Ch. 22: Abdomen

Question 1

A patient is having difficulty swallowing medications and food. How should the nurse document this?

A) aphasia
B) anorexia
C) dysphasia
D) dysphagia

Answer 1

D) dysphagia

Question 2

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) tympany
B) dullness
C) resonance
D) hyperresonance

Answer 2

B) dullness

Question 3

Which structure is located in the left lower quadrant of the abdomen?

A) liver
B) duodenum
C) gallbladder
D) sigmoid colon

Answer 3

D) sigmoid colon

Question 4

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

Answer 4

D) percuss and palpate the midline area above the suprapubic bone

Question 5

The nurse is aware that what change may occur in the gastrointestinal system with aging?

A) increased salivation
B) increased liver size
C) increased esophageal emptying
D) decreased gastric acid secretion

Answer 5

D) decreased gastric acid secretion

Question 6

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) the spleen is normally 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

Answer 6

D) an enlarged spleen should not be palpated because it can easily rupture

Question 7

A patient’s abdomen is bulging and stretched in appearance. How should the nurse document this finding?

A) obese
B) scaphoid
C) herniated
D) protuberant

Answer 7

D) protuberant

Question 8

The nurse is describing a scaphoid abdomen. When assessing the contour of the abdomen from the rib margin to the pubic bone, what would the contour look like?

A) flat
B) convex
C) bulging
D) concave

Answer 8

D) concave

Question 9

While examining a patient, the nurse observes abdominal pulsations between the xiphoid process and umbilicus. What does the nurse suspect?

A) pulsations of the renal arteries
B) normal abdominal aortic pulsations
C) pulsations of the inferior vena cava
D) increased peristalsis from a bowel obstruction

Answer 9

B) normal abdominal aortic pulsations

Question 10

A patient has hypoactive bowel sounds. What is a possible cause of this finding?

A) diarrhea
B) peritonitis
C) laxative use
D) gastroenteritis

Answer 10

B) peritonitis

Question 11

The nurse is watching a new graduate nurse perform auscultation of a patient’s abdomen. Which statement by the new graduate shows a 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 prevents distortion of bowel sounds that might occur after percussion and palpation.”
C) “Auscultation allows the patient more time to relax and therefore be more comfortable with the physical examination.”
D) “Auscultation prevents distortion of vascular sounds, such as bruits and hums, that might occur after percussion and palpation.”

Answer 11

B) “Auscultation prevents distortion of bowel sounds that might occur after percussion and palpation.”

Question 12

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

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

Answer 12

B) are usually high-pitched, gurgling, and irregular sounds

Question 13

The physician comments that a patient has abdominal borborygmi. What is the best description of this term?

A) hypoactive bowel sounds
B) a peritoneal friction rub
C) loud gurgling bowel sounds
D) loud continual humming bowel sounds

Answer 13

C) loud gurgling bowel sounds

Question 14

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) dull percussion note in the left upper quadrant at the midclavicular line
D) palpable spleen between the ninth and eleventh ribs in the left midaxillary line

Answer 14

B) tympanic percussion note in the umbilical region

Question 15

The nurse is assessing the abdomen of a pregnant woman who states she has been having “acid indigestion” all the time. What does the nurse know that esophageal reflux during pregnancy can cause?

A) diarrhea
B) pyrosis
C) dysphagia
D) constipation

Answer 15

B) pyrosis

Question 16

The nurse is performing an abdominal assessment. What types of percussion notes can be heard during abdominal assessment?

A) flatness, resonance, and dullness
B) resonance, dullness, and tympany
C) tympany, hyperresonance, and dullness
D) resonance, hyperresonance, and flatness

Answer 16

C) tympany, hyperresonance, and dullness

Question 17

An older patient has been diagnosed with pernicious anemia. This disorder could be r/t what condition?

A) increased gastric acid secretion
B) decreased gastric acid secretion
C) delayed gastrointestinal emptying timed
D) increase gastrointestinal emptying time

Answer 17

B) decreased gastric acid secretion

Question 18

A patient is reporting sharp pain along the costovertebral angles. What does this symptom most often indicate?

A) ovarian infection
B) liver enlargement
C) spleen enlargement
D) kidney inflammation

Answer 18

D) kidney inflammation

Question 19

A nurse notices that a patient has abdominal ascites. What does this finding indicate?

A) flatus
B) fibroid tumors
C) presence of feces
D) presence of fluid

Answer 19

D) presence of fluid

Question 20

The nurse notices that a patient has had a black, tarry stool. What should the nurse recognize may cause this finding?

A) gallbladder disease
B) overuse of laxatives
C) gastrointestinal bleeding
D) localized bleeding around the anus

Answer 20

C) gastrointestinal bleeding

Question 21

During an abdominal assessment, the nurse elicits tenderness on light palpation in the right lower quadrant. The nurse recognizes this finding could indicate a problem with what structure?

