Deck 22: Abdomen
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Deck 22: Abdomen
1
Which structure is located in the left lower quadrant (LLQ)of the abdomen?
A)Liver
B)Duodenum
C)Gallbladder
D)Sigmoid colon
A)Liver
B)Duodenum
C)Gallbladder
D)Sigmoid colon
Sigmoid colon
2
Percussion notes heard during an abdominal assessment may include:
A)flatness,resonance,and dullness.
B)resonance,dullness,and tympany.
C)tympany,hyperresonance,and dullness.
D)resonance,hyperresonance,and flatness.
A)flatness,resonance,and dullness.
B)resonance,dullness,and tympany.
C)tympany,hyperresonance,and dullness.
D)resonance,hyperresonance,and flatness.
tympany,hyperresonance,and dullness.
3
A patient has been diagnosed with pernicious anemia.The nurse knows that this condition could be related to:
A)increased gastric acid secretion.
B)decreased gastric acid secretion.
C)delayed gastrointestinal emptying time.
D)increased gastrointestinal emptying time.
A)increased gastric acid secretion.
B)decreased gastric acid secretion.
C)delayed gastrointestinal emptying time.
D)increased gastrointestinal emptying time.
decreased gastric acid secretion.
4
While examining a patient,the nurse observes abdominal pulsations between the xiphoid and umbilicus.The nurse would suspect that these are:
A)pulsations of the renal arteries.
B)pulsations of the inferior vena cava.
C)normal abdominal aortic pulsations.
D)increased peristalsis from a bowel obstruction.
A)pulsations of the renal arteries.
B)pulsations of the inferior vena cava.
C)normal abdominal aortic pulsations.
D)increased peristalsis from a bowel obstruction.
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5
Which of the following is a normal finding in an abdominal assessment?
A)The presence of a bruit in the femoral area
B)A tympanic percussion note in the umbilical region
C)A palpable spleen between the ninth and eleventh ribs in the left midaxillary line
D)A dull percussion note in the left upper quadrant (LUQ)at the midclavicular line
A)The presence of a bruit in the femoral area
B)A tympanic percussion note in the umbilical region
C)A palpable spleen between the ninth and eleventh ribs in the left midaxillary line
D)A dull percussion note in the left upper quadrant (LUQ)at the midclavicular line
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6
The main reason auscultation precedes percussion and palpation of the abdomen is to:
A)determine areas of tenderness.
B)prevent distortion of bowel sounds.
C)allow the patient more time to relax,and therefore be more comfortable with the physical examination.
D)prevent distortion of vascular sounds,such as bruits and hums.
A)determine areas of tenderness.
B)prevent distortion of bowel sounds.
C)allow the patient more time to relax,and therefore be more comfortable with the physical examination.
D)prevent distortion of vascular sounds,such as bruits and hums.
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7
Which of the following changes may occur in the gastrointestinal system of an aging adult?
A)Increased salivation
B)Increased esophageal emptying
C)Increased peristalsis
D)Decreased gastric acid secretion
A)Increased salivation
B)Increased esophageal emptying
C)Increased peristalsis
D)Decreased gastric acid secretion
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8
Which of the following is true of bowel sounds?
A)They are usually loud,high-pitched,rushing,tinkling sounds.
B)They are usually high-pitched,gurgling,irregular sounds.
C)They sound like "two pieces of leather being rubbed together."
D)They originate from the movement of air and fluid through the large intestine.
A)They are usually loud,high-pitched,rushing,tinkling sounds.
B)They are usually high-pitched,gurgling,irregular sounds.
C)They sound like "two pieces of leather being rubbed together."
D)They originate from the movement of air and fluid through the large intestine.
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9
When viewed horizontally,a scaphoid contour of the abdomen displays:
A)a flat profile.
B)a convex profile.
C)a bulging profile.
D)a concave profile.
A)a flat profile.
B)a convex profile.
C)a bulging profile.
D)a concave profile.
