Question 1

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?

Accepted Answer

The appendix is located in the right lower quadrant.When the iliopsoas muscle is inflamed, which occurs with an inflamed or perforated appendix, pain is felt in the right lower quadrant.

Question 2

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

Accepted Answer

Black stools may be tarry as a result of occult blood (melena) from gastrointestinal bleeding.Red blood in stools occurs with localized bleeding around the anus.Stools may be black, but nontarry, with use of iron supplements.

Question 3

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?

Accepted Answer

The spleen is located in the left upper quadrant of the abdomen.The gallbladder is in the RUQ, the sigmoid colon is in the left lower quadrant, and the appendix is in the right lower quadrant.

Question 4

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?

Accepted Answer

The nurse should explain that a hernia is a protrusion of the abdominal viscera through an abnormal opening in the muscle wall.

Question 5

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

Accepted Answer

For people with chronic emphysema, the liver is displaced downward by the hyperinflated lungs.Although a dull percussion note can be heard well below the right costal margin, the overall span is still within normal limits.Hepatomegaly refers to an enlarged liver.

Question 6

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?

Accepted Answer

Normally, palpation of the liver causes no pain.In a person with cholecystitis, or inflammation of the gallbladder, pain occurs as the descending liver pushes the inflamed gallbladder onto the examining hand during inspiration.The person feels sharp pain and abruptly stops midway during inspiration; this is termed inspiratory arrest (Murphy's sign).

Question 7

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?

Accepted Answer

Pain associated with duodenal ulcers occurs 2 to 3 hours after a meal; it may be relieved by more food.Chronic pain associated with gastric ulcers usually occurs on an empty stomach.Severe, acute pain would occur with appendicitis and cholecystitis.

Question 8

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

Accepted Answer

Significant peristalsis, together with projectile vomiting, in the newborn suggests pyloric stenosis.After feeding, pronounced peristaltic waves cross from left to right, leading to projectile vomiting.An olive-sized mass can be palpated in the right upper quadrant (RUQ).

Question 9

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

Accepted Answer

In the older adult, the abdominal musculature is thinner and has less tone than that of the younger adult, and abdominal rigidity with an acute abdominal condition is less common in the aging person.The older adult with an acute abdominal condition often complains less about pain compared with a younger person.

Question 10

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:

Accepted Answer

The nurse should save the examination of any identified tender areas until last.This method avoids pain and the resulting muscle rigidity that would obscure deep palpation later in the examination.Auscultation is performed before percussion and palpation because percussion and palpation can increase peristalsis, which would result in false interpretation of bowel sounds.

Question 11

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:

Accepted Answer

Lactose intolerance results from lactase deficiency and can cause bloating, excessive gas or diarrhea after ingesting dairy products, such as milkshakes and ice cream.Wheat allergy or gluten intolerance (e.g., Celiac disease) can result in abdominal pain, distension, or diarrhea.Cholecystitis is biliary colic, which causes sudden pain in the RUQ that may radiate to the right or left scapula and builds over time, lasting 2 to 4 hours, after ingestion of fatty foods, alcohol, or caffeine.It is associated with nausea and vomiting and a positive Murphy's sign (sudden stop in inspiration with RUQ palpation).

Question 12

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?

Accepted Answer

Peptic ulcer disease increases with age and occurs with frequent use of NSAIDs, excessive alcohol consumption, smoking, and infection by Helicobacter pylori.Eight to 10 million Canadians have H.pylori infection, which is also associated with development of stomach cancer; approximately 75% of Indigenous peoples are infected by H.pylori.

Question 13

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

Accepted Answer

A large amount of ascitic fluid produces a dull sound on percussion.

Question 14

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:

Accepted Answer

Absent bowel sounds are rare.The nurse must listen for 5 minutes before deciding that bowel sounds are completely absent.

Question 15

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:

Accepted Answer

A liver span of 10.5 cm is the mean for males and 7 cm for females.Men and taller individuals are at the upper end of this range.Women and shorter individuals are at the lower end of this range.A liver span of 11 cm is within normal limits for this individual.

Question 16

During an abdominal assessment, the nurse tests for a fluid wave.A positive fluid wave test occurs with:

Accepted Answer

If ascites (fluid in the abdomen) is present, then the examiner will feel a fluid wave when assessing the abdomen.A fluid wave is not present with splenomegaly, a distended bladder, or constipation.

Question 17

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?

Accepted Answer

At birth, the umbilical cord is white and contains two umbilical arteries and one vein inside the Wharton's jelly.The umbilical stump dries within a week, hardens, and falls off in 10 to 14 days.Skin will cover the area in 3 to 4 weeks.

Question 18

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:

Accepted Answer

If a bruit is heard on auscultation, the area should not be palpated, to avoid rupturing an abdominal aortic aneurysm.The findings should be reported immediately.

Question 19

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

Accepted Answer

Diastasis recti is a separation of the abdominal rectus muscles, which can occur congenitally, as a result of pregnancy or from significant obesity.Diastasis recti is assessed by having the patient raise the head while remaining in the supine position.

Question 20

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?

Accepted Answer

The umbilicus is normally at midline and inverted with no signs of discoloration.With umbilical hernia, the mass is enlarged and everted.The soft, skin-covered mass is the protrusion of the omentum or intestine through a weakness or incomplete closure in the umbilical ring.It is accentuated by increased intra-abdominal pressure, which occurs with crying, coughing, vomiting, or straining, but the bowel rarely becomes incarcerated or strangulated.It is more common in infants of African or Asian descent and in premature infants.Most umbilical hernias resolve spontaneously by age 1 year.The other responses are incorrect.

Quiz 22: Abdomen