Vital Signs: Definition, Normal Ranges & 50 MCQs | Nursing Notes

Vital Signs: Definition, Normal Ranges & 50 MCQs | Nursing Notes

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Body Temperature (शरीर का तापमान)

It is the balance between heat produced (Thermogenesis) and heat lost (Thermolysis).
यह शरीर द्वारा उत्पन्न ऊष्मा और नष्ट हुई ऊष्मा के बीच का संतुलन है।
Normal Range: 98.6°F (37°C)
Centers: Hypothalamus (The body’s thermostat).

Key Terms:

Pyrexia (Fever): Temperature > 99°F.
Hyperpyrexia: Temperature > 105°F.
Hypothermia: Temperature < 95°F.

Measurement Sites:

Oral: Most common.
Axillary: Safest (Read 1°F less than oral).
Rectal: Most accurate (Read 1°F more than oral).

Pulse (Heart Rate)

The rhythmic expansion and contraction of an artery as blood is pumped by the heart.
हृदय द्वारा रक्त पंप करने पर धमनी में होने वाला लयबद्ध विस्तार और संकुचन।
Normal Range: 60–100 beats per minute (BPM).

Key Terms:

Tachycardia: Pulse > 100 BPM.
Bradycardia: Pulse < 60 BPM.

Pulse Sites:

Temporal: Over the temple.
Carotid: In the neck (Used in emergencies).
Apical: At the heart’s apex (Most accurate).
Brachial: Inner elbow (Used for BP).
Radial: Wrist (Most common).
Femoral: Groin.
Popliteal: Behind the knee.
Dorsalis Pedis: Top of the foot.

Respiration (श्वसन)

The exchange of gases between the atmosphere, the blood, and the cells.
वातावरण, रक्त और कोशिकाओं के बीच गैसों का आदान-प्रदान।
Normal Range: 12–20 breaths per minute.

Key Terms:
Eupnea: Normal breathing.
Tachypnea: Fast breathing (>24 bpm).
Bradypnea: Slow breathing (<10 bpm).
Apnea: Total cessation (stoppage) of breathing.
Dyspnea: Difficulty or labored breathing.
Orthopnea: Difficulty breathing while lying down.

Blood Pressure (रक्तचाप)
The lateral pressure exerted by the blood on the walls of the arteries.
रक्त द्वारा धमनियों की दीवारों पर डाला जाने वाला पार्श्व दबाव।

Normal Range: 120/80 mmHg.

Components:

Systolic (120): Pressure during heart contraction.
Diastolic (80): Pressure during heart relaxation.

Key Terms:
Hypertension: BP > 140/90 mmHg.
Hypotension: BP < 90/60 mmHg.
Pulse Pressure: Difference between systolic and diastolic (Normal = 40).
Instrument: Sphygmomanometer.

Oxygen Saturation (SpO2)
The percentage of hemoglobin saturated with oxygen.
ऑक्सीजन से संतृप्त हीमोग्लोबिन का प्रतिशत।

Normal Range: 95%–100%.
Hypoxia: Low oxygen in tissues.
Hypoxemia: Low oxygen in the blood.
Instrument: Pulse Oximeter.

Pain (The 5th Vital Sign)

Pain is whatever the experiencing person says it is, existing whenever he says it does.
दर्द वह है जो रोगी महसूस करता है और बताता है।
Assessment Tool: Visual Analog Scale (VAS) or Faces Scale (for kids).
Summary Table for Quick Revision

IMPORTANT VITAL SIGNS FORMULAS (एग्जाम के लिए महत्वपूर्ण)
TEMPERATURE CONVERSION (तापमान बदलना):
Celsius to Fahrenheit Formula: F = (C x 9/5) + 32
Fahrenheit to Celsius Formula: C = (F – 32) x 5/9

PULSE PRESSURE:

Formula: Systolic BP – Diastolic BP
Normal Pulse Pressure is 40 mmHg.
MEAN ARTERIAL PRESSURE (MAP):
Formula: [(2 x Diastolic) + Systolic] / 3
VITAL SIGNS FOR CHILDREN (उम्र के अनुसार)

