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CH21 ABDOMEN (2 SETS) EXAM WITH
VERIFIED CORRECT ANSWERS
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A patient is having difficulty in swallowing medications and food
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B) dysphasia
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D) anorexia
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Aphasia and dysphasia are
speech disorders
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How should the
nurse assess for this condition?
A) Percuss and palpate in the lumbar region
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C) Auscultate and percuss in the inguinal region
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CORRECT ANSWER -ANS: D
Dull percussion sounds would be elicited over a distended bladder, and the
hypogastric area would seem firm to palpation
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B) increased liver size
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D) decreased gastric acid secretion
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As one ages, salivation
decreases, esophageal emptying is delayed, and liver size decreases

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
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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
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C) If an enlarged spleen is noticed, then the nurse should palpate
thoroughly to determine size
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- CORRECT ANSWER -ANS: D
If an enlarged spleen is felt, then the nurse should refer the person but
should not continue to palpate it
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A patient's abdomen is bulging and stretched in appearance
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B) herniated
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D) protuberant
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See Figure 217
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The nurse is describing a scaphoid abdomen
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A) flat
B) convex
C) bulging
D) concave - CORRECT ANSWER -ANS: D
Contour describes the profile of the abdomen from the rib margin to the
pubic bone; a scaphoid contour is one that is concave from a horizontal
plane
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While examining a patient, the nurse observes abdominal pulsations
between the xiphoid and umbilicus
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B) pulsations of the inferior vena cava
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D) increased peristalsis from a bowel obstruction
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A patient has hypoactive bowel sounds
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B) peritonitis
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D) gastroenteritis
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The nurse is watching a new graduate nurse perform auscultation of a
patient's abdomen
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B) "It prevents distortion of bowel sounds that might occur after percussion
and palpation
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D) "This prevents distortion of vascular sounds such as bruits and hums
that might occur after percussion and palpation
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The nurse is listening to bowel sounds
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B) They are usually high-pitched, gurgling, irregular sounds
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D) They originate from the movement of air and fluid through the large
intestine
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They originate from the
movement of air and fluid through the small intestine

The physician comments that a patient has abdominal borborygmi
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B) a peritoneal friction rub
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D) hyperactive bowel sounds
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Vascular bruits are not usually present
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Dullness would not be found in the area of lung resonance (left upper
quadrant at the midclavicular line)
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The nurse knows that
esophageal reflux during pregnancy can cause:
A) diarrhea
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C) dysphagia
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- CORRECT ANSWER -ANS: B
Pyrosis, or heartburn (not constipation), is caused by esophageal reflux
during pregnancy
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The nurse is performing percussion during an abdominal assessment
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B) resonance, dullness, and tympany
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D) resonance, hyperresonance, and flatness
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The nurse
knows that this condition could be related to:
A) increased gastric acid secretion
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C) delayed gastrointestinal emptying time
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- CORRECT ANSWER -ANS: B
Gastric acid secretion decreases with aging, and this may cause pernicious
anemia (because it interferes with vitamin B12 absorption), iron deficiency
anemia, and malabsorption of calcium

A patient is complaining of a sharp pain along the costovertebral angles
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B) liver enlargement
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D) spleen enlargement
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The other options are not correct
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B) feces
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D) fibroid tumors
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The nurse knows that during an abdominal assessment, deep palpation is
used to determine:
A) bowel motility
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C) superficial tenderness
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- CORRECT
ANSWER -ANS: B
With deep palpation, the nurse should notice the location, size, consistency,
and mobility of any palpable organs and the presence of any abnormal
enlargement, tenderness, or masses
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B) overuse of laxatives
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D) localized bleeding around the anus
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The nurse interprets that this finding
could indicate a disorder of which of these structures?
A) Spleen

B) Sigmoid
C) Appendix
D) Gallbladder - CORRECT ANSWER -ANS: C
The appendix is located in the right lower quadrant, and when the iliopsoas
muscle is inflamed (which occurs with an inflamed or perforated appendix),
pain is felt in the right lower quadrant
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Which of these
statements regarding the aging adult and abdominal assessment is true?
A) The abdominal tone is increased
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C) Abdominal rigidity with acute abdominal conditions is more common
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- CORRECT ANSWER -ANS: B
In the aging person, the abdominal musculature is thinner and has less
tone than that of the younger adult, and abdominal rigidity with acute
abdominal conditions is less common in aging
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During an assessment of a newborn infant, the nurse recalls that pyloric
stenosis would be manifested by:
A) projectile vomiting
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C) palpable olive-sized mass in right lower quadrant
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- CORRECT
ANSWER -ANS: A

