattern associated with conditions like pericardial tamponade.

p.14
Temperature Measurement Methods

Which temperature measurement is considered more reliable in the presence of discrepancies?
A) Oral temperature
B) Axillary temperature
C) Tympanic temperature
D) Rectal temperature
E) Temporal temperature

D) Rectal temperature
Explanation: Rectal temperature is considered more reliable because oral temperature can be affected by many external factors.

p.6
Blood Pressure Measurement Techniques

What is the importance of choosing the appropriate BP cuff size?
A) It ensures the cuff is comfortable
B) It affects the accuracy of readings
C) It makes the process faster
D) It prevents the cuff from slipping
E) It ensures the cuff is reusable

B) It affects the accuracy of readings
Explanation: The size of the BP cuff will affect the accuracy of readings. Choosing the appropriate cuff size is necessary to ensure accurate blood pressure measurements.

p.6
Blood Pressure Measurement Techniques

What is the correct placement of the BP cuff on the arm?
A) 5 cm above the antecubital fossa
B) 2.5 cm above the antecubital fossa
C) At the wrist
D) At the elbow
E) At the shoulder

B) 2.5 cm above the antecubital fossa
Explanation: The lower border of the BP cuff should be 2.5 cm above the antecubital fossa for accurate placement.

p.2
General Survey Components

Which condition is characterized by a patient being unusually tall?
A) Dwarfism
B) Pituitary Gigantism
C) Osteoporosis
D) Kyphosis
E) Hypogonadism

B) Pituitary Gigantism
Explanation: Pituitary Gigantism is characterized by an unusually tall stature due to excessive growth hormone production.

p.13
Temperature Measurement Methods

Which temperature measurement site is typically 0.4° to 0.5°C higher than the oral temperature?
A) Axillary
B) Tympanic membrane
C) Rectal vault
D) Forehead
E) Oral cavity

C) Rectal vault
Explanation: The rectal vault temperature is typically 0.4° to 0.5°C higher than the oral temperature, making it one of the most accurate sites for measuring body temperature.

p.4
General Survey Components

Which of the following components can be accurately assessed in a non-awake patient?
A) Dress
B) Grooming
C) Hygiene
D) Apparent state of health
E) Mobility

D) Apparent state of health
Explanation: The apparent state of health can sometimes be assessed in a non-awake patient, especially if the patient looks very sick, although it is best assessed when the patient is awake.

p.9
Challenges in Vital Signs Assessment

What should be done if a patient has arrhythmia during blood pressure measurement?
A) Take the blood pressure only once
B) Use a smaller cuff
C) Take the blood pressure at least 3 times and average the results
D) Measure blood pressure at the wrist
E) Ignore the arrhythmia

C) Take the blood pressure at least 3 times and average the results
Explanation: In patients with arrhythmia, blood pressure should be taken at least 3 times and the average of the measurements should be considered.

p.2
General Survey Components

Which of the following is NOT a classical component of the general survey?
A) Development
B) Nutrition
C) Mental Status
D) Skin color and obvious lesions
E) Coherence

D) Skin color and obvious lesions
Explanation: Skin color and obvious lesions are part of the current components of the general survey, not the classical components.

p.8
Respiratory Rate Evaluation

What is the normal range for respiratory rate in breaths per minute?
A) 8-12 bpm
B) 12-20 bpm
C) 20-30 bpm
D) 30-40 bpm
E) 40-50 bpm

B) 12-20 bpm
Explanation: The normal respiratory rate for an adult is between 12 and 20 breaths per minute.

p.8
Respiratory Rate Evaluation

What is the correct method to take the respiratory rate without the patient noticing?
A) Ask the patient to hold their breath
B) Observe the rise and fall of the chest while appearing to take their pulse
C) Ask the patient to breathe deeply
D) Use a stethoscope to listen to the lungs
E) Count the breaths while the patient is talking

B) Observe the rise and fall of the chest while appearing to take their pulse
Explanation: To avoid the patient consciously altering their breathing, observe the rise and fall of the chest while appearing to take their pulse.

p.7
Blood Pressure Measurement Techniques

In which phase of Korotkoff sounds does the onset of silence occur, indicating diastolic blood pressure?
A) Phase I
B) Phase II
C) Phase III
D) Phase IV
E) Phase V

E) Phase V
Explanation: Phase V of Korotkoff sounds is characterized by the onset of silence, which indicates the diastolic blood pressure.

p.10
Blood Pressure Measurement Techniques

How is orthostatic hypotension diagnosed?
A) By measuring blood pressure only in the supine position
B) By measuring blood pressure and heart rate in the supine and standing positions
C) By measuring blood pressure only in the standing position
D) By measuring heart rate only in the supine position
E) By measuring heart rate only in the standing position

B) By measuring blood pressure and heart rate in the supine and standing positions
Explanation: Orthostatic hypotension is determined by measuring blood pressure and heart rate in two positions: supine (after resting for up to 10 minutes) and standing (within 3 minutes after standing up).

p.5
Vital Signs Overview

Which of the following is NOT a component of vital signs?
A) Blood pressure
B) Pulse rate
C) Respiratory rate
D) Blood glucose level
E) Temperature

D) Blood glucose level
Explanation: Vital signs include blood pressure, pulse rate, respiratory rate, temperature, and sometimes blood oxygen saturation, but not blood glucose level.

p.4
General Survey Components

Which of the following cannot be accurately assessed in a non-awake patient?
A) Mobility
B) Posture
C) Gait
D) Motor Activity
E) Dress, Grooming, Hygiene