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10
The physician comments that a patient has abdominal "borborygmi." The nurse knows that this term refers to:
A)a loud,continuous hum.
B)a peritoneal friction rub.
C)hypoactive bowel sounds.
D)hyperactive bowel sounds.
A)a loud,continuous hum.
B)a peritoneal friction rub.
C)hypoactive bowel sounds.
D)hyperactive bowel sounds.
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11
Which of the following is present in a patient with ascites?
A)Fluid
B)Feces
C)Flatus
D)Fibroid tumours
A)Fluid
B)Feces
C)Flatus
D)Fibroid tumours
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12
The nurse knows that a potential cause of hypoactive bowel sounds is:
A)diarrhea.
B)peritonitis.
C)laxative use.
D)gastroenteritis.
A)diarrhea.
B)peritonitis.
C)laxative use.
D)gastroenteritis.
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13
A patient is complaining of tenderness along the costovertebral angles.The nurse knows that this symptom is most often indicative of:
A)ovary infection.
B)liver enlargement.
C)kidney inflammation.
D)spleen enlargement.
A)ovary infection.
B)liver enlargement.
C)kidney inflammation.
D)spleen enlargement.
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14
The nurse suspects that a patient has a distended bladder.How should the nurse assess for this condition?
A)Percuss and palpate in the LLQ.
B)Inspect and palpate in the midline.
C)Auscultate and percuss in right lower quadrant (RLQ).
D)Percuss and palpate in the midline.
A)Percuss and palpate in the LLQ.
B)Inspect and palpate in the midline.
C)Auscultate and percuss in right lower quadrant (RLQ).
D)Percuss and palpate in the midline.
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15
A 22-year-old man falls with his motorcycle and lands on the handlebars on his left side.He comes to the clinic for an examination.The nurse suspects that he may have injured his spleen.Which of the following is true regarding assessment of the spleen in this situation?
A)The spleen can be enlarged as a result of trauma.
B)The spleen is normally felt upon routine palpation.
C)If an enlarged spleen is noted,palpate it thoroughly to determine size.
D)An enlarged spleen should not be palpated because it can rupture easily.
A)The spleen can be enlarged as a result of trauma.
B)The spleen is normally felt upon routine palpation.
C)If an enlarged spleen is noted,palpate it thoroughly to determine size.
D)An enlarged spleen should not be palpated because it can rupture easily.
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16
A patient is having difficulty swallowing medications and food.The nurse would document that this patient has:
A)aphasia.
B)dysphasia.
C)dysphagia.
D)myophagia.
A)aphasia.
B)dysphasia.
C)dysphagia.
D)myophagia.
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17
A patient's abdomen appears bulging and stretched.The nurse would describe this finding as:
A)obese.
B)herniated.
C)scaphoid.
D)protuberant.
A)obese.
B)herniated.
C)scaphoid.
D)protuberant.
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18
The nurse is assessing the abdomen of a pregnant woman,who is complaining of having a continuous "stomach ache." The nurse knows that esophageal reflux during pregnancy can cause:
A)diarrhea.
B)pyrosis.
C)dysphagia.
D)constipation.
A)diarrhea.
B)pyrosis.
C)dysphagia.
D)constipation.
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19
Which sound is normally elicited when percussing in the seventh right intercostal space at the midclavicular line over the liver?
A)Dullness
B)Tympany
C)Resonance
D)Hyperresonance
A)Dullness
B)Tympany
C)Resonance
D)Hyperresonance
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20
The nurse knows that during an abdominal assessment,deep palpation is used to determine:
A)bowel motility.
B)enlarged organs.
C)superficial tenderness.
D)overall impression of skin surface and superficial musculature.
A)bowel motility.
B)enlarged organs.
C)superficial tenderness.
D)overall impression of skin surface and superficial musculature.
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21
A patient is suspected of having cholecystitis (inflammation of the gallbladder).The nurse will conduct which of the following to assess for this condition?
