Nokea
You have just completed an initial shift assessment of a male in his 30s with a history of elevated hypertension and elevated cholesterol. Which of the following assessment findings provides information about his circulatory system?
- A. Skin is pale, warm, and dry
- B. BP is 164/98
- C. R is 27 regular and even
- D. AP is 94 regular and 2+, RP is 90 irregular and 2+, and pulse deficit is 4
- E. Pedal pulses are weak and equal bilaterally
- F. He has 2+ edema of both ankles
- G. He is awake, alert, and oriented to four spheres
Correct Answer: B,D,E,F
Rationale: BP, pulse deficit, pedal pulses, and edema are direct indicators of circulatory status, reflecting vascular pressure, perfusion, and fluid dynamics.
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Which of the following can be indicators of a person's hydration level?
- A. Color of nailbeds
- B. Temperature of skin on lower extremities
- C. Sluggish capillary refill
- D. Positive consensual reflex
- E. Weight
- F. Thirst
Correct Answer: C,E,F
Rationale: Sluggish capillary refill (C), weight changes (E), and thirst (F) are direct indicators of hydration status, reflecting fluid volume and body water needs.
At which of the following locations can you best hear the sound of the aortic valve?
- A. Just to the left of the sternum in the 3rd intercostal space
- B. To the left of the sternum in the 5th intercostal space in the midclavicular line
- C. Just to the right of the sternum in the 2nd intercostal space
- D. Just to the right of the sternum in the 4th intercostal space
Correct Answer: C
Rationale: The aortic valve is best heard at the right 2nd intercostal space near the sternum.
Your instructor has asked you to come to the patient's room to hear a good example of a murmur and a bruit. You know that there are specific instances when you use the bell versus the diaphragm side on your stethoscope and when you use light pressure as opposed to pressing to make a firm seal against the patient's skin. Which of the following correctly describes how to use the bell and diaphragm chest piece of your stethoscope?
- A. Use the flat diaphragm to auscultate lower-pitched sounds
- B. Use the bell to auscultate lower-pitched sounds
- C. When using the bell, press firmly to seal it against the skin
- D. When using the flat diaphragm, press it firmly to seal it against the skin
- E. Murmurs and bruits are considered high-pitched sounds
- F. The S1 and S2 are considered high-pitched sounds
Correct Answer: B,D
Rationale: The bell is used for low-pitched sounds with light pressure, while the diaphragm is pressed firmly for high-pitched sounds like murmurs and bruits.
A patient was admitted yesterday with pneumonia. When auscultating his breath sounds you detect rales in the right lower lobe. How quickly should you reassess this abnormal finding?
- A. Within 15 minutes
- B. Within 60 minutes
- C. In less than 2 hours
- D. In 4 hours or less
- E. When the patient complains of dyspnea
Correct Answer: C
Rationale: Rales (crackles) indicate fluid in the lungs, requiring reassessment within 2 hours to monitor for worsening pneumonia or respiratory distress.
Which lobe(s) of the lungs is(are) accessible for auscultation both anteriorly and posteriorly?
- A. The left upper lobe
- B. The left lower lobe
- C. The right upper lobe
- D. The right middle lobe
- E. The right lower lobe
Correct Answer: A,C
Rationale: The left and right upper lobes can be auscultated anteriorly and posteriorly due to their position in the chest.