Newborn (0-1 Month): Pulse 120-160, Respiration 30-60, BP 60-80/40-50
Toddler (1-3 Years): Pulse 90-140, Respiration 24-40, BP 80-110/50-80
School Age (6-12 Years): Pulse 75-100, Respiration 18-30, BP 100-120/60-80

IMPORTANT NURSING KEY POINTS (इंडिया नर्सिंग एग्जाम्स स्पेशल)
Rectal Temperature: यह सबसे सटीक (Most accurate) तापमान है। इसे दिल के मरीजों (Cardiac patients) में न लें क्योंकि यह Vagus nerve को उत्तेजित कर सकता है।

Pulse Deficit: जब Apical और Radial पल्स में अंतर हो। इसे हमेशा 2 नर्सों को एक साथ मापना चाहिए।
BP Cuff Size: अगर कफ छोटा है, तो BP ज्यादा (High) आएगा। अगर कफ बड़ा है, तो BP कम (Low) आएगा।
Tachycardia: पल्स 100 से ज्यादा होना।
Bradycardia: पल्स 60 से कम होना।

Question 1. Which of the following is considered the primary center for regulating body temperature?

A) Thalamus
B) Hypothalamus
C) Medulla oblongata
D) Pons
Answer: B) Hypothalamus
Rationale: The hypothalamus acts as the body’s thermostat, maintaining the balance between heat production and heat loss.

Question 2. A temperature of 105°F or higher is clinically termed as:

A) Pyrexia
B) Hypothermia
C) Hyperpyrexia
D) Normal range
Answer: C) Hyperpyrexia
Rationale: Hyperpyrexia refers to an exceptionally high fever, usually above 105.8°F, which is a medical emergency.

Question 3. When measuring temperature, which site is known to provide the most accurate core body temperature?

A) Oral
B) Axillary
C) Rectal
D) Tympanic
Answer: C) Rectal
Rationale: The rectal site is highly vascular and less affected by external factors, making it the gold standard for core temperature.

Question 4. What is the average normal respiratory rate for a healthy resting adult?
A) 8–12 breaths/min
B) 12–20 breaths/min
C) 20–30 breaths/min
D) 30–40 breaths/min
Answer: B) 12–20 breaths/min
Rationale: 12 to 20 breaths per minute is the standard physiological range for an adult at rest.

Question 5. The term “Bradypnea” is defined as a respiratory rate of:

A) Less than 10 breaths/min
B) More than 24 breaths/min
C) Absence of breathing
D) Normal breathing
Answer: A) Less than 10 breaths/min
Rationale: Bradypnea refers to an abnormally slow breathing rate, typically below 10 or 12 breaths per minute.

Question 6. A nurse is unable to palpate the radial pulse. Which site should be assessed next in an emergency?

A) Popliteal
B) Dorsalis pedis
C) Carotid
D) Posterior tibial
Answer: C) Carotid
Rationale: The carotid artery is the most reliable site to check for a pulse during emergency or CPR situations.

Question 7. The difference between the systolic and diastolic blood pressure is called:

A) Mean arterial pressure
B) Pulse deficit
C) Pulse pressure
D) Hypertension
Answer: C) Pulse pressure
Rationale: Pulse pressure (Normal ~40 mmHg) represents the force that the heart generates each time it contracts.

Question 8. While assessing blood pressure, using a cuff that is too narrow for the patient’s arm will result in:

A) A falsely low reading
B) A falsely high reading
/C) An accurate reading
D) No reading at all
Answer: B) A falsely high reading
Rationale: A narrow cuff requires more pressure to compress the artery, leading to an overestimation of the blood pressure.

Question 9. Which of the following heart rates indicates Bradycardia in an adult?

A) 110 BPM
B) 85 BPM
C) 52 BPM
D) 72 BPM
Answer: C) 52 BPM
Rationale: Bradycardia is clinically defined as a heart rate of less than 60 beats per minute in an adult.

Question 10. Oxygen saturation (SpO2) levels below 90% are indicative of:

A) Eupnea
B) Hypoxemia
C) Hyperventilation
D) Normal oxygenation
Answer: B) Hypoxemia
Rationale: SpO2 below 90-92% indicates an insufficient amount of oxygen in the blood, requiring clinical intervention.

