Deck 4: Vital Signs

Question 1

Fever is defined as an:

A) infection in the body.
B) elevation of body temperature above normal.
C) increase in the oxygen requirements of the body.
D) elevation of body temperature above normal because of disease.

Answer 1

elevation of body temperature above normal because of disease.

Question 2

Which of the following statements is true regarding oral temperature measurements?

A) They are the most convenient to obtain and are most readily accepted by alert adults.
B) They are useful in infants.
C) They are acceptable in orally intubated patients.
D) They are affected by delivery of oxygen by nasal cannula.

Answer 2

They are the most convenient to obtain and are most readily accepted by alert adults.

Question 3

What is the most common cause of fever above 102°F?

A) Aspiration pneumonitis
B) Infection
C) Blood transfusion reaction
D) Head injury

Answer 3

Infection

Question 4

The normal range for oral body temperature in most people is _____°F to _____°F.

A) 97; 99.5
B) 96.7; 98.5
C) 98.7; 100.5
D) 97.7; 98.5

Question 5

What is the main advantage of tympanic thermometry over the classic forms of temperature measurement?

A) It is fast, clean, and noninvasive.
B) Multiple studies have shown a high correlation with core temperature.
C) It is the preferred method of temperature measurement in the pediatric population.
D) It uses infrared emissions from the surface of the tympanic membrane and is not in contact with skin or other tissue.

Question 6

How often should vital signs be recorded in a patient who is hospitalized but is not in intensive care?

A) Every hour
B) Every 2 to 4 h
C) Every 4 to 6 h
D) Every 8 to 12 h

Question 7

Which of the following statements regarding vital signs is most accurate?

A) Vital signs are used only to establish a baseline.
B) Vital signs monitor only the response to therapy.
C) Trends in vital signs are far more important than a single measurement.
D) Vital signs at baseline should never be compared with those that were obtained 24 h earlier.

Question 8

For every elevation in body temperature of 1°C, oxygen consumption and carbon dioxide production increase by approximately ____%.

A) 2
B) 5
C) 10
D) 20

Question 9

Which of the following scales is the gold standard for assessing trends in the neurologic function of patients who have suffered head trauma?

A) Murray scale
B) PRISM
C) APACHE
D) Glasgow coma scale

Question 10

Which of the following are classified as classic vital signs?
1) Pulse
2) Sensorium
3) Blood pressure
4) Respiratory rate

A)1, 2, and 4
B)1, 3, and 4
C)2 and 3
D)1 and 4

Question 11

Which of the following conditions causes hypothermia?

A) Damage to the hypothalamus
B) Excessive shivering and vasoconstriction
C) Exposure to high environmental temperatures
D) Invasion of the body by microorganisms that produce an infection

Question 12

Which of the following are considered typical sites for temperature measurement?
1) Oral
2) Rectal
3) Axillary
4) Fingertip

A)1 and 4
B)2 and 3
C)2, 3, and 4
D)1, 2, and 3

Question 13

When vital signs are compared with other signs and symptoms to arrive at a conclusion about what is wrong with a patient, this is known as the:

A) review of systems.
B) differential diagnosis.
C) general clinical presentation.
D) objective assessment information.

Question 14

What site is used to measure body temperature in comatose patients?

A) Oral
B) Axillary
C) Rectal
D) Ear

Question 15

A patient's general clinical presentation indicates to the respiratory therapist (RT) that the patient is in distress. The RT's first step should be to:

A) call a code and stand by to assist with cardiopulmonary resuscitation (CPR).
B) do a complete physical examination to determine the precise cause of the distress.
C) evaluate the problem quickly and intervene or locate someone to assist the patient.
D) follow the procedure learned in class to introduce himself or herself to the patient and ask the patient what is wrong.

Question 16

A well-written description of an RT's initial observations is beneficial to other health care providers because it:

A) shows that the RT has established rapport with the patient.
B) helps them know how to plan care and relate to the patient's needs.
C) decreases the length of hospitalization of the patient and keeps costs down.
D) allows them to read the information quickly without confusion and misunderstandings.

Question 17

Assessing the patient's level of consciousness is important because it:

A) suggests the types of questions that the therapist should ask.
B) evaluates the adequacy of cerebral perfusion and oxygenation.
C) indicates whether the patient will take an active role in his or her treatment.
D) documents the patient's mental status at the time of the physical examination.

