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HESI LPN · HESI LPN Fundamentals of Nursing · LPN Vital Signs in Nursing Assessment

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Showing all 5 practice questions with expert explanatory rationales.

Question 1 of 5

Older adults have an increase in systolic pressure related to what?

A. Increased vessel flexibility

B. Decreased vessel elasticity

C. Enlarged vessel dexterity

D. Diminished vessel porosity

Expert Explanatory Rationale

Correct Answer: Decreased vessel elasticity

Question 2 of 5

The nurse palpating the skin of a patient documents a firm 1.5 cm mass on the lower right leg. What type of skin lesion does this describe?

A. macule

B. wheal

C. vesicle

D. nodule

Expert Explanatory Rationale

Correct Answer: nodule

Question 3 of 5

Various sounds are heard when assessing a blood pressure. What does the first sound heard through the stethoscope represent?

A. systolic pressure

B. diastolic pressure

C. auscultatory gap

D. pulse pressure

Expert Explanatory Rationale

Correct Answer: systolic pressure

Question 4 of 5

A nurse assesses orthostatic hypotension in an older adult. What would be an appropriate intervention for this patient?

A. Encourage the patient to rise from a sitting position quickly to improve blood flow.

B. Allow the patient to dangle for a few minutes prior to rising to a standing position.

C. If the patient feels faint or dizzy, return the patient to bed and place in Fowlers position.

D. Administer a beta-adrenergic blocker to increase blood pressure.

Expert Explanatory Rationale

Correct Answer: Allow the patient to dangle for a few minutes prior to rising to a standing position.

Question 5 of 5

Which of the following accurately reflects a recommended guideline when assessing blood pressure?

A. If this is the initial nursing assessment of a patient, take the blood pressure on both arms and use the arm with the lower reading for subsequent pressures.

B. Use electronic monitoring devices on patients with irregular heartbeats, tremors, or the inability to hold the arm still.

C. Raise the patient's arm over the head to help relieve congestion of blood in the limb and make the sounds louder and more distinct.

D. In newborns, take the blood pressure in one arm and one leg and document the difference to check for heart defects.

Expert Explanatory Rationale

Correct Answer: Raise the patient's arm over the head to help relieve congestion of blood in the limb and make the sounds louder and more distinct.

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