A)Obturator test
B)Murphy's sign
C)Assessment for rebound tenderness
D)Iliopsoas muscle test
A)Obturator test
B)Murphy's sign
C)Assessment for rebound tenderness
D)Iliopsoas muscle test
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22
The incidence of lactose intolerance is higher in adults in which group?
A)Canadian Aboriginals
B)Spanish descent
C)European descent
D)Canadians of northern European descent
A)Canadian Aboriginals
B)Spanish descent
C)European descent
D)Canadians of northern European descent
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23
When palpating the abdomen of a 20-year-old patient,the nurse notes the presence of tenderness with deep palpation in the LUQ.Which of the following structures is most likely to be involved?
A)Spleen
B)Sigmoid
C)Appendix
D)Gallbladder
A)Spleen
B)Sigmoid
C)Appendix
D)Gallbladder
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24
The nurse suspects that a patient has appendicitis.Which of the following procedures are appropriate for use when assessing for appendicitis or a perforated appendix? (Select all that apply. )
A)Murphy's sign
B)Blumberg's sign
C)Obturator test
D)Iliopsoas muscle test
A)Murphy's sign
B)Blumberg's sign
C)Obturator test
D)Iliopsoas muscle test
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25
The nurse notes that a patient has had a black,tarry stool.A possible cause would be:
A)gallbladder disease.
B)overuse of laxatives.
C)gastrointestinal bleeding.
D)localized bleeding around the anus.
A)gallbladder disease.
B)overuse of laxatives.
C)gastrointestinal bleeding.
D)localized bleeding around the anus.
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26
Which of the following statements regarding abdominal assessment of the aging adult is true?
A)The abdominal tone is increased.
B)The abdominal musculature is thinner.
C)The abdominal rigidity with acute abdominal conditions is more common.
D)The aging person complains of more pain with an acute abdomen than a younger person would.
A)The abdominal tone is increased.
B)The abdominal musculature is thinner.
C)The abdominal rigidity with acute abdominal conditions is more common.
D)The aging person complains of more pain with an acute abdomen than a younger person would.
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27
During an assessment of a newborn infant,the nurse recalls that pyloric stenosis would be manifested by:
A)projectile vomiting.
B)hypoactive bowel activity.
C)a palpable,olive-sized mass in RLQ.
D)pronounced peristaltic waves crossing from right to left.
A)projectile vomiting.
B)hypoactive bowel activity.
C)a palpable,olive-sized mass in RLQ.
D)pronounced peristaltic waves crossing from right to left.
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28
During an abdominal assessment,the nurse is unable to hear the patient's bowel sounds.Before reporting this finding as "silent bowel sounds," the nurse should listen for at least:
A)1 minute.
B)5 minutes.
C)10 minutes.
D)2 minutes in each quadrant.
A)1 minute.
B)5 minutes.
C)10 minutes.
D)2 minutes in each quadrant.
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29
During an assessment,the nurse notes that a patient's umbilicus is enlarged and everted.It is midline,and there is no change in skin colour.The nurse recognizes that the patient may have which condition?
A)Intra-abdominal bleeding
B)Constipation
C)Umbilical hernia
D)An abdominal tumour
A)Intra-abdominal bleeding
B)Constipation
C)Umbilical hernia
D)An abdominal tumour
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30
While participating in patient assessment,the student nurse hears that a patient has "hepatomegaly" and recognizes that this term refers to:
A)an enlarged liver.
B)an enlarged spleen.
C)distended bowels.
D)excessive diarrhea.
A)an enlarged liver.
B)an enlarged spleen.
C)distended bowels.
D)excessive diarrhea.
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31
To detect diastasis recti,the nurse should have the patient perform which of the following manoeuvres?
A)Relax in the supine position.
B)Raise arms in the left lateral position.
C)Raise arms over the head while supine.
D)Raise the head while remaining supine.
A)Relax in the supine position.
B)Raise arms in the left lateral position.
C)Raise arms over the head while supine.
D)Raise the head while remaining supine.
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32
Which of the following statements about aortic aneurysm is true?