E) Dress, Grooming, Hygiene
Explanation: Dress, grooming, and hygiene cannot be accurately assessed in a non-awake patient as these require the patient to be awake and able to interact.

p.11
Pulse Rate Assessment

Which abnormal pulse pattern is associated with left ventricular failure?
A) Bisferiens pulse
B) Pulsus alternans
C) Paradoxical pulse
D) Bigeminal pulse
E) Bounding pulse

B) Pulsus alternans
Explanation: Pulsus alternans is an abnormal pulse pattern associated with left ventricular failure.

p.12
Respiratory Rate Evaluation

Which condition is associated with obstructive breathing?
A) Diabetic coma
B) Chronic bronchitis
C) Increased intracranial pressure
D) Uremia
E) Metabolic acidosis

B) Chronic bronchitis
Explanation: Obstructive breathing can be associated with conditions such as asthma, chronic bronchitis, and COPD.

p.2
General Survey Components

What does the 'apparent state of health' refer to in a general survey?
A) The patient's mental status
B) The patient's nutritional status
C) The general judgment based on observations throughout the encounter
D) The patient's mobility
E) The patient's height and weight

C) The general judgment based on observations throughout the encounter
Explanation: Apparent state of health refers to the overall judgment of the patient's health based on observations made during the encounter.

p.8
Respiratory Rate Evaluation

How should the respiratory rate be counted to minimize errors?
A) Count for 10 seconds and multiply by 6
B) Count for 15 seconds and multiply by 4
C) Count for 30 seconds and multiply by 2
D) Count for 5 seconds and multiply by 12
E) Count for 20 seconds and multiply by 3

C) Count for 30 seconds and multiply by 2
Explanation: Counting the respiratory rate for at least 30 seconds and then multiplying by 2 helps minimize errors that can occur when counting for shorter periods.

p.7
Blood Pressure Measurement Techniques

What should you do if the first two blood pressure readings differ by more than 5 mmHg?
A) Take the average of the two readings
B) Ignore the readings and start over
C) Take additional readings and then average again
D) Use the higher reading
E) Use the lower reading

C) Take additional readings and then average again
Explanation: If the first two readings differ by more than 5 mmHg, additional readings should be taken and then averaged to ensure accuracy.

p.7
Pulse Rate Assessment

Which pulse site is considered the most convenient for measuring pulse rate?
A) Brachial Pulse
B) Carotid Pulse
C) Femoral Pulse
D) Dorsalis Pedis Pulse
E) Radial Pulse

E) Radial Pulse
Explanation: The radial pulse is considered the most convenient site for measuring pulse rate due to its accessibility.

p.10
Challenges in Vital Signs Assessment

What is a common cause of orthostatic hypotension?
A) High salt intake
B) Drugs that lower blood pressure
C) Excessive exercise
D) High cholesterol levels
E) Dehydration

B) Drugs that lower blood pressure
Explanation: Causes of orthostatic hypotension include drugs that lower blood pressure, loss of blood, prolonged bed rest, and diseases of the autonomic nervous system.

p.5
Blood Pressure Measurement Techniques

What is the usual site for measuring blood pressure?
A) Wrist
B) Upper arm
C) Ankle
D) Neck
E) Finger

B) Upper arm
Explanation: The usual site for measuring blood pressure is the upper arm, although it can also be taken on the thighs.

p.1
General Survey Components

What is the purpose of a general survey in a physical examination?
A) To replace the need for diagnostic tests
B) To gather nutritional data
C) To formulate initial impressions and differential diagnoses
D) To measure blood pressure
E) To assess oxygen saturation

C) To formulate initial impressions and differential diagnoses
Explanation: The general survey helps clinicians in formulating initial impressions, differential diagnoses, and deciding on diagnostic tests and eventual management.

p.4
Reporting General Survey Findings

Which of the following is NOT typically reported in the general survey of an awake patient?
A) Level of consciousness
B) Coherence
C) Apparent state of health
D) Height and built
E) Signs of distress

D) Height and built
Explanation: Height and built are not typically reported in the general survey of an awake patient unless there is something unusual or noteworthy about them.

p.6
Vital Signs Overview

Which of the following should a patient avoid before taking blood pressure?
A) Eating a meal
B) Drinking water
C) Recent exercise, caffeine, and nicotine
D) Talking
E) Watching TV

C) Recent exercise, caffeine, and nicotine
Explanation: The patient must avoid recent exercise, caffeine, and nicotine for at least 30 minutes before taking blood pressure to avoid affecting the reading.

p.13
Temperature Measurement Methods

What is the proper procedure for taking a tympanic membrane temperature?
A) Insert the thermometer under the tongue
B) Insert the thermometer into the rectum
C) Position the probe into the auditory canal aiming at the tympanic membrane
D) Place the thermometer in the armpit
E) Place the thermometer on the forehead

C) Position the probe into the auditory canal aiming at the tympanic membrane
Explanation: For accurate tympanic membrane temperature measurement, the probe must be positioned into the auditory canal so that the infrared beam is aimed at the tympanic membrane.

p.3
General Survey Components

Which skin color change is associated with liver diseases?
A) Pallor
B) Cyanosis
C) Jaundice
D) Erythema
E) Vitiligo

C) Jaundice
Explanation: Jaundice, characterized by a yellowing of the skin, is often associated with liver diseases.

