CNA Vital Signs and Measurements 1 — Questions and Answers

Question 1: What is the normal resting heart rate range for an adult?

40–60 beats per minute
60–100 beats per minute (Correct answer)
100–120 beats per minute
120–140 beats per minute

Correct answer: 60–100 beats per minute

A normal adult resting heart rate is 60–100 beats per minute. Values outside this range may indicate bradycardia or tachycardia and should be reported.

Question 2: Which site is most commonly used by CNAs to measure pulse?

Apical
Radial (Correct answer)
Carotid
Femoral

Correct answer: Radial

The radial pulse at the wrist is the most common site used by CNAs because it is easy to access and requires no special equipment.

Question 3: Normal adult blood pressure is considered to be:

90/60 mmHg
120/80 mmHg (Correct answer)
140/90 mmHg
160/100 mmHg

Correct answer: 120/80 mmHg

120/80 mmHg is considered normal adult blood pressure. The top number (systolic) represents pressure when the heart beats; the bottom (diastolic) when it rests.

Question 4: A resident's blood pressure is 150/95 mmHg. How should the CNA respond?

Recheck in one hour and document only if still elevated
Administer an antihypertensive medication
Report the finding to the nurse immediately (Correct answer)
Ask the resident to exercise to lower it

Correct answer: Report the finding to the nurse immediately

A blood pressure of 150/95 mmHg exceeds normal limits and must be reported to the nurse promptly so that appropriate follow-up can occur.

Question 5: What is the normal adult respiratory rate range?

4–8 breaths per minute
12–20 breaths per minute (Correct answer)
24–30 breaths per minute
30–40 breaths per minute

Correct answer: 12–20 breaths per minute

Normal adult respirations are 12–20 breaths per minute. Rates above or below this range should be reported to the nurse.

Question 6: When counting respirations, the CNA should:

Tell the resident to breathe normally while counting
Count while pretending to still take the pulse (Correct answer)
Ask the resident to count with the CNA
Count only exhalations for 30 seconds and double the result

Correct answer: Count while pretending to still take the pulse

Counting respirations while appearing to still take the pulse prevents the resident from consciously altering their breathing pattern, ensuring accuracy.

Question 7: What is the normal oral temperature for an adult?

96.8°F (36.0°C)
98.6°F (37.0°C) (Correct answer)
100.4°F (38.0°C)
102.2°F (39.0°C)

Correct answer: 98.6°F (37.0°C)

Normal oral temperature is approximately 98.6°F (37.0°C). Temperatures above 100.4°F generally indicate fever and should be reported.

Question 8: A rectal temperature reading compared to an oral temperature is typically:

0.5–1°F lower
The same
0.5–1°F higher (Correct answer)
2–3°F higher

Correct answer: 0.5–1°F higher

Rectal temperatures are approximately 0.5–1°F higher than oral temperatures because the rectum is a closed, more insulated body cavity.

Question 9: Which of the following is NOT an appropriate site for thermometer placement by a CNA?

Oral
Axillary
Rectal (Correct answer)
Tympanic

Correct answer: Rectal

Rectal temperature measurement is considered an invasive procedure and is generally outside the CNA's scope of practice in most states; it requires specific facility policy authorization.

Question 10: An axillary temperature is taken:

In the mouth under the tongue
In the ear canal
Under the arm in the armpit (Correct answer)
On the forehead

Correct answer: Under the arm in the armpit

Axillary temperature is measured by placing the thermometer under the arm in the axilla (armpit). It is the least invasive method but is also the least accurate.

Question 11: When measuring blood pressure, the cuff should be placed:

Directly over clothing
About 1 inch above the antecubital space (Correct answer)
Below the elbow
Tightly over the brachial vein

Correct answer: About 1 inch above the antecubital space

The blood pressure cuff should be placed about 1 inch (2.5 cm) above the antecubital fossa (inner elbow crease) to allow correct positioning of the stethoscope over the brachial artery.

Question 12: Pulse oximetry measures:

Blood glucose level
Oxygen saturation in the blood (Correct answer)
Carbon dioxide level
Blood pressure

Correct answer: Oxygen saturation in the blood

Pulse oximetry measures the percentage of hemoglobin saturated with oxygen (SpO2). Normal values are typically 95–100%.

Question 13: A normal SpO2 reading for a healthy adult is:

85–90%
90–94%
95–100% (Correct answer)
100–105%

Correct answer: 95–100%

Normal oxygen saturation (SpO2) for a healthy adult is 95–100%. Values below 90% are considered dangerously low and require immediate reporting.

Question 14: Which of the following would cause an inaccurate pulse oximetry reading?

