Deck 21: Abdomen

Question 1

Which structure is located in the left lower quadrant of the abdomen?
1)Liver
2)Duodenum
3)Gallbladder
4)Sigmoid colon

Answer 1

4
The sigmoid colon is located in the left lower quadrant of the abdomen.

Question 2

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 handlebars.The nurse suspects that he may have injured his spleen.Which of the following is true regarding assessment of the spleen in this situation?
1)The spleen can be enlarged as a result of trauma.
2)The spleen is normally felt upon routine palpation.
3)If an enlarged spleen is noted,palpate thoroughly to determine size.
4)An enlarged spleen should not be palpated because it can rupture easily.

Answer 2

4
If you feel an enlarged spleen,refer the person but do not continue to palpate it.An enlarged spleen is friable and can rupture easily with overpalpation.

Question 3

A nurse notes that a patient has ascites,which indicates that which of the following is present?
1)Fluid
2)Feces
3)Flatus
4)Fibroid tumors

Answer 3

1
Ascites occurs with heart failure,portal hypertension,cirrhosis,hepatitis,pancreatitis,and cancer.

Question 4

The physician comments that a patient has abdominal "borborygmi." The nurse knows that this term refers to:
1)a loud continuous hum.
2)a peritoneal friction rub.
3)hypoactive bowel sounds.
4)hyperactive bowel sounds.

Question 5

Which sound is normal to elicit when percussing in the seventh right intercostal space at the midclavicular line over the liver?
1)Dullness
2)Tympany
3)Resonance
4)Hyperresonance

Question 6

Percussion notes heard during the abdominal assessment may include:
1)flatness,resonance,and dullness.
2)resonance,dullness,and tympany.
3)tympany,hyperresonance,and dullness.
4)resonance,hyperresonance,and flatness.

Question 7

To the horizontal plane,a scaphoid contour of the abdomen depicts:
1)a flat profile.
2)a convex profile.
3)a bulging profile.
4)a concave profile.

Question 8

Which of the following is a normal finding in the abdominal assessment?
1)The presence of a bruit in the femoral area
2)A tympanic percussion note in the umbilical region
3)A palpable spleen between the ninth and eleventh ribs in the left midaxillary line
4)A dull percussion note in the left upper quadrant at the midclavicular line

Question 9

A patient has been diagnosed with pernicious anemia.The nurse knows that this condition could be related to:
1)increased gastric acid secretion.
2)decreased gastric acid secretion.
3)delayed gastrointestinal emptying time.
4)increased gastrointestinal emptying time.

Question 10

The nurse notes that a patient has had a black,tarry stool and recalls that a possible cause would be:
1)gallbladder disease.
2)overuse of laxatives.
3)gastrointestinal bleeding.
4)localized bleeding around the anus.

Question 11

The nurse is aware that a change that may occur in the gastrointestinal system of an aging adult is:
1)increased salivation.
2)decreased peristalsis.
3)increased esophageal emptying.
4)decreased gastric acid secretion.

Question 12

The nurse is listening to bowel sounds.Which of the following is true of bowel sounds?
1)They are usually loud,high-pitched,rushing,tinkling sounds.
2)They are usually high-pitched,gurgling,irregular sounds.
3)They sound like "two pieces of leather being rubbed together."
4)They originate from the movement of air and fluid through the large intestine.

Question 13

While examining a patient,the nurse observes abdominal pulsations between the xiphoid and umbilicus.The nurse would suspect that these are:
1)pulsations of the renal arteries.
2)pulsations of the inferior vena cava.
3)normal abdominal aortic pulsations.
4)increased peristalsis from a bowel obstruction.

Question 14

The nurse suspects that a patient has a distended bladder.How should the nurse assess for this condition?
1)Percuss and palpate in the lumbar region.
2)Inspect and palpate in the epigastric region.
3)Auscultate and percuss in the inguinal region.
4)Percuss and palpate in the hypogastric region.

Question 15

Tenderness on light palpation in the right lower quadrant could indicate a disorder of which of the following structures?
1)Spleen
2)Sigmoid
3)Appendix
4)Gallbladder

Question 16

The nurse is assessing the abdomen of a pregnant woman,who is complaining of having a "stomach ache" all the time.The nurse knows that esophageal reflux during pregnancy can cause:
1)diarrhea.
2)pyrosis.
3)dysphagia.
4)constipation.