p.7
Blood Pressure Measurement Techniques

What should be done to avoid missing an auscultatory gap?
A) Inflate the cuff to the maximum level
B) Deflate the cuff rapidly
C) Estimate the systolic blood pressure using the palpatory method
D) Use a digital blood pressure monitor
E) Measure blood pressure in a lying position

C) Estimate the systolic blood pressure using the palpatory method
Explanation: To avoid missing an auscultatory gap, it is important to estimate the systolic blood pressure using the palpatory method.

p.10
Blood Pressure Measurement Techniques

What defines orthostatic hypotension in terms of blood pressure changes?
A) A drop in systolic pressure of at least 10 mmHg within 3 minutes of standing
B) A drop in diastolic pressure of at least 5 mmHg within 3 minutes of standing
C) A drop in systolic pressure of at least 20 mmHg and/or diastolic pressure of at least 10 mmHg within 3 minutes of standing
D) A rise in systolic pressure of at least 20 mmHg within 3 minutes of standing
E) A rise in diastolic pressure of at least 10 mmHg within 3 minutes of standing

C) A drop in systolic pressure of at least 20 mmHg and/or diastolic pressure of at least 10 mmHg within 3 minutes of standing
Explanation: Orthostatic hypotension is defined as a drop in systolic pressure of at least 20 mmHg and/or diastolic pressure of at least 10 mmHg within 3 minutes of standing.

p.5
Blood Pressure Measurement Techniques

What should be avoided when taking blood pressure?
A) Using the upper arm
B) Using a quiet room
C) Taking BP on sites with AV shunts
D) Using a sphygmomanometer
E) Recording readings in mmHg

C) Taking BP on sites with AV shunts
Explanation: Blood pressure should not be taken on sites with AV shunts, fistula, lesions, or the affected arm of post-mastectomy patients.

p.11
Pulse Rate Assessment

What is the recommended method for assessing heart rate in patients with known irregular heart rhythm?
A) Counting the pulse rate for 30 seconds
B) Using a blood pressure cuff
C) Cardiac auscultation for a full minute
D) Measuring respiratory rate
E) Using a thermometer

C) Cardiac auscultation for a full minute
Explanation: For patients with known irregular heart rhythm, it is best to proceed with cardiac auscultation for heart rate, and the rate should be counted for a full minute due to the irregular rhythm.

p.14
Challenges in Vital Signs Assessment

What should be done when difficulties in determining vital signs are recognized?
A) Ignore the difficulties
B) Use alternative methods without addressing the issue
C) Recognize the difficulties and institute solutions
D) Avoid taking vital signs
E) Only rely on one method of measurement

C) Recognize the difficulties and institute solutions
Explanation: Recognizing difficulties and abnormalities peculiar to a patient allows for the institution of appropriate solutions, ensuring accurate vital signs determination.

p.2
General Survey Components

Which of the following is a current component of the general survey?
A) Development
B) Nutrition
C) Mental Status
D) Orientation to time, place, and person
E) Dress, grooming, hygiene

E) Dress, grooming, hygiene
Explanation: Dress, grooming, and hygiene are part of the current components of the general survey.

p.13
Temperature Measurement Methods

Which site for temperature measurement is considered to approximate core body temperature?
A) Oral cavity
B) Rectal vault
C) Axillary
D) Tympanic membrane
E) Forehead

D) Tympanic membrane
Explanation: The tympanic membrane temperature is often considered to approximate core body temperature due to its proximity to the hypothalamus, which regulates body temperature.

p.8
Pulse Rate Assessment

How should you count the pulse rate if the rhythm is regular?
A) Count for 10 seconds and multiply by 6
B) Count for 15 seconds and multiply by 4
C) Count for 1 minute
D) Count for 5 seconds and multiply by 12
E) Count for 20 seconds and multiply by 3

B) Count for 15 seconds and multiply by 4
Explanation: If the rhythm is regular, you can count the pulse for 15 seconds and multiply by 4 or count for 30 seconds and multiply by 2 to determine the rate.

p.7
Blood Pressure Measurement Techniques

What is the correct rate to deflate the blood pressure cuff when measuring blood pressure?
A) 1 mmHg per second
B) 2 mmHg per second
C) 3 mmHg per second
D) 4 mmHg per second
E) 5 mmHg per second

B) 2 mmHg per second
Explanation: The correct rate to deflate the blood pressure cuff is 2 mmHg per second to ensure accurate measurement of blood pressure.

p.8
Challenges in Vital Signs Assessment

What is considered a clinical emergency in terms of oxygen saturation?
A) < 85%
B) < 90%
C) < 95%
D) < 100%
E) < 105%

B) < 90%
Explanation: An oxygen saturation level below 90% is considered a clinical emergency and may indicate severe hypoxia, often accompanied by cyanosis.

p.5
Vital Signs Overview

What is the purpose of measuring vital signs?
A) To determine the patient's blood type
B) To identify the presence of an acute medical problem
C) To assess the patient's mental health
D) To diagnose genetic disorders
E) To evaluate the patient's diet

B) To identify the presence of an acute medical problem
Explanation: Measuring vital signs helps identify acute medical problems, quantify the magnitude of illness, and monitor chronic disease states.

p.5
General Survey Components

What does the general survey report indicate about the patient's mobility?
A) Ambulatory
B) Wheelchair-bound
C) Bedridden
D) Walking with assistance
E) Running

C) Bedridden
Explanation: The general survey report states that the patient is bedridden, indicating limited mobility.