The probe is on the index finger
The resident has dark nail polish on the finger (Correct answer)
The resident is lying still
The probe is at room temperature

Correct answer: The resident has dark nail polish on the finger

Dark nail polish, artificial nails, or poor circulation can interfere with the light sensor in a pulse oximeter, causing falsely low or inaccurate readings.

Question 15: What does a pulse deficit indicate?

The apical rate is lower than the radial rate
The radial rate is lower than the apical rate (Correct answer)
Both rates are equal
The pulse is too fast to count

Correct answer: The radial rate is lower than the apical rate

A pulse deficit occurs when the radial pulse is lower than the apical pulse, indicating that not every heartbeat generates enough force to be felt at the wrist. This should be reported.

Question 16: How long should a CNA count an irregular pulse?

15 seconds and multiply by 4
30 seconds and multiply by 2
A full 60 seconds (Correct answer)
Until it becomes regular

Correct answer: A full 60 seconds

An irregular pulse should be counted for a full 60 seconds to ensure accuracy, as shorter counting periods may magnify errors when the rate is inconsistent.

Question 17: Which factor can temporarily INCREASE blood pressure?

Sleeping
Pain or anxiety (Correct answer)
Warm bath
Meditation

Correct answer: Pain or anxiety

Pain, anxiety, stress, and physical exertion can all temporarily raise blood pressure. The CNA should allow the resident to rest before retaking the reading if these factors are present.

Question 18: When taking a blood pressure on a resident who recently exercised, the CNA should:

Take it immediately
Wait at least 5–10 minutes for the resident to rest first (Correct answer)
Take it on both arms and average the results
Use a smaller cuff

Correct answer: Wait at least 5–10 minutes for the resident to rest first

Exercise temporarily elevates blood pressure. Waiting 5–10 minutes allows the cardiovascular system to return toward baseline, producing a more accurate resting measurement.

Question 19: Which of the following best describes systolic blood pressure?

Pressure in arteries when the heart is at rest
Pressure in veins during contraction
Pressure in arteries when the heart contracts (Correct answer)
Average arterial pressure over the full cycle

Correct answer: Pressure in arteries when the heart contracts

Systolic pressure is the higher number and represents the force exerted on arterial walls when the heart contracts and pumps blood out.

Question 20: A resident's temperature is 104°F. What should the CNA do?

Give the resident water and recheck in 2 hours
Apply a heating pad
Report the reading to the nurse immediately (Correct answer)
Document and continue other tasks

Correct answer: Report the reading to the nurse immediately

A temperature of 104°F (40°C) is dangerously high and must be reported to the nurse immediately, as it can indicate serious infection or heat stroke requiring prompt intervention.

Question 21: When should vital signs be documented?

At the end of the shift only
Immediately after measurement (Correct answer)
Only when they are abnormal
Once per day at a standard time

Correct answer: Immediately after measurement

Vital signs must be documented immediately after measurement to ensure accuracy and to provide a timely record for the care team.

Question 22: Which instrument is used to measure blood pressure?

Stethoscope alone
Sphygmomanometer and stethoscope (Correct answer)
Pulse oximeter
Thermometer

Correct answer: Sphygmomanometer and stethoscope

A sphygmomanometer (blood pressure cuff) combined with a stethoscope is used to measure blood pressure by listening for Korotkoff sounds.

Question 23: The term 'bradycardia' refers to:

Heart rate above 100 bpm
Irregular heartbeat
Heart rate below 60 bpm (Correct answer)
Absence of a pulse

Correct answer: Heart rate below 60 bpm

Bradycardia is a heart rate below 60 beats per minute. It may cause dizziness, fatigue, or fainting and should be reported to the nurse.

Question 24: The term 'tachycardia' refers to:

Heart rate below 60 bpm
Heart rate above 100 bpm (Correct answer)
Irregular heartbeat
Normal heart rate

Correct answer: Heart rate above 100 bpm

Tachycardia is a resting heart rate above 100 beats per minute. Causes include fever, pain, anxiety, dehydration, and heart conditions.

Question 25: What does hypertension mean?

Abnormally low blood pressure
Abnormally high blood pressure (Correct answer)
Abnormally low heart rate
Abnormally high temperature

Correct answer: Abnormally high blood pressure

Hypertension (high blood pressure) is generally defined as a consistent reading at or above 130/80 mmHg and is a major risk factor for heart disease and stroke.

Question 26: What does hypotension mean?

Abnormally high blood pressure
Abnormally low blood pressure (Correct answer)
Abnormally fast heart rate
Abnormally slow breathing

Correct answer: Abnormally low blood pressure

Hypotension (low blood pressure) is generally defined as a reading below 90/60 mmHg. It can cause dizziness, fainting, and falls, especially in older adults.

