Deck 9: Assessing the Abdomen

Question 1

The nurse notes a positive Murphy sign during the physical assessment. Which does the nurse suspect based on this data?

A) Ascites
B) Appendicitis
C) Cholecystitis
D) Pelvic abscess

Answer 1

Cholecystitis

Question 2

The nurse is assessing a patient who is admitted to the emergency department (ED) for an acetaminophen overdose. Which will the nurse monitor this patient for based on this data?

A) Diarrhea
B) Constipation
C) Gastrointestinal bleeding
D) Hepatic necrosis

Answer 2

Hepatic necrosis

Question 3

The nurse places the nondominant hand over the costovertebral angle (CVA) and strikes it with the dominant hand. This tests for tenderness in which organ?

A) Spleen
B) Kidney
C) Liver
D) Bladder

Answer 3

Kidney

Question 4

Which structure is found in the midline of the abdomen?

A) Aorta
B) Femoral artery
C) Umbilical artery
D) Superior vena cava

Question 5

What factor explains the protruding abdomen of an infant?

A) Weak spinal muscles
B) Weak abdominal muscles
C) Bladder pressure above the symphysis pubis
D) Enlarged liver

Question 6

Which is a life threatening cause of abdominal pain?

A) Abdominal aortic aneurysm (AAA)
B) Cholecystitis
C) Gastroesophageal reflux disease (GERD)
D) Sickle cell disease

Question 7

The nurse is providing care to a patient who reports diffuse abdominal pain. Upon assessment, the nurse notes absent bowel sounds and abdominal distension. Based on this data which medical diagnosis does the nurse suspect?

A) Appendicitis
B) Bowel obstruction
C) Cirrhosis
D) Cholelithiasis

Question 8

Which disease process is more likely to occur in the Jewish population?

A) Colon cancer
B) Pancreatitis
C) Thalassemia
D) Sickle cell anemia

Question 9

When taking the health history of a patient who presents with acute abdominal pain, which is the priority action by the nurse?

A) Administering pain medication
B) Collecting detailed demographic information
C) Exploring the past history of GI illness
D) Assessing vital signs

Question 10

Which structure of the gastrointestinal (GI) system is found in the right upper quadrant (RUQ) and is the primary site of absorption?

A) Stomach
B) Duodenum
C) Sigmoid
D) Large intestine

Question 11

Which finding on the abdominal exam would indicate the need for further evaluation?

A) A flat abdomen in a young adult patient within normal weight range for height
B) Visible peristalsis in a thin child
C) A slight pulsation in the epigastric region of an adult patient
D) Presence of spider angiomas on the abdomen

Question 12

Which of the following changes to bowel sounds occurs during pregnancy?

A) Hypoactivity
B) Hyperactivity
C) Absent
D) Normal

Question 13

How long do you listen to each quadrant to determine that bowel sounds are absent?

A) 30 seconds
B) 60 seconds
C) 2 minutes
D) 5 minutes

Question 14

The patient is complaining of left upper quadrant (LUQ) pain. Based on this data which does the nurse suspect?

A) Ruptured spleen
B) Pneumonia
C) Hepatitis
D) Duodenal ulcer

Question 15

Which is the main site for metabolizing drugs which may become impaired with the aging process?

A) Stomach
B) Liver
C) Spleen
D) Large intestine

Question 16

The nurse notes a positive shifting dullness. Which diagnosis does this assessment finding support?

A) Ascites
B) Liver enlargement
C) Pancreatitis
D) An abdominal mass

Question 17

Which is the correct sequence for the abdominal exam?

A) Inspection, palpation, percussion, and auscultation
B) Inspection, percussion, palpation, and auscultation
C) Inspection, auscultation, percussion, and palpation
D) Inspection, auscultation, palpation, and percussion

Question 18

Which gastrointestinal (GI) changes is not anticipated when assessing an older adult patient?