Question 18

Which of the following is the method of choice for measuring temperature in neonates?

A) Oral
B) Rectal
C) Axillary
D) Tympanic

Question 19

If dehydration is suspected in a patient, which of the following parameters should be monitored often?

A) Pulse rate
B) Weight
C) Fluid intake and output
D) Blood pressure

Question 20

Which of the following statements best reflects the importance of comparing changes in vital signs?

A) It allows assessment of important subjective patient data.
B) It allows recognition of the development of a particular problem.
C) It allows detection of additional symptoms.
D) It does not allow changes in therapy.

Question 21

What is an important reason to monitor the heart rate in patients with lung disease?

A) A heart rate above or below the normal range is dangerous.
B) As the heart rate increases, the tissue's demand for oxygen decreases.
C) The more efficiently the heart is pumping, the lower is the resting pulse rate.
D) Tachycardia is a common finding when hypoxemia is present.

Question 22

The diastolic blood pressure is a reflection of:

A) the pressure exerted during left ventricular relaxation.
B) the peak pressure exerted during left ventricular contraction.
C) the difference between systolic and diastolic pressures.
D) the force exerted against the walls of the arteries as blood flows through them.

Question 23

Which of the following reasons has been listed as the number one concern regarding use of the tympanic site for body temperature measurement?

A) Speed
B) Safety
C) Accuracy
D) Cost

Question 24

Which of the following are causes of hypotension?
1) Left ventricular failure
2) Peripheral vasodilation
3) Hypovolemia
4) Right heart failure

A)1 and 4
B)2 and 3
C)2, 3, and 4
D)1, 2, and 3

Question 25

What is the most probable cause for the significant decrease in blood pressure that occurs during inhalation in some patients?

A) Hypovolemia
B) Variable systemic vascular resistance
C) Early left ventricular failure caused by coronary artery insufficiency
D) Negative intrathoracic pressure that diminishes blood flow out of the left ventricle

Question 26

An alternating succession of strong and weak pulses that usually is not related to respiratory disease is known as pulsus:

A) tardus.
B) alternans.
C) paradoxus.
D) asymmetrical.

Question 27

Which of the following terms is used to describe a significant decrease in pulse pressure during spontaneous inspiration?

A) Pulsus alternans
B) Pulsus paradoxus
C) Pulsus respiratory
D) Pulsus asymmetrical

Question 28

Which of the following organs are at risk for disease in the presence of systemic hypertension?
1) Heart
2) Kidneys
3) Blood vessels
4) Pancreas

A)1 and 4
B)2 and 3
C)2, 3, and 4
D)1, 2, and 3

Question 29

In postoperative patients, the degree of tachypnea typically is related to the degree of:

A) anesthetic received during surgery.
B) pain medication received.
C) pneumonia.
D) atelectasis.

Question 30

Which of the following are true about pulse pressure?
1) It normally is between 35 and 40 mm Hg.
2) It is calculated from the 12-lead electrocardiographic printout.
3) It is the difference between the systolic and diastolic pressures.
4) The peripheral pulse is difficult to detect when the pulse pressure falls to below 30 mm Hg.

A)1 and 4
B)2 and 3
C)1, 3, and 4
D)1, 2, and 3

Question 31

Hypotension associated with changes in posture in patients with hypovolemia is known as _____ hypotension.

A) persistent
B) orthostatic
C) hypovolemic
D) peristaltic

Question 32

A pulse rate above the normal range is the definition of which of the following terms?

A) Tachypnea
B) Arrhythmia
C) Bradycardia
D) Tachycardia

Question 33

Which of the following arteries is most appropriate for measuring the pulse of a patient with very low blood pressure?

A) Radial artery
B) Popliteal artery
C) Brachial artery
D) Femoral artery

Question 34

Bradypnea can be caused by which of the following?
1) Hypothermia
2) Narcotic overdose
3) Head injury
4) Infection

A)1 and 4
B)2 and 3
C)2, 3, and 4
D)1, 2, and 3

Question 35

A respiratory rate of greater than _____ breaths/min is considered abnormal at any age.