Marked peristalsis together with projectile vomiting in the newborn
suggests pyloric stenosis
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One can also palpate an
olive-sized mass in the right upper quadrant
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B) Raise the arms in the left lateral position
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D) Raise the head while remaining supine
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This is
assessed by having the patient raise the head while remaining supine
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Which of
these statements is true regarding an aortic aneurysm?
A) A bruit is absent
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C) A pulsating mass is usually present
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- CORRECT ANSWER -ANS: C
Most aortic aneurysms are palpable during routine examination and feel
like a pulsating mass
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Such aneurysms are located in the upper abdomen
just to the left of midline
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Before reporting this finding as "silent bowel
sounds" the nurse should listen for at least:
A) 1 minute
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C) 10 minutes
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- CORRECT ANSWER -ANS: B
Absent bowel sounds are rare
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A patient is suspected of having inflammation of the gallbladder, or
cholecystitis
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In a person with inflammation
of the gallbladder, or cholecystitis, pain occurs as the descending liver
pushes the inflamed gallbladder onto the examining hand during
inspiration (Murphy's test)
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Just before going home, a new mother asks the nurse about the infant's
umbilical cord
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B) "It will soften before it falls off
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"
D) "Skin will cover the area within 1 week
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The umbilical stump dries within a week,
hardens, and falls off by 10 to 14 days
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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 - CORRECT ANSWER -ANS: A
The presence of fluid causes a dull sound to percussion
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A 40-year-old man states that his physician told him that he has a hernia
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Which response by the nurse
is appropriate?
A) "No need to worry
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"
B) "A hernia is a loop of bowel protruding through a weak spot in the
abdominal muscles
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"
D) "I'll have to have your physician explain this to you
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A 45-year-old man is in the clinic for a physical examination
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The nurse
should:
A) document the presence of hepatomegaly
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C) describe this as an enlarged liver and refer him to a physician
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CORRECT ANSWER -ANS: D
The average liver span in the midclavicular line is 6 to 12 cm
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Women and shorter
individuals are at the lower end of this range
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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
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The
gallbladder is in the right upper quadrant, the sigmoid colon is in the left
lower quadrant, and the appendix is in the right lower quadrant
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In the United
States, the incidence of lactose intolerance is higher in adults of which
ethnic group?
A) African-Americans
B) Hispanics
C) Whites
D) Asians - CORRECT ANSWER -ANS: A
A recent study found lactose-intolerance prevalence estimates as follows:
19
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72% for whites
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During report, the student nurse hears that a patient has "hepatomegaly"
and recognizes that this term refers to:
A) an enlarged liver
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C) distended bowel
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- CORRECT ANSWER -ANS: A

The term hepatomegaly refers to an enlarged liver
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The other responses are not correct
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It is midline, and there is no change in skin color
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With an umbilical hernia, the mass is enlarged and everted
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During an abdominal assessment, the nurse tests for a fluid wave
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B) distended bladder
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D) ascites
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A fluid wave is not present with
splenomegaly, a distended bladder, or constipation
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Which technique is correct during the
assessment? The nurse should:

A) examine the tender area first
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C) avoid palpating the tender area
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CORRECT ANSWER -ANS: B
The nurse should save the examination of any identified tender areas until
last
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Auscultation is done
before percussion and palpation because percussion and palpation can
increase peristalsis, which would give a false interpretation of bowel
sounds
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It's worse two hours after I eat, but it gets better if I eat
again!" The nurse suspects that the patient has which condition, based on
these symptoms?
A) Appendicitis
B) Gastric ulcer
C) Duodenal ulcer
D) Cholecystitis - CORRECT ANSWER -ANS: C
Pain associated with duodenal ulcers occurs 2 to 3 hours after a meal, yet it
is relieved by more food
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Severe, acute pain would occur with
appendicitis and cholecystitis
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a) aortic, renal, iliac, and femoral
b) jugular, aortic, carotid, and femoral
c) pulmonic, aortic, and portal
d) renal, iliac, internal jugular, and basilic - CORRECT ANSWER -a

The range of normal liver span in the right midclavicular line in the adult is:
a) 2-6cm
b) 4-8cm
c) 8-14cm
d) 6-12cm - CORRECT ANSWER -d

The upper left quadrant (LUQ) contains the:
a) liver
b) appendix
c) left ovary
d) spleen - CORRECT ANSWER -d

Striae, which occur when the elastic fibers in the reticular layer of the skin
are broken after rapid or prolonged stretching, have a distinct color when of
long duration
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c) found if the examination follows a large meal
d) indicative of splenic enlargement - CORRECT ANSWER -d

Shifting dullness is a test for:
a) ascities
b) splenic enlargement
c) inflammation of the kidney
d) hepatomegaly - CORRECT ANSWER -a

Tenderness during abdominal palpation is expected when palpating:

a) the liver edge
b) the spleen
c) the sigmoid colon
d) the kidneys - CORRECT ANSWER -c

Murphy sign is best described as:
a) the pain felt when the hand of the examiner is rapidly removed from an
inflamed appendix
b) pain felt when taking a deep breath when the examiner's fingers are on
the approximate location of the inflamed gall bladder
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d) not a valid examination technique - CORRECT ANSWER -b

A positive Blumberg sign indicates:
a) a possible aortic aneurysm
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c) an enlarged, nodular liver
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- CORRECT ANSWER -d

What is the significance of black stools? Contrast this with the significance
of red blood in stools
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The blood has been partially broken down during the
digestive process
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Red blood in stools occurs with localized bleeding in the

lower gastrointestinal tract and around the anus, such as occurs with
hemorrhoids
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Which sound should the nurse expect to
hear?
A) Dullness
B) Tympany
C) Resonance
D) Hyperresonance - CORRECT ANSWER -ANS: A
The liver is located in the right upper quadrant and would elicit a dull
percussion note
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Which of these
procedures are appropriate for use when assessing for appendicitis or a
perforated appendix? Select all that apply
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B) Test for Blumberg's sign
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D) Perform iliopsoas muscle test
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- CORRECT ANSWER -ANS: B, D
Testing for Blumberg's sign (rebound tenderness) and performing the
iliopsoas muscle test should be used to assess for appendicitis
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Testing
for a fluid wave and shifting dullness is done to assess for ascites

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