Question 17

A patient is complaining of tenderness along the costovertebral angles.The nurse knows that this symptom is most often indicative of:
1)ovary infection.
2)liver enlargement.
3)kidney inflammation.
4)spleen enlargement.

Question 18

A patient has hypoactive bowel sounds.The nurse knows that a potential cause of hypoactive bowel sounds is:
1)diarrhea.
2)peritonitis.
3)laxative use.
4)gastroenteritis.

Question 19

The main reason auscultation precedes percussion and palpation of the abdomen is to:
1)determine areas of tenderness before using percussion and palpation.
2)prevent distortion of bowel sounds that might occur after percussion and palpation.
3)allow the patient more time to relax and therefore be more comfortable with the physical examination.
4)prevent distortion of vascular sounds such as bruits and hums that might occur after percussion and palpation.

Question 20

The nurse knows that during an abdominal assessment,deep palpation is used to determine:
1)bowel motility.
2)enlarged organs.
3)superficial tenderness.
4)overall impression of skin surface and superficial musculature.

Question 21

A 45-year-old man is in the clinic for a physical.During the abdominal assessment,the nurse percusses and notes an area of dullness above the right costal margin of about 10 cm.The nurse should:
1)document the presence of hepatomegaly.
2)ask additional history questions regarding his alcohol intake.
3)describe this as an enlarged liver and refer him to a physician.
4)consider this a normal finding and proceed with the examination.

Question 22

During an abdominal assessment,the nurse tests for a fluid wave.A positive fluid wave test occurs with:
1)splenomegaly.
2)distended bladder.
3)constipation.
4)ascites.

Question 23

To detect diastasis recti,the nurse should have the patient perform which of the following maneuvers?
1)Relax in the supine position.
2)Raise arms in the left lateral position.
3)Raise arms over the head while supine.
4)Raise the head while remaining supine.

Question 24

The nurse is preparing to examine patient who has been complaining of right lower quadrant pain.Which technique is correct during the assessment?
1)The nurse should examine the tender area first.
2)The nurse should examine the tender area last.
3)The nurse should avoid palpating the tender area.
4)The nurse should palpate the area first and then auscultate for bowel sounds.

Question 25

When palpating the abdomen of a 20-year-old patient,the nurse notes the presence of tenderness in the left upper quadrant with deep palpation.Which of the following structures is most likely to be involved?
1)Spleen
2)Sigmoid
3)Appendix
4)Gallbladder

Question 26

Which of the following percussion findings would be found in a patient with a large amount of ascites?
1)Dullness across the abdomen
2)Flatness in the right upper quadrant
3)Hyperresonance in the left upper quadrant
4)Tympany in the right and left lower quadrants

Question 27

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:
1)1 minute.
2)5 minutes.
3)10 minutes.
4)2 minutes in each quadrant.

Question 28

During an assessment of a newborn infant,the nurse recalls that pyloric stenosis would be manifested by:
1)projectile vomiting.
2)hypoactive bowel activity.
3)palpable olive-sized mass in right lower quadrant.
4)pronounced peristaltic waves crossing from right to left.

Question 29

During report,the student nurse hears that a patient has "hepatomegaly" and recognizes that this term refers to a/an:
1)enlarged liver.
2)enlarged spleen.
3)distended bowels.
4)excessive diarrhea.

Question 30

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.
1)Murphy's sign
2)Blumberg's sign
3)Obturator test
4)Iliopsoas muscle test

Question 31

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 action by the nurse is appropriate?
1)Tell him not to worry,that most men his age develop hernias.
2)Refer him to his physician for additional consultation because he or she made the initial diagnosis.
3)Explain that a hernia is a loop of bowel protruding through a weak spot in the abdominal muscles.
4)Explain that hernias that occur in adulthood are often the result of prenatal growth abnormalities.

Question 32

The nurse is assessing a patient for possible peptic ulcer disease and knows that which condition often causes this problem?
1)Hypertension
2)Streptococcus infections
3)History of constipation and frequent laxative use
4)Frequent use of nonsteroidal anti-inflammatory drugs

Question 33

A patient is suspected of having inflammation of the gallbladder,or cholecystitis.The nurse will conduct which of the following to assess for this condition?
1)Obturator test
2)Murphy's sign
3)Assess for rebound tenderness
4)Iliopsoas muscle test

Question 34

The incidence of lactose intolerance is higher in adults of which ethnic group?
1)American Indians
2)Hispanics
3)Whites of British descent
4)Americans of northern European descent