A) 60
B) 50
C) 40
D) 30

Question 36

Which of the following techniques are useful in measuring the respiratory rate in patients who are spontaneously breathing and alert?
1) Ask the patient to breathe normally.
2) Lay the hand you are using to count the patient's pulse on the patient's abdomen, and watch abdominal movements.
3) Count the rate for 30 s and multiply by 2.
4) Pretend to be counting the pulse while counting the respiratory rate.

A)1 and 4
B)2 and 3
C)2, 3, and 4
D)1, 2, and 3

Question 37

Which of the following breathing patterns describes Kussmaul breathing?

A) Normal
B) Shallow
C) Fast and shallow
D) Fast and deep

Question 38

Which of the following characteristics should be included in the assessment of a patient's pulse?

A) Age, rate, and strength
B) Rate, rhythm, and strength
C) Age, rhythm, and status
D) Strength, amplitude, and volume

Question 39

When the blood pressure is measured, the sounds that are heard through the stethoscope between the systolic and diastolic pressures are known as _____ sounds.

A) Meckel
B) Brachial
C) Korotkoff
D) Succussion

Question 40

The normal pulse rate range for adults is _____ beats/min.

A) 60 to 100
B) 70 to 110
C) 80 to 120
D) 90 to 160

Question 41

An RT has just finished administering an aerosol treatment by a small-volume nebulizer to a patient who has a serious case of pneumonia. For the past 24 h, the patient has had a fever of 39 to 40° C. Just as the therapist is finishing, a nursing aide comes in to record the vital signs. She uses an electronic thermometer to record an oral temperature of 36.5° C and comments to the patient, "Well, Mr. Jones, you must be getting better because your fever is completely gone." The therapist should:

A) also verbally encourage the patient by saying that he is getting better.
B) totally ignore the situation and continue with the post-treatment assessment.
C) complete the treatment and assessment, record the results in the patient's chart, then go on to the next patient.
D) go to the nursing aide after she leaves the room and tell her that the temperature she recorded is probably not accurate and should be repeated.

Question 42

An RT attempts to take the blood pressure of the patient in question 42. The RT notes that the pulse intensity determined from palpation of the radial artery decreases during inspiration. The most likely explanation for this would be:

A) a myocardial infarction.
B) an acute asthma exacerbation.
C) dehydration.
D) a cerebrovascular accident (CVA; stroke).

Question 43

A 42-year-old male patient with a history of poorly controlled asthma is seen in the emergency department by the respiratory therapist (RT). The patient is seated in a chair and clearly is in extreme respiratory distress, with inspiratory and expiratory wheezing throughout. He reports that he has had a fever for the past 2 days and has eaten and drunk very little. He also reports some chest pain, and his blood pressure is 95/55 mm Hg. At one point, the patient stands to move from the chair to the stretcher and has an episode of syncope. The differential diagnosis for this patient should include which of the following?
1) Myocardial infarction (MI)
2) Acute asthma exacerbation
3) Dehydration
4) Cerebrovascular accident (CVA; stroke)

A)1 and 4
B)2 and 3
C)2, 3, and 4
D)1, 2, and 3

Question 44

An RT is called to the emergency department on New Year's Eve to assist in the treatment of a 5-year-old child pulled from under the ice of a local pond. When the child arrives, he has been intubated and has a weak, irregularly irregular pulse of 55 beats/min, no spontaneous respiratory effort, and a body temperature of 30° C. The normal practice in this hospital is to use heat-moisture exchangers (HMEs) for all mechanically ventilated patients. Which of the following should the therapist suggest for the ventilator setup?

A) Greater than normal rate and tidal volume
B) Higher than usual inspiratory flow rate
C) Heated humidity in place of the HME
D) Lower than normal rate and tidal volume

Question 45

Which of the following conditions are associated with the presence of pulsus paradoxus?
1) Hypervolemia
2) Cardiac tamponade
3) Constrictive pericarditis
4) Asthma

A)1 and 4
B)2 and 3
C)2, 3, and 4
D)1, 2, and 3

Question 46

An RT is taking the blood pressure in the arm of a 12-year-old girl. The only sphygmomanometer available has a cuff in which the ends overlap slightly when it is inflated. The pressure that the RT records:

A) should be accurate if the measurement is otherwise done properly.
B) is likely to be in error, showing a value that is too low.
C) is likely to be in error, showing a value that is too high.
D) will have a value that cannot be predicted to be either too high or too low.