p.1
General Survey Components

When does the general survey begin during a patient encounter?
A) After taking vital signs
B) During the first moments of the encounter
C) After the physical examination
D) During the nutritional assessment
E) After history taking

B) During the first moments of the encounter
Explanation: The general survey begins during the first moments of the patient encounter, as observations are made upon entering the patient's room or the patient entering the clinic.

p.11
Pulse Rate Assessment

Which condition is associated with small, weak pulses?
A) Fever
B) Anemia
C) Severe aortic stenosis
D) Hyperthyroidism
E) Aortic regurgitation

C) Severe aortic stenosis
Explanation: Small, weak pulses can be caused by decreased stroke volume, which is seen in conditions such as severe aortic stenosis.

p.12
Respiratory Rate Evaluation

Which condition is associated with rapid shallow breathing (tachypnea)?
A) Asthma
B) Diabetic coma
C) Restrictive lung disease
D) Anxiety
E) Heart failure

C) Restrictive lung disease
Explanation: Rapid shallow breathing, or tachypnea, can be associated with restrictive lung disease, pleuritic chest pain, and an elevated diaphragm.

p.14
Challenges in Vital Signs Assessment

Which of the following is NOT a common cause of hypothermia?
A) Exposure to cold
B) Reduced movement
C) Malignancy
D) Excess alcohol
E) Hypothyroidism

C) Malignancy
Explanation: Malignancy is a common cause of fever, not hypothermia. Common causes of hypothermia include exposure to cold, reduced movement, sepsis, excess alcohol, hypothyroidism, and hypoglycemia.

p.6
Blood Pressure Measurement Techniques

How should the arm be positioned when taking blood pressure?
A) At the level of the heart
B) Above the head
C) Below the waist
D) At the level of the knee
E) At the level of the shoulder

A) At the level of the heart
Explanation: The arm should be positioned such that the antecubital crease is at the level of the heart to ensure accurate blood pressure readings.

p.2
General Survey Components

Which of the following is a sign of anxiety in a patient?
A) Inexpressive affect
B) Poor eye contact
C) Psychomotor slowing
D) Cold and moist palms
E) Holding on to the painful area

D) Cold and moist palms
Explanation: Cold and moist palms are a sign of anxiety, along with fidgety movements and restless behavior.

p.13
Temperature Measurement Methods

What is the normal temperature range for the oral cavity?
A) 35°C
B) 36°C
C) 37°C
D) 38°C
E) 39°C

C) 37°C
Explanation: The normal temperature for the oral cavity is 37°C, which is considered the standard baseline for body temperature.

p.3
General Survey Components

What might excess clothing on a patient indicate?
A) Hyperthyroidism
B) Depression
C) Cold intolerance in hypothyroidism
D) Anxiety
E) Diabetes

C) Cold intolerance in hypothyroidism
Explanation: Excess clothing could indicate cold intolerance in hypothyroidism, hiding skin rash or needle marks, or a personal lifestyle preference.

p.3
General Survey Components

What does a preferred posture of leaning forward indicate?
A) Heart failure
B) Acute pancreatitis
C) Depression
D) Anxiety
E) Diabetes

B) Acute pancreatitis
Explanation: A preferred posture of leaning forward can indicate acute pancreatitis.

p.1
General Survey Components

What can be inferred from a patient gesturing a headache during a general survey?
A) The patient has a confirmed brain hemorrhage
B) The patient is likely experiencing pain
C) The patient has no significant complaints
D) The patient is experiencing a heart attack
E) The patient has a respiratory infection

B) The patient is likely experiencing pain
Explanation: A patient gesturing a headache suggests that they are likely experiencing pain, which could be due to various conditions such as a tension headache, migraine, or even a brain hemorrhage.

p.12
Respiratory Rate Evaluation

What is a potential cause of slow breathing (bradypnea)?
A) Exercise
B) Anxiety
C) Increased intracranial pressure
D) Asthma
E) COPD

C) Increased intracranial pressure
Explanation: Slow breathing, or bradypnea, can be caused by factors such as drugs, diabetic coma, increased intracranial pressure, and drug-induced respiratory depression.

p.12
Respiratory Rate Evaluation

Which breathing pattern is characterized by a recurring pattern of apnea, hypopnea, and hyperpnea?
A) Ataxic Breathing
B) Obstructive Breathing
C) Cheyne-Stokes Breathing
D) Kussmaul Respiration
E) Sighing Respiration

C) Cheyne-Stokes Breathing
Explanation: Cheyne-Stokes Breathing is characterized by a recurring pattern of apnea, hypopnea, and hyperpnea, and can be normal in children and elderly or associated with conditions like heart failure, uremia, and cerebral damage.

p.6
Blood Pressure Measurement Techniques

What percentage of the arm circumference should the inflatable bladder of the BP cuff cover?
A) 50%
B) 60%
C) 70%
D) 80%
E) 90%

D) 80%
Explanation: The inflatable bladder should reach ≥ 80% around the circumference of the arm to ensure accurate blood pressure readings.

p.6
Blood Pressure Measurement Techniques

How do you determine the Maximum Inflation Level (MIL) for BP measurement?
A) Inflate the cuff to 100 mmHg
B) Inflate the cuff until the patient feels discomfort
C) Add 30 mmHg to the estimated systolic pressure
D) Inflate the cuff to 200 mmHg
E) Inflate the cuff until the pulse is felt