A) spleen
B) sigmoid
C) appendix
D) gallbladder

Answer 21

C) appendix

Question 22

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 conditionis more common
D) the older adult with an acute abdominal condition complains more about pain than the younger person

Answer 22

B) abdominal musculature is thinner

Question 23

During an assessment of a newborn infant, the nurse suspects the infant has pyloric stenosis. What finding would cause the nurse to suspect this?

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

Answer 23

A) projectile vomiting

Question 24

The nurse is reviewing the assessment of an aortic aneurysm. Which of these statements is true regarding an aortic aneurysm?
A) a bruit is absent
B) femoral pulses are increased
C) a pulsating mass is usually present
D) most are located below the umbilicus

Answer 24

C) a pulsating mass is usually present

Question 25

During an abdominal assessment, the nurse is unable to hear bowel sounds in a patient’s abdomen. How long should the nurse listen before reporting absent bowel sounds?

A) 1 minute
B) 5 minutes
C) 10 minutes
D) 2 minutes in each quadrant

Answer 25

B) 5 minutes

Question 26

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

A) obturator test
B) test for Murphy sign
C) iliopsoas muscle test
D) assess for rebound tenderness

Answer 26

B) test for Murphy sign

Question 27

Just before going home, a new mother asks the nurse about the infant’s umbilical cord. Which of these statements 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.”

Answer 27

A) “It should fall off in 10 to 14 days.”

Question 28

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 right upper quadrant
C) hyperresonance in the left upper quadrant
D) tympany in the right and left lower quadrants

Answer 28

A) dullness across the abdomen

Question 29

A 40-year-old man states that his physician told him that he has 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 protruding 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.”

Answer 29

B) “A hernia is a loop of bowel protruding through a weak spot in the abdominal muscles.”

Question 30

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. How should the nurse proceed?

A) document the presence of hepatomegaly
B) ask additional health history questions regarding his alcohol intake
C) consider this finding as normal, and proceed with the examination
D) describe this dullness as indicative of an enlarged liver, and refer him to a physician

Answer 30

C) consider this finding as normal, and proceed with the examination

Question 31

When palpating the abdomen of a 20-year-old patient, 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) appendix
C) gallbladder
D) sigmoid colon

Answer 31

A) spleen

Question 32

The nurse is reviewing information on lactose intolerance and learned that in some racial groups lactase activity (ability to digest and absorb lactose) is high at birth but declines to low levels by adulthood. Which ethnic group has the highest potential for lactose-intolerance symptoms in adulthood?

A) Asians
B) African Americans
C) White Americans
D) American Indians

Answer 32

D) American Indians

Question 33

The nurse is assessing a patient for possible peptic ulcer disease. Which condition or history often causes this disorder?

A) hypertension
B) streptococcal infections
C) recurrent constipation with frequent laxative use
D) frequent use of nonsteroidal antiinflammatory drugs

Answer 33

D) frequent use of nonsteroidal antiinflammatory drugs

Question 34

During the change-of-shift report, the student nurse hears that a patient has hepatomegaly. What should the student recognizes that this term means?

A) enlarged liver
B) enlarged spleen
C) distended bowel
D) excessive diarrhea

Answer 34

A) enlarged liver

The term hepatomegaly refers to an enlarged liver. The term splenomegaly refers to an enlarged spleen. The other responses are not correct.

Question 35

During an assessment, the nurse notices that a patient’s umbilicus is enlarged and everted. It is positioned midline with no change in skin color. The nurse recognizes that the patient may have which condition?

A) constipation
B) abdominal tumor
C) umbilical hernia
D) intra-abdominal bleeding

Answer 35

C) umbilical hernia

Question 36

During an abdominal assessment, the nurse tests for a fluid wave. What condition would produce a positive fluid wave test?

A) ascites
B) splenomegaly
C) constipation
D) distended bladder

Answer 36

A) ascites

Question 37

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

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

Answer 37

B) examine the tender area last

Question 38

During a 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!” Based on these symptoms, the nurse suspects that the patient has which condition?

A) appendicitis
B) gastric ulcer
C) duodenal ulcer
D) cholecystitis

Answer 38

C) duodenal ulcer

Question 39

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 fluid wave
B) test for the Murphy sign
C) test for the Blumberg sign
D) test for shifting dullness
E) perform the iliopsoas muscle test

Answer 39

C) test for the Blumberg sign

E) perform the iliopsoas muscle test

Question 40

Structures in RUQ

Answer 40

liver
gallbladder
duodenum
head of pancreas
right kidney and adrenal
hepatic flexure of colon
part of ascending and transverse colon

Question 41

Structures in RLQ

Answer 41

cecum
appendix
right ovary and tube
right ureter
right spermatic cord

Question 42

Structures in the LUQ

Answer 42

Stomach
Spleen
Left lobe of liver
Body of Pancreas
Left kidney and adrenal
Splenic flexure of colon
Part of Transverse and descending colon

Question 43

Structures in the LLQ

Answer 43

Part of descending colon
Sigmoid colon
Left ovary and tube
Left ureter
Left spermatic cord