Deck 36: Nursing Assessment of the Patient With Gastrointestinal, Renal, or Urinary Disorders

Question 1

The nurse is assessing a 68-year-old female patient who states, "I am having episodes of urinary incontinence." The nurse should recognize that this statement indicates which situation?

A) An abnormal finding requiring further testing
B) The presence of a urinary infection
C) A normal outcome of the aging process
D) The result of having several children

Answer 1

An abnormal finding requiring further testing

Question 2

The nurse is percussing a patient's kidneys as part of the physical assessment. Which nursing action displays a need for further instruction regarding this assessment technique?

A) The nurse focuses the examination at the patient's costal vertebral angles.
B) The nurse asks the patient to sit on the side of the examination table.
C) The nurse gently strikes the patient with the palmar surface of the hand.
D) The nurse applies the technique to either side of the spine between the last rib and the lumbar vertebrae.

Answer 2

The nurse gently strikes the patient with the palmar surface of the hand.

Question 3

A newly licensed nurse is assessing a patient who reports constant dull pain over the lower abdomen. The nurse inspects, percusses, palpates, and auscultates the patient's abdomen. After leaving the patient's room, the preceptor says, "Your assessment findings may not be accurate." What is the rationale for the preceptor's statement?

A) The nurse palpated prior to auscultating.
B) The nurse inspected prior to palpating.
C) The nurse inspected prior to auscultating.
D) The nurse percusses before palpating.

Answer 3

The nurse palpated prior to auscultating.

Question 4

The nurse is caring for an adolescent who experienced trauma to the spleen that requires its removal. When discussing the proposed surgery with the patient's parents, the nurse would provide which information? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.

A) The spleen is located in the left upper abdominal quadrant.
B) The spleen is involved in the return of bile to the liver.
C) The spleen has a minimal vascular system.
D) The spleen acts as a blood filtration system.
E) The spleen destroys aged red blood cells.

Question 5

An older adult patient states, "My mouth is always dry." The nurse recognizes that which priority health promotion problem should be addressed?

A) Poorly chewed food will remain in the patient's mouth, supporting bacterial growth.
B) The normal aging process reduces the antibacterial properties of saliva.
C) A lack of salivary gland lubrication makes chewing the food difficult, resulting in gum trauma.
D) A dry mouth lacks bacteria-fighting immunoglobulin A.

Question 6

A patient is reporting intermittent pain in the left upper abdomen. To best assess the characteristics of the pain, the nurse would ask which questions? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.

A) "Can you describe the pain for me?"
B) "What do you think is causing the pain?"
C) "When did you first notice the pain?"
D) "Can you do anything that makes the pain go away?"
E) "Does anything make the pain worse?"

Question 7

The nurse evaluates which patient observation as indicating the patient correctly understands the functions of the stomach?

A) "The process of absorption of nutrients begins in my stomach."
B) "My stomach turns food into liquid so it can be digested."
C) "My stomach begins the digestion of carbohydrates."
D) "Sulfuric acid is secreted by the stomach."

Question 8

The patient reports feeling pain in the right lower quadrant. The nurse shows an understanding of the anatomical location of organs in the abdomen by asking the patient which question?

A) "Do you have any problems eating fatty foods?"
B) "Can you tell me about your bowel habits?"
C) "When you eat, do you experience any nausea?"
D) "Do you get clammy when you miss a meal?"

Question 9

A nurse preceptor is reviewing the skill of percussing a patient's abdomen with a newly licensed nurse. The preceptor will intervene when the nurse makes which statement?

A) "I will percuss the abdomen using a systematic path."
B) "I anticipate hearing tympany over stool-filled intestines."
C) "Dullness is the expected percussion over the liver."
D) "Percussion is a useful tool for assessing the spleen, kidneys, and liver."

Question 10

Which question would the nurse ask to most effectively assess the patient's pattern of elimination?

A) "Are you having any bowel problems?"
B) "Have you had any recent difficulties with your stools?"
C) "Tell me about your usual bowel habits."
D) "Are your bowel movements normal?"

Question 11

During an assessment of a patient's abdomen, frequent pulsations are noted in the epigastric region. What action by the nurse is indicated?

A) Document the findings as hyperactive bowel sounds.
B) Review the patient's medical records for signs and symptoms of cirrhosis, which may indicate ascites.
C) Note the time when the patient last voided.
D) Auscultate for a bruit.

Question 12

When assessing a patient who is scheduled to have a CT scan of the kidneys, which finding would prompt the nurse to notify the primary health care provider?

A) Allergy to iodine and seafood
B) Urinary output of 1,200 mL in 24 hours
C) Last bowel movement one day ago
D) Height 5'8" and weight 160 pounds

Question 13

When assessing a patient's abdomen, the nurse recognizes the importance of reserving palpation as the last technique. What rationale would the nurse provide for this sequence?

A) Early palpation may result in rebound pain.
B) The technique is likely to increase the patient's level of anxiety.
C) Most patients do not like being touched.
D) The pressure of palpation can interfere with hearing bowel sounds.

Question 14

It is thought that a patient may be experiencing pancreatitis. Which nursing action would be useful in helping diagnose this disorder?

