Patient Intake and Vitals — practice questions

9.3% of the exam ≈14 real questions 17 free questions here

14 scored items. Taking vitals correctly, knowing what is out of range, and knowing which readings must go to the provider immediately. Expect scenarios where the technique itself is the error.

Where people lose points

• A cuff that is too small reads falsely high; too large reads falsely low. Cuff size is the most common source of a bad blood pressure.
• Temperature norms shift by route — rectal and tympanic read higher than oral, axillary reads lower. A single number is not 'normal' without the route.
• Respirations should be counted without telling the patient, because awareness changes the rate. Count them while appearing to still take the pulse.
• An arm below heart level reads falsely high; above heart level reads falsely low. Support the arm at heart level.
• Orthostatic vitals mean measuring in a specific position sequence, not just taking one reading while the patient stands.

Questions and answers, explained

All 10 questions above, with the correct answer and why it is correct. Everything here is on patient intake and vitals.

1. A medical assistant brings a patient from the waiting room to the exam room to obtain vital signs. Which action correctly identifies the patient?

   • AAsk the patient to state their full name and date of birth, then match both against the chart.Correct
   • BAnnounce the patient's last name in the waiting area and take whoever stands up.
   • CVerify the patient's name and the exam room number assigned to them.
   • DAsk, "You are Ms. Rivera, right?" and continue when she nods.

   Why: The Joint Commission's National Patient Safety Goal on patient identification (NPSG.01.01.01) requires two person-specific identifiers, and the patient should state them rather than simply confirm them. Option D is a leading question — a distracted, confused, or hard-of-hearing patient may agree to the wrong name, which is exactly how wrong-patient errors happen.

   Reference Domain 3A (3A2, k43); The Joint Commission NPSG.01.01.01 two patient identifiers

2. To avoid missing an auscultatory gap, what should the medical assistant do before auscultating the blood pressure?

   • AInflate the cuff to a standard 200 mm Hg on every single patient regardless of size.
   • BTake a reading in each arm and average the two together.
   • CPalpate the radial pulse while inflating, then go 30 mm Hg above where it vanishes.Correct
   • DDeflate slowly enough to hear all five of the Korotkoff phases.

   Why: The AHA directs that the cuff be inflated to at least 30 mm Hg above the point at which the palpated radial pulse disappears. Starting above the true systolic is what keeps a silent auscultatory gap from being mistaken for the systolic value. Option D is good technique but does not help if inflation began inside the gap, and routine inflation to a fixed 200 mm Hg (A) is uncomfortable and may still fall short in severe hypertension.

   Reference Domain 3A (3A4, k47); AHA scientific statement, Measurement of Blood Pressure in Humans (2019)

3. Orthostatic hypotension is present when, within 3 minutes of standing, the blood pressure falls by at least:

   • A10 mm Hg systolic or 5 mm Hg diastolic
   • B15 mm Hg systolic or 15 mm Hg diastolic
   • C20 mm Hg systolic or 10 mm Hg diastolicCorrect
   • D30 mm Hg systolic or 20 mm Hg diastolic

   Why: The consensus diagnostic criterion is a sustained drop of at least 20 mm Hg systolic or at least 10 mm Hg diastolic within 3 minutes of standing from supine. The smaller drop in option A is within normal postural variation and would over-identify the finding.

   Reference Domain 3A (k48); American Autonomic Society / American Academy of Neurology consensus definition of orthostatic hypotension

4. While taking a radial pulse, the medical assistant notices the rhythm is irregular. What is the appropriate next step?

   • ACount the radial pulse for 15 seconds and multiply by 4.
   • BRecount the radial pulse in the other wrist for 30 seconds and double it.
   • CAuscultate the apical pulse for a full 60 seconds and document both the rate and the irregularity.Correct
   • DChart "pulse irregular" without recording a rate.

   Why: An irregular rhythm makes short-interval counts inaccurate, and weak beats may not reach the wrist at all, so the apical pulse is auscultated for a full minute. Option D leaves the provider without the numeric data needed to act on the finding.