C) Add 30 mmHg to the estimated systolic pressure
Explanation: To determine the MIL, add 30 mmHg to the estimated systolic pressure obtained by palpating the radial pulse.

p.13
Temperature Measurement Methods

What should be done if a patient has just eaten or drank hot or cold food before taking an oral temperature?
A) Take the temperature immediately
B) Delay the measurement for 10 to 15 minutes
C) Use a rectal thermometer instead
D) Use an axillary thermometer instead
E) Use a tympanic thermometer instead

B) Delay the measurement for 10 to 15 minutes
Explanation: If a patient has just eaten or drank hot or cold food, it is recommended to delay the oral temperature measurement for 10 to 15 minutes to ensure accuracy.

p.3
General Survey Components

What can sudden weight loss indicate in a patient?
A) Cushing Syndrome
B) Hypothyroidism
C) Diabetes
D) Depression
E) Dementia

C) Diabetes
Explanation: Sudden weight loss can be a valuable diagnostic clue for conditions such as Diabetes and Hyperthyroidism.

p.7
Blood Pressure Measurement Techniques

What is the significance of Phase I of Korotkoff sounds?
A) It indicates the diastolic blood pressure
B) It indicates the systolic blood pressure
C) It is the point of maximum inflation
D) It is the point where sounds become muffled
E) It is the point where sounds disappear

B) It indicates the systolic blood pressure
Explanation: Phase I of Korotkoff sounds is characterized by a faint, clear tapping sound that gradually increases in intensity and indicates the systolic blood pressure.

p.3
General Survey Components

What might decreased eye contact suggest?
A) Hyperthyroidism
B) Anxiety, fear, or sadness
C) Cushing Syndrome
D) Diabetes
E) Liver disease

B) Anxiety, fear, or sadness
Explanation: Decreased eye contact may suggest anxiety, fear, or sadness.

p.10
Challenges in Vital Signs Assessment

What is a common problem encountered in pulse and respiratory rate assessment?
A) High blood pressure
B) Irregular heart rhythm
C) Low blood sugar
D) High cholesterol
E) Dehydration

B) Irregular heart rhythm
Explanation: Common problems encountered in pulse and respiratory rate assessment include irregular heart rhythm, abnormal pattern of pulses, and abnormal breathing patterns.

p.4
Types of Patients in General Survey

What should be done to determine the level of consciousness in a non-awake patient?
A) Measure blood pressure
B) Apply a certain stimulation
C) Check for pulse rate
D) Assess respiratory rate
E) Evaluate temperature

B) Apply a certain stimulation
Explanation: To determine the level of consciousness in a non-awake patient, a certain stimulation should be applied, such as a sternal rub, to elicit a response.

p.9
Challenges in Vital Signs Assessment

What is one method to amplify weak Korotkoff sounds?
A) Use a smaller cuff
B) Inflate the cuff and ask the patient to make a fist several times
C) Take the blood pressure at the wrist
D) Use a digital blood pressure monitor
E) Measure blood pressure in a noisy environment

B) Inflate the cuff and ask the patient to make a fist several times
Explanation: Inflating the cuff and asking the patient to make a fist several times is one of the maneuvers suggested to intensify weak Korotkoff sounds.

p.14
Challenges in Vital Signs Assessment

Which of the following is a common cause of hypothermia?
A) Trauma
B) Malignancy
C) Sepsis
D) Starvation
E) Drug reactions

D) Starvation
Explanation: Starvation is a common cause of hypothermia, along with exposure to cold, reduced movement, sepsis, excess alcohol, hypothyroidism, and hypoglycemia.

p.2
General Survey Components

Which of the following is a sign of respiratory distress?
A) Fidgety movements
B) Holding their chest
C) Poor eye contact
D) Inexpressive affect
E) Psychomotor slowing

B) Holding their chest
Explanation: Holding their chest is a sign of cardiac or respiratory distress, indicating potential issues with the heart or lungs.

p.13
Temperature Measurement Methods

What is a disadvantage of taking rectal temperature?
A) Inaccuracy
B) Invasiveness
C) Slow measurement time
D) Inability to measure core temperature
E) Affected by eating or drinking

B) Invasiveness
Explanation: Rectal temperature measurement is often not preferred due to its invasive nature, making it uncomfortable for patients.

p.8
Temperature Measurement Methods

What is considered hypothermia in terms of body temperature?
A) < 35°C
B) < 36°C
C) < 37°C
D) < 38°C
E) < 39°C

A) < 35°C
Explanation: Hypothermia is defined as a body temperature below 35°C.

p.8
Temperature Measurement Methods

What is the normal range for body temperature in Celsius?
A) 34-35°C
B) 35-37.7°C
C) 37.8-39°C
D) 39-40°C
E) 40-41°C

B) 35-37.7°C
Explanation: The normal range for body temperature is between 35°C and 37.7°C.

p.7
Blood Pressure Measurement Techniques

What should be done if you are unsure about the point where systole and diastole occurred during blood pressure measurement?
A) Ignore the reading and move on
B) Repeat the measurement
C) Use the previous reading
D) Estimate the values
E) Inflate the cuff to a higher pressure

B) Repeat the measurement
Explanation: If you are unsure about the point where systole and diastole occurred, it is recommended to repeat the measurement for accuracy.

p.10
Blood Pressure Measurement Techniques

What is the normal response of blood pressure when a person rises from a supine to a standing position?
A) Systolic pressure rises significantly
B) Diastolic pressure drops significantly
C) Systolic pressure drops slightly or remains unchanged, while diastolic pressure rises slightly
D) Both systolic and diastolic pressures drop significantly
E) Both systolic and diastolic pressures rise significantly