A) The patient bends the right knee and flexes the right hip, while the nurse flexes the thigh to a right angle and externally and internally rotates the leg.
B) The nurse inquires with radiology when an endoscopy can be scheduled for the patient.
C) The nurse anticipates that the patient's health care provider will order a barium enema.
D) Placing the hand on the lateral surface of the patient's flexed right thigh, the nurse asks the patient to push against the applied resistance.

Question 15

Which assessment finding alerts the nurse to the likelihood that the patient has a distended bladder?

A) Percussion in the middle of the lower abdomen elicits a dull sound.
B) The patient states, "My back is killing me."
C) Percussion over the costovertebral angle produces pain.
D) The patient complains of colicky pain in the side.

Question 16

The nurse is initiating a history and physical assessment on a patient who reports intermittent right-sided abdomen pain, especially after eating fatty foods. How should the nurse conduct the history? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.

A) Encourage the patient to express his or her concerns.
B) Include documentation of the patient's own words.
C) Direct questions toward ruling out a gallbladder problem
D) Use direct questioning so the interview remains nurse-driven.
E) Establish the nurse-patient relationship.

Question 17

Arrange the four parts of abdominal assessment in the order the nurse should follow. Standard Text: Click and drag the options below to move them up or down.
Choice

A) Percussion Choice
B) Inspection Choice
C) Palpation Choice
D) Auscultation

Question 18

The nurse is teaching a patient who has a diagnosis of a kidney stone in the left ureter. The nurse knows the patient understands the instruction when the patient makes which statement?

A) "My kidney stone is in the tube that empties my bladder."
B) "The stone in my kidney is causing my pain."
C) "If my kidney stone keeps moving down the ureter, it will eventually move into my bladder."
D) "The kidney contracts and pushes the stone down my ureter."

Question 19

When percussing a patient's abdomen to gather assessment data, the nurse must rely most heavily on which ability?

A) Locating the margins of the various abdominal organs
B) Differentiating the various elicited sounds
C) Supplementing the technique with fine finger dexterity
D) Observing subtle variations in the contour of the abdomen

Question 20

The nurse is preparing to assess a patient who reports abdominal pain as 6 on a scale of 0 to 10. To best facilitate the abdominal assessment, what nursing action is indicated?

A) First medicate the patient for the pain.
B) Palpate the patient's abdomen last.
C) Assist the patient into the knees-bent supine position.
D) Encourage the patient to take slow, deep breaths.

Question 21

The preceptor would intervene if the newly licensed nurse planned to test for the iliopsoas sign in which patients? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.

A) A patient immobilized after sustaining a neck injury
B) A 70-year-old patient hospitalized with abdominal pain
C) A patient who had hip-replacement surgery 6 years ago
D) A patient with suspected inflammation of the cecum
E) A patient who may have appendicitis

Question 22

The nurse includes which data when documenting a patient's biographic and demographic information? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.

A) The patient has a high school diploma.
B) The patient drinks two to three beers per day.
C) The patient is male.
D) The patient lives on a farm in a rural area.
E) The patient is 24 years old.

Question 23

The nurse recognizes that a patient diagnosed with poorly controlled type 2 diabetes is at risk for developing which gastrointestinal complication?

A) Paralytic ileus
B) Peptic ulcer
C) Gastroparesis
D) Gastric reflux disease

Question 24

Which techniques would the nurse use to elicit rebound tenderness in a patient's abdomen? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.

A) Start in an area away from the painful area.
B) Start with deep palpation.
C) Release pressure on the abdomen quickly.
D) Stop the assessment as soon as rebound tenderness is elicited.
E) Start the assessment by gently stroking the painful area of the abdomen.

Question 25

A patient reports epigastric pain that occurs after meals and often awakens the patient at night. The nurse would ask additional assessment questions about which disorder?

A) Urinary tract infection
B) Duodenal ulcer
C) Gastric ulcer
D) Intussusception

Question 26

A patient is having diagnostic testing done after experiencing new-onset abdominal pain. Laboratory results reveal that the serum creatinine is elevated. The nurse would look for additional assessment findings of which disorder?

A) Appendicitis
B) Renal failure
C) GERD
D) Constipation

Question 27

Which data would the nurse document regarding a patient's complaint of abdominal pain? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.

A) The patient fears losing her job if pain causes another absence.
B) The patient describes the pain as sharp and stabbing.
C) Walking exacerbates the pain.
D) Belching has lessened the pain.
E) The pain began 24 hours ago.

Question 28

The nurse assesses for a positive Murphy's sign in a patient suspected of having which disorder?

A) Urinary retention
B) Diverticulitis
C) Cholecystitis
D) Renal calculi

Question 29

The nurse would recommend avoiding ginger as complimentary therapy for gastrointestinal distress in which individuals? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.

A) A patient with peptic ulcer disease
B) Persons younger than 30 years of age
C) Persons taking anticoagulants for atrial fibrillation
D) Women
E) Patients with documented sun sensitivity

Question 30

A patient is hospitalized with possible pancreatitis. The nurse would evaluate which laboratory test results as supporting that diagnosis? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.

A) Increased serum amylase
B) Increased serum lipase
C) Decreased serum indirect bilirubin
D) Increased blood urea nitrogen
E) Increased partial thromboplastin time PTT)