Deck 22: Abdomen

Question 1

A patient is complaining of a sharp pain along the costovertebral angle.The nurse is aware that this symptom is most often indicative of:

A)Ovary infection
B)Liver enlargement
C)Kidney inflammation
D)Spleen enlargement

Answer 1

Kidney inflammation

Question 2

The nurse is describing a scaphoid abdomen.To the horizontal plane, a scaphoid contour of the abdomen depicts a __________ profile.

A)Flat
B)Convex
C)Bulging
D)Concave

Answer 2

Concave

Question 3

The nurse is percussing the seventh right intercostal space at the midclavicular line over the liver.Which sound should the nurse expect to hear?

A)Dullness
B)Tympany
C)Resonance
D)Hyper-resonance

Answer 3

Dullness

Question 4

The nurse is aware that one change that may occur in the gastrointestinal system of an aging adult is:

A)Increased salivation
B)Increased liver size
C)Increased esophageal emptying
D)Decreased gastric acid secretion

Question 5

A patient is having difficulty swallowing medications and food.The nurse would document that this patient has:

A)Aphasia
B)Dysphasia
C)Dysphagia
D)Anorexia

Question 6

During an abdominal assessment, the nurse would consider which of these findings as normal?

A)Presence of a bruit in the femoral area
B)Tympanic percussion note in the umbilical region
C)Palpable spleen between the ninth and eleventh ribs in the left midaxillary line
D)Dull percussion note in the left upper quadrant at the midclavicular line

Question 7

The nurse is listening to bowel sounds.Which of these statements is true of bowel sounds? Bowel sounds:

A)Are usually loud, high-pitched, rushing, and tinkling sounds
B)Are usually high-pitched, gurgling, and irregular sounds
C)Sound like two pieces of leather being rubbed together
D)Originate from the movement of air and fluid through the large intestine

Question 8

While examining a patient, the nurse observes abdominal pulsations between the xiphoid process 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

Question 9

A patient has hypoactive bowel sounds.The nurse knows that a potential cause of hypoactive bowel sounds is:

A)Diarrhea
B)Peritonitis
C)Laxative use
D)Gastroenteritis

Question 10

When percussing the left lower quadrant of the abdomen, the nurse elicits a drumlike sound normal for the:

A)Liver
B)Pancreas
C)Left kidney
D)Sigmoid colon

Question 11

The physician comments that a patient has abdominal borborygmi.The nurse knows that this term refers to:

A)Loud continual hum
B)Peritoneal friction rub
C)Hypoactive bowel sounds
D)Hyperactive bowel sounds

Question 12

The nurse is watching a new graduate nurse perform auscultation of a patient's abdomen.Which statement by the new graduate shows correct understanding of the reason auscultation precedes percussion and palpation of the abdomen?

A)"We need to determine the areas of tenderness before using percussion and palpation."
B)"Auscultation prior prevents distortion of bowel sounds that might occur after percussion and palpation."
C)"Auscultation allows the patient more time to relax and thus be more comfortable with the physical examination."
D)"Auscultation prevents distortion of vascular sounds, such as bruits and hums, which might occur after percussion and palpation."

Question 13

A nurse notices that a patient has ascites, which indicates the presence of:

A)Fluid
B)Feces
C)Flatus
D)Fibroid tumours

Question 14

During inspection of a 52-year-old patient, the nurse notes that the patient's abdomen is bulging and stretched with dullness percussed to the left lower quadrant.The nurse will document that the patient:

A)Is obese and on a weight loss program
B)Has a hernia and awaiting surgery
C)Has a scaphoid abdomen and there are no concerns
D)Has a protuberant abdomen, which requires further investigation

Question 15

A 22-year-old man comes to the clinic for an examination after falling off his motorcycle and landing on his left side on the handle bars.The nurse suspects that he may have injured his spleen.Which of these statements is true regarding assessment of the spleen in this situation?

A)The spleen can be enlarged as a result of trauma.
B)Normally, the spleen is felt on routine palpation.
C)If an enlarged spleen is noted, then the nurse should thoroughly palpate to determine its size.
D)An enlarged spleen should not be palpated because it can easily rupture.

Question 16

During abdominal assessment, the nurse performs deep palpation to screen for:

A)Bowel motility
B)Changes in size of organs
C)Gastroesophageal reflux
D)Abdominal skin and musculature

Question 17

The nurse is performing percussion during an abdominal assessment.Percussion notes heard during the abdominal assessment may include:

A)Flatness, resonance, and dullness
B)Resonance, dullness, and tympany
C)Tympany, hyper-resonance, and dullness
D)Resonance, hyper-resonance, and flatness

Question 18

An older 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

Question 19

The nurse is assessing the abdomen of a pregnant woman who is complaining of having "acid indigestion" all the time.The nurse knows that esophageal reflux during pregnancy can cause:

A)Diarrhea
B)Pyrosis
C)Dysphagia
D)Constipation

Question 20

The nurse suspects that a patient has a distended bladder.How should the nurse assess for this condition?

A)Percuss and palpate in the lumbar region
B)Inspect and palpate in the epigastric region
C)Auscultate and percuss in the inguinal region
D)Percuss and palpate the midline area above the suprapubic bone

Question 21

During an abdominal assessment, the nurse elicits tenderness on light palpation in the right lower quadrant.The nurse interprets that this finding could indicate a disorder of which of these structures?

A)Spleen
B)Sigmoid
C)Appendix
D)Gallbladder

Question 22

The nurse notices that a patient has black, tarry stools and recognizes that they could indicate:

A)Gallbladder disease
B)Iron supplementation
C)Gastrointestinal bleeding
D)Localized bleeding around the anus

Question 23

When palpating the abdomen of a 20-year-old patient who was injured in a motor vehicle accident, the nurse notices the presence of tenderness in the left upper quadrant with deep palpation.Which of these structures is most likely to be involved?