C) Systolic pressure drops slightly or remains unchanged, while diastolic pressure rises slightly
Explanation: Normally, when a person rises from a horizontal to a standing position, systolic pressure drops slightly or remains unchanged, and diastolic pressure rises slightly.

p.5
Blood Pressure Measurement Techniques

Which of the following is NOT a part of a sphygmomanometer?
A) Bladder
B) Cuff
C) Valve
D) Bulb
E) Thermometer

E) Thermometer
Explanation: A sphygmomanometer includes a bladder, cuff, valve, bulb, connecting tubes, and manometer, but not a thermometer.

p.4
General Survey Components

What is a key observation in the general survey of an awake patient?
A) Patient's height
B) Patient's built
C) Patient's skin color
D) Patient's coherence
E) Patient's odor

D) Patient's coherence
Explanation: In an awake patient, coherence is a key observation in the general survey, as it indicates the patient's ability to converse and respond appropriately.

p.9
Challenges in Vital Signs Assessment

Which of the following is NOT a possible difficulty encountered during blood pressure assessment?
A) Weak Korotkoff sounds
B) Taking the BP at the thigh
C) Patients with arrhythmia
D) Orthostatic hypotension
E) High cholesterol levels

E) High cholesterol levels
Explanation: High cholesterol levels are not listed as a difficulty in blood pressure assessment. The other options are all mentioned as potential challenges.

p.14
Challenges in Vital Signs Assessment

Which of the following is a common cause of fever?
A) Exposure to cold
B) Reduced movement
C) Infection
D) Excess alcohol
E) Hypothyroidism

C) Infection
Explanation: Infection is a common cause of fever, along with trauma, malignancy, blood disorders, drug reactions, and immune disorders.

p.6
Blood Pressure Measurement Techniques

What should be the width of the BP cuff relative to the upper arm circumference?
A) 20%
B) 30%
C) 40%
D) 50%
E) 60%

C) 40%
Explanation: The width of the BP cuff should cover ≥ 40% of the upper arm circumference to ensure accurate readings.

p.2
General Survey Components

What is the correct classification for a patient who is difficult to arouse and needs constant stimulation to follow commands?
A) Alert & Oriented
B) Lethargic
C) Obtunded
D) Stupor
E) Coma

C) Obtunded
Explanation: An obtunded patient is difficult to arouse and needs constant stimulation to follow commands.

p.13
Temperature Measurement Methods

Which site for temperature measurement is generally considered less accurate?
A) Oral cavity
B) Rectal vault
C) Axillary
D) Tympanic membrane
E) Forehead

C) Axillary
Explanation: Axillary temperature measurement is generally considered less accurate compared to other sites and takes longer to register.

p.13
Temperature Measurement Methods

What is the recommended action if a patient is unconscious or unable to close their mouth for oral temperature measurement?
A) Use a rectal thermometer
B) Use an axillary thermometer
C) Use a tympanic thermometer
D) Take the temperature orally anyway
E) Use a forehead thermometer

C) Use a tympanic thermometer
Explanation: If a patient is unconscious or unable to close their mouth, it is recommended to use a tympanic thermometer as it is quick, safe, and reliable.

p.8
Temperature Measurement Methods

What should be done if the recorded temperature seems discordant with the patient's clinical condition?
A) Ignore the reading
B) Repeat the measurement
C) Assume the patient is lying
D) Use a different thermometer
E) Record the temperature as is

B) Repeat the measurement
Explanation: If the recorded temperature seems discordant with the patient's clinical condition, it is necessary to repeat the measurement to ensure accuracy.

p.7
Blood Pressure Measurement Techniques

What is the recommended action if repeated blood pressure measurements are uncomfortable for the patient?
A) Stop the measurements immediately
B) Use a different arm
C) Allow the cuff to completely deflate and wait a minute before repeating
D) Use a digital blood pressure monitor
E) Take the average of the initial readings

C) Allow the cuff to completely deflate and wait a minute before repeating
Explanation: To reduce discomfort, it is recommended to allow the cuff to completely deflate and wait a minute before repeating the measurement.

p.1
General Survey Components

What should a clinician do during the first moments of encountering a patient?
A) Immediately start taking vital signs
B) Begin with a nutritional assessment
C) Make observations and be observant
D) Perform a detailed physical examination
E) Ask the patient to fill out a questionnaire

C) Make observations and be observant
Explanation: During the first moments of encountering a patient, a clinician should make observations and be observant to gather initial data for the general survey.

p.12
Respiratory Rate Evaluation

Which of the following is characterized by episodes of apnea, hypopnea, and hyperpnea that do NOT occur in a recurring pattern?
A) Cheyne-Stokes Breathing
B) Ataxic Breathing (Biot’s Breathing)
C) Obstructive Breathing
D) Kussmaul Respiration
E) Rapid Shallow Breathing

B) Ataxic Breathing (Biot’s Breathing)
Explanation: Ataxic Breathing, also known as Biot’s Breathing, is characterized by episodes of apnea, hypopnea, and hyperpnea that do not occur in a recurring pattern.

p.6
Blood Pressure Measurement Techniques

What happens if the BP cuff is too small?
A) Readings will be falsely elevated
B) Readings will be falsely low
C) Readings will be accurate
D) The cuff will not inflate
E) The cuff will be uncomfortable