Question 27: Orthostatic hypotension is BEST described as:

Blood pressure that is consistently high
A drop in blood pressure when moving from lying to standing (Correct answer)
A rise in blood pressure during exercise
Blood pressure that changes with each heartbeat

Correct answer: A drop in blood pressure when moving from lying to standing

Orthostatic (postural) hypotension is a drop of ≥20 mmHg systolic when rising from lying or sitting to standing, causing dizziness and risk of falls.

Question 28: Which of the following is a sign of orthostatic hypotension?

Headache while lying down
Dizziness upon standing (Correct answer)
Increased urine output
Chest pain during rest

Correct answer: Dizziness upon standing

Dizziness, lightheadedness, or fainting upon standing are hallmark signs of orthostatic hypotension, caused by a temporary drop in blood pressure as the body adjusts.

Question 29: A resident's SpO2 drops to 88%. What is the PRIORITY action?

Continue monitoring and document the result
Reposition the probe and recheck; if still low, notify the nurse immediately (Correct answer)
Increase the resident's fluid intake
Encourage deep breathing exercises without reporting

Correct answer: Reposition the probe and recheck; if still low, notify the nurse immediately

First, verify the reading (check probe placement, nail polish, circulation). If the reading remains at 88%, immediately notify the nurse, as this is below the acceptable minimum of 90%.

Question 30: When measuring weight, the CNA should:

Weigh the resident with shoes on for accuracy
Weigh at different times of day for comparison
Weigh at the same time of day, in similar clothing, and on the same scale (Correct answer)
Estimate weight from appearance if the scale is unavailable

Correct answer: Weigh at the same time of day, in similar clothing, and on the same scale

Consistent technique — same time of day (usually morning after toileting), similar clothing, and the same scale — ensures accurate weight comparisons over time.

Question 31: A resident has gained 3 pounds in one day. What should the CNA do?

Increase fluid intake to dilute retained fluid
Document only and recheck tomorrow
Report the sudden weight gain to the nurse (Correct answer)
Restrict the resident's diet immediately

Correct answer: Report the sudden weight gain to the nurse

Sudden weight gain (especially 3+ pounds overnight) can indicate fluid retention related to heart failure or kidney problems and must be reported to the nurse promptly.

Question 32: The apical pulse is measured:

At the wrist over the radial artery
At the neck over the carotid artery
At the apex of the heart using a stethoscope (Correct answer)
At the groin over the femoral artery

Correct answer: At the apex of the heart using a stethoscope

The apical pulse is listened to with a stethoscope placed at the apex of the heart (left midclavicular line, 5th intercostal space). It is counted for a full minute.

Question 33: Which vital sign is monitored to assess breathing effectiveness?

Blood pressure
Pulse
Respirations (Correct answer)
Temperature

Correct answer: Respirations

Respirations (breathing rate, depth, and rhythm) are monitored to assess the effectiveness of the respiratory system in delivering oxygen and removing carbon dioxide.

Question 34: What does a rapid, shallow respiratory pattern suggest?

Normal breathing
Respiratory distress (Correct answer)
Deep sleep
Hyperventilation only

Correct answer: Respiratory distress

Rapid, shallow breathing (tachypnea with decreased tidal volume) often indicates respiratory distress, pain, anxiety, or pulmonary conditions and must be reported.

Question 35: The CNA notes the resident's radial pulse is 52 bpm and weak. The BEST action is to:

Continue the assessment and chart it at the end of shift
Ask the resident if they feel okay and wait to see
Report to the nurse immediately (Correct answer)
Ask a colleague to recheck to confirm

Correct answer: Report to the nurse immediately

A pulse of 52 bpm is below the normal range (bradycardia). Combined with weakness, it should be reported to the nurse immediately for evaluation.

Question 36: When is it appropriate to use the temporal artery thermometer?

Only after oral thermometry fails
When a quick, non-invasive temperature reading is needed (Correct answer)
Only for infants under 1 year
Only when rectal measurement is indicated

Correct answer: When a quick, non-invasive temperature reading is needed

Temporal artery thermometers provide a quick, non-invasive reading by scanning the forehead. They are appropriate for residents of all ages when a fast, comfortable measurement is needed.

Question 37: Which of the following changes in vital signs requires IMMEDIATE reporting?

Temperature of 98.4°F
Blood pressure of 118/76 mmHg
Pulse of 130 bpm with chest pain (Correct answer)
Respiratory rate of 16 breaths per minute

Correct answer: Pulse of 130 bpm with chest pain

A pulse of 130 bpm accompanied by chest pain is a potentially life-threatening finding (possible cardiac event or severe tachycardia) requiring immediate notification of the nurse.

CNA Vital Signs and Measurements 1

What is the normal resting heart rate range for an adult?

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