Which set of vital signs, taken on an adult, is cause for concern and requires further evaluation?
Temperature 96.9°F; pulse 100 bpm; respirations 20 breaths/minute; blood pressure 120/80 mmHg.
Temperature 97.0°F; pulse 54 bpm; respirations 14 breaths/minute; blood pressure 196/114 mmHg.
Temperature 98.6°F; pulse 60 bpm; respirations 14 breaths/minute; blood pressure 110/66 mmHg.
Temperature 99°F; pulse 72 bpm; respirations 16 breaths/minute; blood pressure 100/60 mmHg.
The Correct Answer is B
Temperature 97.0°F; pulse 54 bpm; respirations 14 breaths/minute; blood pressure 196/114 mmHg.
This set of vital signs is cause for concern because the blood pressure is significantly elevated.
A blood pressure reading of 196/114 mmHg is considered a hypertensive crisis and requires immediate medical attention.
Choice A) Temperature 96.9°F; pulse 100 bpm; respirations 20 breaths/minute; blood pressure 120/80 mmHg is within normal limits for an adult.
Choice C) Temperature 98.6°F; pulse 60 bpm; respirations 14 breaths/minute; blood pressure 110/66 mmHg is also within normal limits for an adult.
Choice D) Temperature 99°F; pulse 72 bpm; respirations 16 breaths/minute; blood pressure 100/60 mmHg is slightly elevated but not cause for immediate concern.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
“Do you know how to change your dressing?” This statement can create a barrier to communication because it may make the patient feel judged or defensive if they do not know how to change their dressing.
It is better to phrase the question in a more open-ended and non-judgmental way, such as “Can you tell me about your experience with changing your dressing?”
Choice B is not an answer because it encourages the patient to share information about their hospitalization and promotes open communication.
Choice C is not an answer because it shows that the speaker is actively listening and engaging with the patient’s previous statements.
Choice D is not an answer because it encourages the patient to share information about their pain management and promotes open communication.
Correct Answer is D
Explanation
According to Maslow’s Hierarchy of Needs, all people have basic human needs that must be met before they can attend to higher needs.
These basic human needs are physiological (food and clothing), safety (job security), love and belonging needs (friendship), esteem, and self-actualization1.
Choice A is incorrect because people do not have the same needs at the same time.
Choice B is incorrect because Maslow’s Hierarchy of Needs does not mention the risk of becoming ill.
Choice C is incorrect because not all people have a desire to be the best.
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