CKE Vital Signs and Basic Assessment 2

Question 1

When placing a blood pressure cuff on the arm, the lower edge of the cuff should be positioned:

Accepted Answer

Approximately 1 inch (2–3 cm) above the antecubital fossa

Answer

Directly over the antecubital fossa

Answer

At least 3 inches above the antecubital fossa

Answer

Over clothing at mid-upper arm

Question 2

For the most accurate respiratory rate assessment, how long should respirations be counted?

Accepted Answer

30 seconds, then multiply by 2 if regular; 60 seconds if irregular

Answer

15 seconds, then multiply by 4

Answer

20 seconds, then multiply by 3

Answer

10 seconds, then multiply by 6

Question 3

The apical pulse is best assessed by placing a stethoscope at the:

Accepted Answer

Fifth intercostal space at the midclavicular line

Answer

Second intercostal space, right sternal border

Answer

Third intercostal space, left sternal border

Answer

Fourth intercostal space at the anterior axillary line

Question 4

Which technique is correct when palpating a radial pulse?

Accepted Answer

Use the index and middle fingers with moderate pressure

Answer

Use the thumb, applying firm pressure

Answer

Use all four fingers simultaneously

Answer

Use the palm of the hand over the wrist

Question 5

Orthostatic hypotension is assessed by measuring blood pressure and heart rate in which sequence?

Accepted Answer

While supine, then seated, then standing after 1–3 minutes in each position

Answer

Only while standing for 5 minutes

Answer

Only in the seated and standing positions

Answer

While walking and immediately after stopping

Question 6

Blood pressure should NOT be measured in an arm that has which of the following conditions?

Accepted Answer

A peripheral IV, AV fistula, or is on the side of a mastectomy

Answer

Visible veins at the antecubital fossa

Answer

A healed fracture with no current cast

Answer

Previously recorded a higher BP than the opposite arm

Question 7

Axillary temperature readings are generally how much lower than core (rectal) temperature?

Accepted Answer

1.0–2.0°F lower

Answer

0.2–0.4°F lower

Answer

0.5–1.0°F lower

Answer

Axillary is typically higher than rectal