A) Readings will be falsely elevated
Explanation: If the BP cuff is too small, the readings will be falsely elevated. Conversely, if the cuff is too large, the readings will be falsely low.

p.8
Pulse Rate Assessment

What should you do if the pulse rhythm is irregular?
A) Count for 15 seconds and multiply by 4
B) Count for 30 seconds and multiply by 2
C) Verify the rate by listening over the heart for 1 minute
D) Ignore the irregularity and proceed
E) Count for 10 seconds and multiply by 6

C) Verify the rate by listening over the heart for 1 minute
Explanation: If the pulse rhythm is irregular, it is important to verify the rate by listening over the heart or doing a cardiac auscultation for 1 minute to ensure accuracy.

p.8
Challenges in Vital Signs Assessment

What is the normal range for oxygen saturation?
A) 85-90%
B) 90-95%
C) 95-100%
D) 100-105%
E) 105-110%

C) 95-100%
Explanation: The normal range for oxygen saturation is between 95% and 100%. Values below 95% may indicate hypoxia.

p.3
General Survey Components

What odor is associated with diabetic ketoacidosis?
A) Uremic breath
B) Fruity and ketone breath
C) Scent of alcohol
D) Ammonia breath
E) Garlic breath

B) Fruity and ketone breath
Explanation: Diabetic ketoacidosis can cause a fruity and ketone breath odor.

p.3
General Survey Components

What might a limp or discomfort in gait indicate?
A) Liver disease
B) Neurologic or muscular disorders
C) Depression
D) Anxiety
E) Diabetes

B) Neurologic or muscular disorders
Explanation: Issues with gait, such as a limp or discomfort, may signal neurologic or muscular disorders.

p.5
General Survey Components

Which of the following is NOT reported in the general survey due to normal findings?
A) Height and built
B) Mobility
C) Signs of distress
D) Level of consciousness
E) Apparent state of health

A) Height and built
Explanation: Height and built, along with skin color, obvious lesions, and odor, are not reported because they are normal.

p.1
General Survey Components

Which of the following is NOT a component of the general survey?
A) Observing the patient's gestures
B) Inspecting the patient from head to toe
C) Measuring blood pressure
D) Making initial observations upon entering the room
E) Formulating differential diagnoses based on observations

C) Measuring blood pressure
Explanation: Measuring blood pressure is part of the vital signs assessment, not the general survey. The general survey involves initial observations and inspections.

p.11
Pulse Rate Assessment

Which of the following is NOT a cause of large, bounding pulses?
A) Fever
B) Anemia
C) Hyperthyroidism
D) Severe aortic stenosis
E) Aortic regurgitation

D) Severe aortic stenosis
Explanation: Large, bounding pulses are associated with increased stroke volume or decreased peripheral resistance, seen in conditions like fever, anemia, hyperthyroidism, and aortic regurgitation, but not severe aortic stenosis.

p.9
Blood Pressure Measurement Techniques

What are Korotkoff sounds used to signal?
A) Heart rate
B) Respiratory rate
C) Systolic and diastolic blood pressures
D) Body temperature
E) Oxygen saturation levels

C) Systolic and diastolic blood pressures
Explanation: Korotkoff sounds are used to signal the levels of systolic and diastolic blood pressures during a blood pressure measurement.

p.9
Challenges in Vital Signs Assessment

Which of the following is NOT a possible reason for weak Korotkoff sounds?
A) Erroneous placement of stethoscope
B) Failure to make full skin contact with the bell
C) Venous engorgement of the patient’s arm
D) Presence of shock
E) High blood sugar levels

E) High blood sugar levels
Explanation: High blood sugar levels are not mentioned as a reason for weak Korotkoff sounds. The other options are all possible reasons.

p.9
Blood Pressure Measurement Techniques

When taking blood pressure at the thigh, where should the bladder of the cuff be centered?
A) Over the anterior surface
B) Over the lateral surface
C) Over the posterior surface
D) Over the medial surface
E) Over the distal surface

C) Over the posterior surface
Explanation: When taking blood pressure at the thigh, the bladder of the cuff should be centered over the posterior surface.

p.12
Respiratory Rate Evaluation

Which of the following is a characteristic of Kussmaul respiration?
A) Rapid shallow breathing
B) Episodes of apnea, hypopnea, and hyperpnea without a recurring pattern
C) Rapid deep breathing or hyperventilation
D) Recurring pattern of apnea, hypopnea, and hyperpnea
E) Sighing respiration

C) Rapid deep breathing or hyperventilation
Explanation: Kussmaul respiration, also known as rapid deep breathing or hyperventilation, is characterized by rapid deep breathing and can be associated with exercise, anxiety, and metabolic acidosis.

p.2
General Survey Components

What does the 'level of consciousness' assess in a general survey?
A) The patient's nutritional status
B) The patient's mental status
C) The patient's state of awareness
D) The patient's mobility
E) The patient's height and weight

C) The patient's state of awareness
Explanation: Level of consciousness assesses the patient's state of awareness, including whether they are alert, lethargic, obtunded, in stupor, or in a coma.

p.13
Temperature Measurement Methods

What is a key disadvantage of using the axillary site for temperature measurement?
A) It is invasive
B) It is less accurate
C) It is uncomfortable
D) It is affected by eating or drinking
E) It is dangerous

B) It is less accurate
Explanation: The axillary site for temperature measurement is less accurate and takes longer to obtain a reading compared to other sites.

