😀 EASY

 Warwick Medical School’s Clinical Skills Society had a session on recording blood pressure, vital signs and BMI. Watch the video to see what was covered and then attempt the questions below to test your understanding.

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Clinical skills - BP, vitals and BMI

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Question 1
You are taking a patient's blood pressure. You estimate their systolic blood pressure to be approximately 120 mmHg. To what pressure should you increase the pressure to before taking the actual measurement?
A
120
B
130
C
140
D
150
E
160
Question 1 Explanation: 
The British and Irish Hypertension Society suggest you increase the pressure to 30 mmHg above the estimated systolic blood pressure.
Question 2
Which of the following is correct regarding taking blood pressure?
A
The patient should be seated for at least 3 minutes before measuring BP
B
You should deflate the cuff at a rate of 5 mmHg a second
C
A bladder that encircles only 70 percent of the arm will underestimate BP
D
The cuff should be level with the heart
E
The bell of the stethoscope is used to auscultate the brachial artery
Question 2 Explanation: 
D is the correct answer - the cuff should be level with the heart.

A - patient should be seated for 5 minutes

B - it is recommended to reduce the pressure at a rate of 2-3mmHg/second

C - the bladder of the BP cuff should encircle 80-100 percent of the arm; if it too small/less than this, it will overestimate BP

E - we use the diaphragm of the stethoscope to listen for the Korotkoff sounds

Question 3
Which Korotkoff sound gives you the diastolic BP?
A
I
B
II
C
III
D
IV
E
V
Question 3 Explanation: 
The fifth Korotkoff sound is 'nothing' - diastolic pressure is the pressure when the sounds disappear. Some text books/sources say the fourth sound but the fifth sound appears to be more accepted, although it may slightly underestimate the true diastolic pressure.
Question 4
Which of the following vital signs falls outside of the 'normal' range?
A
Resp rate = 14
B
Heart rate = 84
C
Oxygen sats = 94
D
Temp = 36
E
BP = 110/68
Question 4 Explanation: 
In most patients you want to maintain sats between 96 and 100 percent, although in some patients with COPD you will want to aim for sats below this. Also remember that it is just as important to consider what is normal for the patient (a professional athlete may have a systolic BP of 90) and what the trend is doing: a resp rate of 18 would be encouraging if the previous two observations were 26 and 22, but more concerning if the previous observations were 12 and 16.
Question 5
What’s the first thing you should do when taking a patient’s vital signs?
A
Measure pulse
B
Measure resp rate
C
Measure pulse and resp rate together
D
Wash hands
Question 5 Explanation: 
This question was simply to remind you that whenever you examine a patient you must WIPE: wash hands, introduce yourself, identify the patient, explain the procedure and get consent.
Question 6
Which pulse do you use to measure rate and rhythm?
A
Brachial
B
Carotid
C
Femoral
D
Radial
E
Ulnar
Question 7
Which letter marks the approximate position where you would find the brachial pulse?
A
A (dorsum of hand in webspace between thumb and index finger)
B
B
C
C
D
D
E
Not shown
Question 8
What is the name of the tendon medial to B?          
A
Biceps tendon
B
Extensor pollicis brevis
C
Extensor pollicis longus
D
Flexor carpi radialis
E
Flexor carpi ulnaris
Question 9
You are assisting the GP practice nurse. A patient weighs 72kg and is 1.64m tall. Calculate their BMI.
A
26.0
B
26.8
C
27.3
D
31.6
E
35.5
Question 9 Explanation: 
BMI = kg / (m x m) = 72 / (1.64 x 1.64)
Question 10
How would you categorise the patient’s BMI?
A
Underweight
B
Healthy
C
Overweight
D
Obese
E
Need more information
Question 10 Explanation: 
BMIs between 25 and 29.9 are classified as overweight.
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