A) Changes to dentation
B) An increase in muscle mass
C) Painful mastication
D) A decrease in liver function

Question 19

The nurse is assessing a patient who is prescribed an anticholinergic agent. Which assessment finding indicates the patient is experiencing an adverse reaction to the drug?

A) GI bleeding
B) Hepatic necrosis
C) Diarrhea
D) Paralytic ileus

Question 20

The Rovsing's sign and iliopsoas muscle test are useful to determine the presence of which disease process?

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

Question 21

Which structure is located in the right upper quadrant (RUQ) of the abdomen?

A) Spleen
B) Stomach
C) Sigmoid
D) Liver

Question 22

The nurse is assessing an adolescent patient admitted to the emergency department (ED) with right lower quadrant (RLQ) pain. What test can be done to assess for appendicitis?

A) Murphy sign
B) Iliopsoas muscle test
C) CVA tenderness
D) Scratch test

Question 23

The nurse auscultates for bowel sounds. What is the normal frequency of bowel sounds?

A) Every 5 to 15 seconds
B) Every 15 to 30 seconds
C) Every 30 to 60 seconds
D) Every 5 to 7 minutes

Question 24

An older adult patient is admitted to the hospital with blunt trauma to the abdomen after an auto accident. Which finding may indicate intra-abdominal bleeding?

A) Borborygmi
B) Everted umbilicus
C) Visible peristaltic waves
D) Discoloration around the umbilicus

Question 25

The nurse is providing care for an adult patient admitted to the hospital with hepatic cirrhosis. Auscultation of the abdomen is included in the assessment. Which sound suggests increased collateral circulation between the portal and the systemic venous systems?

A) Bruit
B) Borborygmi
C) Friction rub
D) Venous hum

Question 26

Which sound would the nurse expect to elicit when percussing the liver?

A) Resonance
B) Hyperresonance
C) Dullness
D) Tympany

Question 27

Which is a term that indicates hyperactive peristalsis?

A) Succession splash
B) Venous hum
C) Friction rub
D) Scratch test

Question 28

Which type of bowel sound may be indicative of an early bowel obstruction?

A) Hyperperistaltic bowel sounds
B) Hypoperistaltic bowel sounds
C) Absent bowel sounds
D) Epigastric bowel sounds

Question 29

Aside from percussion, which other test may be performed to locate the inferior border of the liver?

A) Fluid wave test
B) Rebound test
C) Obturator test
D) Scratch test

Question 30

Which assessment data indicates the patient is experiencing hypoactive bowel sounds?

A) More than 30 clicks per minute
B) More than 40 clicks per minute
C) Less than 5 clicks per minute
D) Less than 20 clicks per minute

Question 31

While inspecting the adolescent patient's abdomen, the nurse may see aortic pulsations in which area?

A) Epigastric
B) Right inguinal
C) Hypogastric
D) Left lumbar

Question 32

Which is the normal liver span at the midclavicular line?

A) 3 to 6 cm
B) 4 to 8 cm
C) 6 to 12 cm
D) 12 to 16 cm

Question 33

Which structure is located in the left upper quadrant (LUQ) of the abdomen?

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

Question 34

Which structure is located in the right lower quadrant (RLQ) of the abdomen?

A) Liver
B) Stomach
C) Cecum
D) Sigmoid

Question 35

Which action by the nurse is appropriate when attempting to locate the spleen during the abdominal assessment?

A) Percussing over the 9th to the 11th ribs at the midaxillary line
B) Performing the scratch test
C) Auscultating for venous hums
D) Palpating for the apical pulse

Question 36

The nurse is assessing a patient's bladder. Which action is accurate if ascites is noted?

A) Preparing for bladder catheterization
B) Documenting this has a normal finding
C) Auscultating the heart and lungs
D) Percussing the abdomen for shifting dullness

Question 37

The nurse attempts to elicit rebound tenderness. Which finding indicates positive rebound tenderness?

A) Pain during light palpation over the affected area
B) Pain during deep palpation over the affected area
C) Pain upon gradual withdrawal of fingers after light palpation
D) Pain upon sudden withdrawal of fingers after deep palpation