p.13
Temperature Measurement Methods

What is the proper procedure for taking an oral temperature using a glass thermometer?
A) Insert it into the rectum
B) Place it in the armpit
C) Shake it down to 35°C, insert under the tongue, wait 3 to 5 minutes, then read
D) Place it on the forehead
E) Insert it into the ear canal

C) Shake it down to 35°C, insert under the tongue, wait 3 to 5 minutes, then read
Explanation: The proper procedure for taking an oral temperature with a glass thermometer involves shaking it down to 35°C, inserting it under the tongue, waiting 3 to 5 minutes, and then reading the temperature.

p.3
General Survey Components

What might a patient’s unkempt appearance indicate?
A) Anxiety
B) Dementia
C) Hyperthyroidism
D) Cushing Syndrome
E) Liver disease

B) Dementia
Explanation: An unkempt appearance may be seen in conditions such as depression and dementia.

p.7
Blood Pressure Measurement Techniques

In which conditions might Phase V of Korotkoff sounds be absent, requiring Phase IV to be used for diastolic blood pressure?
A) Hypertension
B) Hyperkinetic states like pregnancy, anemia, hyperthyroidism, and aortic insufficiency
C) Hypotension
D) Normal healthy adults
E) Children over 13 years old

B) Hyperkinetic states like pregnancy, anemia, hyperthyroidism, and aortic insufficiency
Explanation: In hyperkinetic states such as pregnancy, anemia, hyperthyroidism, and aortic insufficiency, Phase V may be absent, and Phase IV should be used to determine diastolic blood pressure.

p.10
Vital Signs Overview

According to the 8th Joint National Committee (JNC), what is the systolic blood pressure range for Stage I hypertension?
A) 120-139 mmHg
B) 140-159 mmHg
C) 160 mmHg or higher
D) Less than 120 mmHg
E) 130-139 mmHg

B) 140-159 mmHg
Explanation: According to the JNC 8th classification, Stage I hypertension is defined by a systolic blood pressure range of 140-159 mmHg.

p.3
General Survey Components

What facial expression might suggest depression?
A) Stare
B) Asymmetric facial expression
C) Flat or sad facial expression
D) Increased eye contact
E) Smiling

C) Flat or sad facial expression
Explanation: A flat or sad facial expression may suggest depression.

p.3
General Survey Components

Which condition might cause a patient to have a stare?
A) Depression
B) Hyperthyroidism
C) Anxiety
D) Dementia
E) Cushing Syndrome

B) Hyperthyroidism
Explanation: Hyperthyroidism may cause a patient to have a stare in some cases.

p.5
General Survey Components

What is the level of consciousness of the patient in the general survey report?
A) Alert
B) Lethargic
C) Stuporous
D) Comatose
E) Confused

C) Stuporous
Explanation: The general survey report specifically mentions that the patient is stuporous, indicating a reduced level of consciousness.

p.10
Vital Signs Overview

What is the blood pressure category for a reading of 135/100 mmHg according to the JNC 8th classification?
A) Normal
B) Prehypertension
C) Stage I hypertension
D) Stage II hypertension
E) Hypertensive crisis

D) Stage II hypertension
Explanation: According to the JNC 8th classification, a blood pressure reading of 135/100 mmHg falls into Stage II hypertension because the diastolic pressure is at least 100 mmHg.

p.7
Blood Pressure Measurement Techniques

According to the 2017 American Guidelines on Blood Pressure, what is required for home blood pressure monitoring using automated devices?
A) The device must be used only in the morning
B) The device must be validated to be accurate
C) The device must be used by a healthcare professional
D) The device must be used only once a week
E) The device must be used in a clinical setting

B) The device must be validated to be accurate
Explanation: According to the 2017 American Guidelines on Blood Pressure, automated devices are acceptable for home blood pressure monitoring as long as the machine is validated to be accurate.

p.10
Vital Signs Overview

What is the definition of isolated systolic hypertension?
A) Systolic BP is at least 140 mmHg, while diastolic BP is less than 90 mmHg
B) Systolic BP is less than 120 mmHg, while diastolic BP is at least 90 mmHg
C) Both systolic and diastolic BP are less than 120 mmHg
D) Both systolic and diastolic BP are at least 140 mmHg
E) Systolic BP is less than 140 mmHg, while diastolic BP is at least 90 mmHg

A) Systolic BP is at least 140 mmHg, while diastolic BP is less than 90 mmHg
Explanation: Isolated systolic hypertension is common in elderly patients and is defined by a systolic BP of at least 140 mmHg, while diastolic BP is less than 90 mmHg.

p.5
Vital Signs Overview

What is the significance of deranged vital signs?
A) They indicate the patient is healthy
B) They suggest the patient is getting better
C) They quantify the magnitude of illness
D) They show the patient's diet
E) They measure the patient's height

C) They quantify the magnitude of illness
Explanation: Deranged vital signs help rapidly quantify the magnitude of an illness and determine how well the body is coping with physiologic stress.

p.5
Vital Signs Overview

What is the first step in preparing to take vital signs?
A) Prepare the materials
B) Prepare personal skills
C) Ensure the examination room is quiet, warm, and well-lit
D) Take the patient's history
E) Measure the patient's height

C) Ensure the examination room is quiet, warm, and well-lit
Explanation: The first step in preparation is to make sure the examination room is quiet, warm, and well-lit.

Study Smarter, Not Harder
Study Smarter, Not Harder