A)Spleen
B)Sigmoid colon
C)Appendix
D)Gallbladder

Question 24

A 40-year-old man states that his physician diagnosed him with a hernia.He asks the nurse to explain what a hernia is.Which response by the nurse is appropriate?

A)"No need to worry.Most men your age develop hernias."
B)"A hernia is a loop of bowel that has pushed through a weak spot in the abdominal muscles."
C)"A hernia is the result of prenatal growth abnormalities that are just now causing problems."
D)"I'll have to have your physician explain this to you."

Question 25

During assessment of a patient with chronic emphysema, the nurse recognizes that percussing the liver border below the right costal margin:

A)Can indicate liver cirrhosis
B)Indicates hepatomegaly
C)Requires immediate reporting of findings
D)Is an expected finding in this patient

Question 26

A patient is suspected of having cholecystitis, or inflammation of the gallbladder.The nurse should conduct which of these techniques to assess for this condition?

A)Obturator test
B)Test for inspiratory arrest
C)Assess for rebound tenderness
D)Iliopsoas muscle test

Question 27

During the health history, the patient tells the nurse, "I have pain all the time in my stomach.It's worse 2 hours after I eat, but it gets better if I eat again!" On the basis of these symptoms, the nurse suspects that the patient has which condition?

A)Appendicitis
B)Gastric ulcer
C)Duodenal ulcer
D)Cholecystitis

Question 28

During an assessment of a newborn infant, the nurse recalls that pyloric stenosis would be exhibited by:

A)Projectile vomiting
B)Hypoactive bowel activity
C)Palpable olive-sized mass in the right lower quadrant
D)Pronounced peristaltic waves crossing from right to left

Question 29

The nurse is assessing the abdomen of an older adult.Which statement regarding the older adult and abdominal assessment is true?

A)Abdominal tone is increased.
B)Abdominal musculature is thinner.
C)Abdominal rigidity with an acute abdominal condition is more common.
D)The older adult with an acute abdominal condition complains more about pain than the younger person.

Question 30

The nurse is preparing to examine a patient who has been complaining of right lower quadrant pain.Which technique is correct during the assessment? The nurse should:

A)Examine the tender area first
B)Examine the tender area last
C)Avoid palpating the tender area
D)Palpate the tender area first and then auscultate for bowel sounds

Question 31

The 22-year-old patient informs the nurse she feels bloated and has diarrhea when she drinks milkshakes and eats ice cream.The nurse recognizes this as possible:

A)Celiac disease
B)Lactose intolerance
C)Cholecystitis
D)Wheat allergy

Question 32

The nurse is assessing a 60-year-old male patient with sharp upper abdominal pain.What additional finding during history taking indicates possible peptic ulcer disease?

A)Lactose intolerance
B)Streptococcal infections
C)Recurrent constipation with frequent laxative use
D)Frequent use of nonsteroidal anti-inflammatory drugs (NSAIDs)

Question 33

Which of these percussion findings would the nurse expect to find in a patient with a large amount of ascites?

A)Dullness across the abdomen
B)Flatness in the RUQ
C)Hyper-resonance in the left upper quadrant
D)Tympany in the right and left lower quadrants

Question 34

During an abdominal assessment, the nurse is unable to hear bowel sounds in a patient's abdomen.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

Question 35

A 45-year-old man is in the clinic for a physical examination.During the abdominal assessment, the nurse percusses the abdomen and notices an area of dullness above the right costal margin of approximately 11 cm.The nurse should:

A)Document the presence of hepatomegaly
B)Ask additional health history questions regarding his alcohol intake
C)Describe this dullness as indicative of an enlarged liver and refer him to a physician
D)Consider this finding as normal and proceed with the examination

Question 36

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

Question 37

Just before going home, a new mother asks the nurse about the infant's umbilical cord.Which of these statements by the nurse is correct?

A)"It should fall off in 10 to 14 days."
B)"It will soften before it falls off."
C)"It contains two veins and one artery."
D)"Skin will cover the area within 1 week."

Question 38

During abdominal assessment of an adult patient, the nurse auscultates a bruit in the upper abdomen area just left of the midline.The nurse will:

A)Palpate the area
B)Document the findings as normal
C)Report the findings immediately
D)Assess for rebound tenderness

Question 39

To detect diastasis recti, the nurse should ask the patient to perform which of these manoeuvres?

A)Relaxing in the supine position
B)Raising the arms in the left lateral position
C)Raising the arms over the head while in a supine position
D)Raising the head while in the supine position

Question 40

During an assessment, the nurse notices that a 6-month-old patient's umbilicus is enlarged and everted.It is positioned midline with 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)Abdominal tumour

Question 41

When inspecting a patient's abdomen, the nurse notes an old surgical scar at midline extending vertically below the umbilicus.The nurse will: (Select all that apply.)

A)Not be concerned with it because it is an old scar.
B)Ask the patient about the scar.
C)Not consider it relevant because the patient did not identify it.
D)Include a drawing of the scar's location on the abdomen in the documentation.
E)Measure and record the length of the scar in the documentation.

Question 42

The nurse suspects that a patient has appendicitis.Which of these procedures are appropriate for use when assessing for appendicitis or a perforated appendix? (Select all that apply.)

A)Test for Murphy's sign
B)Test for Blumberg's sign
C)Test for shifting dullness
D)Perform the iliopsoas muscle test
E)Test for fluid wave