A)A bruit is absent.
B)Femoral pulses are increased.
C)A pulsating mass is usually present.
D)Most are located below the umbilicus.
A)A bruit is absent.
B)Femoral pulses are increased.
C)A pulsating mass is usually present.
D)Most are located below the umbilicus.
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33
The nurse is preparing to examine a patient who has been complaining of RLQ pain.Which technique is correct during the assessment?
A)The nurse should examine the tender area first.
B)The nurse should examine the tender area last.
C)The nurse should avoid palpating the tender area.
D)The nurse should palpate the area first and then auscultate for bowel sounds.
A)The nurse should examine the tender area first.
B)The nurse should examine the tender area last.
C)The nurse should avoid palpating the tender area.
D)The nurse should palpate the area first and then auscultate for bowel sounds.
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34
During an abdominal assessment,the nurse tests for a fluid wave.A positive fluid wave test occurs with:
A)splenomegaly.
B)distended bladder.
C)constipation.
D)ascites.
A)splenomegaly.
B)distended bladder.
C)constipation.
D)ascites.
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35
A 40-year-old man states that his doctor told him that he has a hernia.He asks the nurse to explain what a hernia is.Which appropriate action can be taken by the nurse?
A)Tell him not to worry,since most men his age develop hernias.
B)Refer him to his physician for additional consultation,because he or she made the initial diagnosis.
C)Explain that a hernia is a loop of bowel protruding through a weak spot in the abdominal muscles.
D)Explain that hernias that occur in adulthood are often the result of prenatal growth abnormalities.
A)Tell him not to worry,since most men his age develop hernias.
B)Refer him to his physician for additional consultation,because he or she made the initial diagnosis.
C)Explain that a hernia is a loop of bowel protruding through a weak spot in the abdominal muscles.
D)Explain that hernias that occur in adulthood are often the result of prenatal growth abnormalities.
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36
Tenderness on light palpation in the RLQ could indicate a disorder of which of the following structures?
A)Spleen
B)Sigmoid
C)Appendix
D)Gallbladder
A)Spleen
B)Sigmoid
C)Appendix
D)Gallbladder
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37
A 45-year-old man visits the clinic for a physical.During the abdominal assessment,the nurse percusses and notes a 10-cm area of dullness above the right costal margin.The nurse should:
A)document the presence of hepatomegaly.
B)ask additional history questions regarding the patient's alcohol intake.
C)describe this as an enlarged liver,and refer the patient to a physician.
D)consider this a normal finding,and proceed with the examination.
A)document the presence of hepatomegaly.
B)ask additional history questions regarding the patient's alcohol intake.
C)describe this as an enlarged liver,and refer the patient to a physician.
D)consider this a normal finding,and proceed with the examination.
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38
The nurse is assessing a patient for possible peptic ulcer disease.Which condition often causes this problem?
A)Hypertension
B)Streptococcus infections
C)History of constipation and frequent laxative use
D)Frequent use of nonsteroidal anti-inflammatory drugs
A)Hypertension
B)Streptococcus infections
C)History of constipation and frequent laxative use
D)Frequent use of nonsteroidal anti-inflammatory drugs
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39
Just before going home,a new mother asks the nurse about her baby's umbilical cord.The nurse would tell her that:
A)it should fall off by 10 to 14 days.
B)at birth,the cord is a bluish colour.
C)it contains two veins and one artery.
D)skin will cover the area within 1 week.
A)it should fall off by 10 to 14 days.
B)at birth,the cord is a bluish colour.
C)it contains two veins and one artery.
D)skin will cover the area within 1 week.
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40
Which of the following percussion findings would be found in a patient with a large amount of ascites?
A)Dullness across the abdomen
B)Flatness in the RUQ
C)Hyperresonance in the LUQ
D)Tympany in the RLQ and LLQ
A)Dullness across the abdomen
B)Flatness in the RUQ
C)Hyperresonance in the LUQ
D)Tympany in the RLQ and LLQ
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