Question 11. What is the normal pulse range for a newborn (at birth)?

A) 60–100 BPM
B) 100–180 BPM
C) 80–120 BPM
D) 50–70 BPM
Answer: B) 100–180 BPM
Rationale: Newborns have a significantly higher metabolic rate and smaller hearts, resulting in faster heart rates.

Question 12. The 5th vital sign, as recognized in modern clinical practice, is:

A) Oxygen saturation
B) Pain
C) Level of consciousness
D) Glucose level
Answer: B) Pain
Rationale: Pain assessment is standardized to be recorded along with traditional vital signs to ensure patient comfort and care.

Question 13. Which pulse site is located on the inner side of the ankle?

A) Popliteal
B) Dorsalis pedis
C) Posterior tibial
D) Femoral
Answer: C) Posterior tibial
Rationale: The posterior tibial pulse is found behind and slightly below the medial malleolus (inner ankle bone).

Question 14. An apical pulse should be counted for a full 60 seconds especially when:

A) The patient is sleeping
B) The rhythm is irregular
C) The patient is a young adult
D) Before giving Paracetamol
Answer: B) The rhythm is irregular
Rationale: Full-minute counting ensures that any dysrhythmias are accurately captured in the final heart rate count.

Question 15. The “Lubb-Dupp” sounds of the heart are best heard using which assessment technique?

A) Palpation
B) Percussion
C) Auscultation
D) Inspection
Answer: C) Auscultation
Rationale: Auscultation involves using a stethoscope to listen to internal body sounds like heart valves closing.

Question 16. What does a systolic blood pressure of 150 mmHg and diastolic of 95 mmHg indicate?

A) Normal BP
B) Hypotension
C) Hypertension
D) Orthostatic hypotension
Answer: C) Hypertension
Rationale: Readings consistently above 140/90 mmHg are categorized as hypertension (high blood pressure).

Question 17. The conversion of 37°C to Fahrenheit is:

A) 97.6°F
B) 98.6°F
C) 99.4°F
D) 100°F
Answer: B) 98.6°F
Rationale: Using the formula (C × 9/5) + 32, 37°C equals exactly 98.6°F.

Question 18. “Dyspnea” is a term used to describe:

A) Rapid breathing
B) Difficulty or labored breathing
C) Slow breathing
D) Absence of breathing
Answer: B) Difficulty or labored breathing
Rationale: Dyspnea is the subjective sensation of breathlessness or “air hunger” during respiration.

Question 19. A pulse deficit is calculated by taking the difference between:

A) Systolic and Diastolic BP
B) Apical and Radial pulse
C) Oral and Axillary temperature
D) Inspiratory and Expiratory rate
Answer: B) Apical and Radial pulse
Rationale: A deficit occurs when the heart contracts (apical) but the pulse doesn’t reach the periphery (radial).

Question 20. Which factor can lead to a physiological increase in body temperature?

A) Sleep
B) Exercise and Stress
C) Fasting
D) Hypothyroidism
Answer: B) Exercise and Stress
Rationale: Physical activity and emotional stress increase metabolic rate, thereby increasing heat production.

Question 21. When assessing a patient’s respiration, the nurse should ideally:

A) Tell the patient to breathe deeply
B) Count without the patient being aware
C) Count for only 10 seconds
D) Ask the patient to hold their breath
Answer: B) Count without the patient being aware
Rationale: If patients know their breathing is being watched, they often change their natural rate consciously or unconsciously.

Question 22. In an adult, the normal Diastolic blood pressure should be around:

A) 120 mmHg
B) 80 mmHg
C) 100 mmHg
D) 60 mmHg
Answer: B) 80 mmHg
Rationale: Diastolic pressure (80 mmHg) represents the pressure in the arteries when the heart is at rest between beats.

Question 23. Which term refers to a body temperature that alternates between periods of fever and periods of normal temperature?

A) Constant fever
B) Intermittent fever
C) Remittent fever
D) Relapsing fever
Answer: B) Intermittent fever
Rationale: Intermittent fever drops to normal at least once every 24 hours.

