GNA Vital Signs and Physical Assessment 2

Question 1

A nursing assistant is preparing to take a resident's blood pressure. What is the correct placement of the blood pressure cuff?

Accepted Answer

Around the upper arm, about 1 inch above the elbow crease

Answer

Around the forearm, below the elbow

Answer

Around the wrist, over the pulse point

Answer

Around the upper arm, above the shoulder

Question 2

Which thermometer route is most appropriate for a resident who is confused and cannot follow instructions to hold the thermometer under the tongue?

Accepted Answer

Axillary (armpit)

Answer

Oral

Answer

Rectal

Answer

Tympanic (ear)

Question 3

What is the normal oral body temperature range for an adult?

Accepted Answer

97.6°F–99.6°F (36.4°C–37.6°C)

Answer

95.0°F–97.0°F (35°C–36.1°C)

Answer

100.0°F–101.5°F (37.8°C–38.6°C)

Answer

102°F–104°F (38.9°C–40°C)

Question 4

When counting a resident's pulse, the nursing assistant notices the rhythm is irregular. What is the best action?

Accepted Answer

Count the pulse for a full minute and report the finding to the nurse

Answer

Ignore it since irregular pulses are common in the elderly

Answer

Count for only 15 seconds and multiply by four for speed

Answer

Ask the resident if they feel the irregularity

Question 5

The nursing assistant notices a resident's skin is pale, cool, and clammy. Which vital sign change is most consistent with these findings?

Accepted Answer

Low blood pressure and rapid pulse

Answer

Elevated temperature and increased blood pressure

Answer

Slow pulse and elevated temperature

Answer

Normal blood pressure and slow respiratory rate

Question 6

How many full seconds should the nursing assistant count a regular pulse before multiplying to obtain the rate per minute?

Accepted Answer

30 seconds, then multiply by 2

Answer

15 seconds, then multiply by 4

Answer

20 seconds, then multiply by 3

Answer

60 seconds with no multiplication needed

Question 7

Which of the following is an early sign of hypoxia (low blood oxygen) that the nursing assistant should report?

Accepted Answer

Restlessness and confusion

Answer

Flushed, warm skin

Answer

Increased urine output

Answer

Bradycardia (slow pulse)