   Reference Domain 3A (3A4, 3A7, k49)

5. What is the correct way to count a patient's respirations?

   • ATell the patient you are counting their breaths so that they will hold perfectly still.
   • BCount for 15 seconds and multiply by 4 in every single patient.
   • CKeep fingers on the wrist and count chest rises, a full 60 seconds if irregular.Correct
   • DAsk the patient to breathe deeply so the chest rises are easier to see.

   Why: Breathing is partly under voluntary control, so patients who know they are being watched change their pattern; respirations are counted unobtrusively immediately after the pulse, for a full minute when the rhythm or depth is irregular. Coaching the patient to breathe deeply (D) makes the measurement meaningless.

   Reference Domain 3A (3A4, k50)

6. A patient states, "I can't catch my breath," but the counted respiratory rate is 18 breaths per minute. How should the medical assistant handle this?

   • AChart the rate of 18 and disregard the patient’s statement entirely, since the rate is normal.
   • BDocument the rate of 18 plus the reported shortness of breath, and tell the provider.Correct
   • CChart "tachypnea" because the patient reports difficulty breathing.
   • DChart "possible asthma exacerbation" as the working impression.

   Why: Dyspnea is the subjective sensation of difficult breathing and can occur with a normal, high, or low rate, so both the objective count and the subjective complaint belong in the record and the symptom is reported. Option C mislabels a normal rate as tachypnea (which requires more than 20), and option D is a diagnosis, which is outside the medical assistant's scope.

   Reference Domain 3A (3A7, k50); scope of practice

7. A patient with dark acrylic nails produces an erratic SpO2 reading. What is the best action?

   • APress the probe more tightly onto the nail surface.
   • BChart "unable to obtain" and move on to the next task.
   • CIncrease the room lighting directly over the probe and retry.
   • DMove the probe to a bare finger, earlobe, or toe and retry.Correct

   Why: The FDA lists nail polish, artificial nails, and dyes among the causes of inaccurate pulse oximetry because they block the light path, so an unobstructed site restores the signal. Bright ambient light (C) is itself an FDA-listed source of error, and squeezing the probe (A) reduces perfusion and makes the reading worse.

   Reference Domain 3A (k51); FDA pulse oximeter safety communication

8. Which measured temperature meets the CDC definition of fever?

   • A37.3°C (99.1°F)
   • B37.8°C (100.0°F)
   • C38.0°C (100.4°F)Correct
   • D36.6°C (97.9°F)

   Why: The CDC defines fever as a measured temperature of 100.4°F (38.0°C) or greater. Option B is above average but still below the CDC threshold, so it would be documented as an elevated temperature rather than reported as a fever.

   Reference Domain 3A (k52); CDC definition of fever (≥100.4°F / 38.0°C)

9. The medical assistant is taking a tympanic temperature on a 20-month-old child. What is the correct technique?

   • APull the pinna down and back to straighten the ear canal.Correct
   • BPull the pinna up and back, the same as for an adult.
   • CPull the pinna straight outward and insert the probe deeply.
   • DNo manipulation of the ear is needed with a tympanic thermometer.

   Why: In children under 3 years the ear canal angles differently, so the pinna is pulled down and back; up and back (B) is correct only for adults and children age 3 and older. Aiming the probe away from the tympanic membrane produces a falsely low reading, and the probe tip is inserted only at the opening of the canal, never forced.

   Reference Domain 3A (k52, k58)

10. An adult patient's BMI is calculated as 27.4. According to CDC adult BMI categories, this is:

    • AHealthy weight
    • BObesity, class 1
    • COverweightCorrect
    • DUnderweight

    Why: CDC adult BMI categories are: underweight below 18.5, healthy weight 18.5 to under 25, overweight 25 to under 30, and obesity 30 or greater. Class 1 obesity (B) does not begin until a BMI of 30.

    Reference Domain 3A (3A6, k57); CDC adult BMI categories

Topics inside this domain

• Correcting an error in the medical record
• Medical assistant scope of practice
• Vital sign normal ranges and technique errors
• Blood pressure categories and measurement errors

Drill other domains

• Foundational Knowledge and Basic Science (10%)
• Anatomy and Physiology (5.3%)
• General Patient Care (18.7%)
• Infection Control and Safety (10%)
• Point of Care Testing and Laboratory Procedures (6%)
• Phlebotomy (8%)

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