Question 24. A nurse finds a pulse of 120 BPM in an adult. This is recorded as:

A) Bradycardia
B) Tachycardia
C) Normal
D) Dysrhythmia
Answer: B) Tachycardia
Rationale: Tachycardia is a heart rate above 100 BPM in adults.

Question 25. Orthostatic hypotension is defined as a sudden drop in BP when:

A) Exercising
B) Moving from lying to standing position
C) Sleeping
D) Eating a heavy meal
Answer: B) Moving from lying to standing position
Rationale: The body fails to constrict blood vessels quickly enough upon standing, leading to a drop in pressure and dizziness.

Question 26. Which anatomical line is used to locate the Apical pulse?

A) Anterior axillary line
B) Midclavicular line
C) Midaxillary line
D) Sternal line
Answer: B) Midclavicular line
Rationale: The apical pulse is at the 5th intercostal space, left midclavicular line.

Question 27. The most common site for checking pulse in children over 3 years and adults is:

A) Carotid artery
B) Radial artery
C) Brachial artery
D) Femoral artery
Answer: B) Radial artery
Rationale: The radial artery is easily accessible and comfortable for both the patient and the nurse for routine checks.

Question 28. Which vital sign measurement is most affected by drinking hot coffee 5 minutes prior?

A) Pulse
B) Oral Temperature
C) Respiration
D) Blood Pressure
Answer: B) Oral Temperature
Rationale: Hot or cold liquids temporarily alter the temperature of the oral mucosa, leading to an inaccurate reading.

Question 29. A respiratory rate of 30 breaths/min in an adult is termed:

A) Bradypnea
B) Tachypnea
C) Apnea
D) Eupnea
Answer: B) Tachypnea
Rationale: Tachypnea is rapid breathing, defined as more than 20 or 24 breaths per minute in adults.

Question 30. What is the normal SpO2 range for a patient with no underlying respiratory disease?

A) 80–85%
B) 95–100%
C) 70–80%
D) 85–90%
Answer: B) 95–100%
Rationale: Healthy individuals usually maintain an oxygen saturation level of 95% or higher.

Question 31. The instruments used to measure Blood Pressure include:
A) Thermometer and Stethoscope
B) Sphygmomanometer and Stethoscope
C) Pulse Oximeter and Watch
D) Glucometer
Answer: B) Sphygmomanometer and Stethoscope
Rationale: The cuff (sphygmomanometer) creates pressure, and the stethoscope is used to hear Korotkoff sounds.

Question 32. Which pulse site is used to measure BP in the upper arm?
A) Radial
B) Brachial
C) Ulnar
D) Axillary
Answer: B) Brachial
Rationale: The stethoscope diaphragm is placed over the brachial artery in the antecubital fossa to hear blood flow.

Question 33. A patient has a BP of 80/50 mmHg. This condition is known as:
A) Hypertension
B) Hypotension
C) Normal
D) Tachycardia
Answer: B) Hypotension
Rationale: Hypotension is generally defined as a BP lower than 90/60 mmHg.

Question 34. How many seconds should a nurse count a regular pulse to save time?
A) 10 seconds x 6
B) 30 seconds x 2
C) 15 seconds x 4
D) 60 seconds always
Answer: B) 30 seconds x 2
Rationale: For a regular rhythm, counting for 30 seconds and multiplying by 2 is an efficient and accurate clinical practice.

Question 35. Which factor typically causes the heart rate to decrease?
A) Fever
B) Acute pain
C) Hypothermia
D) Hemorrhage
Answer: C) Hypothermia
Rationale: Cold temperatures slow down metabolic processes and heart contractions.

Question 36. An “Arrhythmia” refers to:
A) A very fast heart rate
B) A very slow heart rate
C) An irregular heart rhythm
D) Normal heart rate
Answer: C) An irregular heart rhythm
Rationale: Arrhythmia (or dysrhythmia) is any deviation from the normal rhythmic beating of the heart.

Question 37. Temperature taken in the axilla is usually _ than the oral temperature.
A) 1°F Higher
B) 1°F Lower
C) Same
D) 2°F Higher
Answer: B) 1°F Lower
Rationale: The axillary site is more external and less vascular than the mouth, resulting in a slightly lower reading.

Question 38. Cheyne-Stokes respiration is characterized by:
A) Constant rapid breathing
B) Periods of apnea alternating with deep/rapid breathing
C) Slow, shallow breathing
D) Difficult, noisy breathing
Answer: B) Periods of apnea alternating with deep/rapid breathing
Rationale: This pattern is often seen in terminal illness or severe heart failure.

Question 39. The term “Febrile” means:
A) Having no fever
B) Having a fever
C) Feeling cold
D) Normal BP
Answer: B) Having a fever
Rationale: A febrile patient is one who has an elevated body temperature (fever).

Question 40. When the heart contracts, the pressure exerted on the arteries is the:

A) Diastolic pressure
B) Systolic pressure
C) Pulse pressure
D) Mean pressure
Answer: B) Systolic pressure
Rationale: Systolic pressure is the maximum pressure exerted during ventricular contraction.

Question 41. Which pulse site is checked during infant CPR?

A) Radial
B) Brachial
C) Carotid
D) Popliteal
Answer: B) Brachial
Rationale: The brachial pulse is the most accessible and reliable site for pulse checks in infants.

Question 42. A nurse finds a pulse pressure of 60 mmHg (e.g., 140/80). This pulse pressure is considered:

A) Normal
B) Narrow
C) Widened
D) Low
Answer: C) Widened
Rationale: A normal pulse pressure is around 40 mmHg; 60 mmHg indicates a widened gap, often seen in atherosclerosis.

Question 43. The “Apex” of the heart is its:

A) Upper part
B) Lower, pointed part
C) Right side
D) Middle part
Answer: B) Lower, pointed part
Rationale: The apex is the bottom tip of the heart, directed toward the left hip.

Question 44. Hyperventilation leads to a decrease in which blood gas?

A) Oxygen
B) Carbon dioxide (CO2)
C) Nitrogen
D) Hydrogen
Answer: B) Carbon dioxide (CO2)
Rationale: Rapid breathing “washes out” CO2 from the blood, potentially leading to respiratory alkalosis.

Question 45. Which thermometer should be used for a patient who is unconscious?

A) Oral glass thermometer
B) Rectal or Tympanic thermometer
C) Oral electronic thermometer
D) None
Answer: B) Rectal or Tympanic thermometer
Rationale: Unconscious patients cannot hold an oral thermometer safely and may bite it; rectal or tympanic sites are safer.

Question 46. What is the normal respiratory rate for a newborn?

A) 12–20 breaths/min
B) 30–60 breaths/min
C) 20–30 breaths/min
D) 10–15 breaths/min
Answer: B) 30–60 breaths/min
Rationale: Newborns breathe much faster than adults to maintain adequate oxygenation.

Question 47. Which vital sign is most critical to monitor in a patient with a head injury?

A) Temperature
B) Respiratory pattern and BP
C) Pain
D) SpO2
Answer: B) Respiratory pattern and BP
Rationale: Changes in BP (Cushing’s triad) and breathing patterns are early indicators of increased intracranial pressure.

Question 48. Pulse volume of “3+” or “Bounding” is often seen in:

]
A) Dehydration
B) Fluid overload or Exercise
C) Hemorrhage
D) Shock
Answer: B) Fluid overload or Exercise
Rationale: Increased blood volume or high cardiac output creates a very strong, easily felt pulse.

Question 49. The process of heat loss through direct contact with a cooler object is:

A) Radiation
B) Convection
C) Conduction
D) Evaporation
Answer: C) Conduction
Rationale: Conduction involves heat transfer between two objects in physical contact.

Question 50. In the abbreviation “BP 120/80 mmHg”, mmHg stands for:

A) Millimeters of Heart
B) Millimeters of Mercury
C) Milligrams of Mercury
D) Millimeters of Helium
Answer: B) Millimeters of Mercury
Rationale: Mercury (Hg) is the traditional element used in manometers to measure pressure accurately.

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