Chapter 16 PrepU

A client exhibits many of the most common signs and symptoms of peptic ulcer disease. What interview question addresses the most plausible cause of the client's health problem?

"Do you take painkillers like aspirin on a regular basis?"

A client reports that he has been experiencing diarrhea for the past week. What question by the nurse will assist in determining whether this client is truly experiencing an alteration in bowel pattern?

"How many times a day are you having a bowel movement?"

A nurse examines a client with a paralytic ileus. Which alteration in the bowel sounds should the nurse expect to find with auscultation of the client's abdomen?

Absent

The nurse is caring for a client who has been diagnosed with colon cancer. When planning the client's care, the nurse should be aware of what function of the colon?

Absorbing large amounts of water

The client has epigastric pain that is poorly localized and radiates to the back. What would be an important diagnosis to assess for?

Acute pancreatitis

Which finding obtained during the abdominal assessment in an older adult client should prompt the nurse to perform an additional assessment to determine the cause?

An enlarged liver felt during palpation

A client presents at the clinic with a chief complaint of "indigestion." The client tells the nurse, "It usually happens after I do things like mowing the lawn or doing other yard work." What should the nurse suspect?

Angina

The nurse identifies the client has a positive Obturator sign. The nurse identifies this is due to what?

Appendicitis

The nurse would assess for positive Blumberg sign how?

Applying and releasing pressure to the abdomen

A client's bladder is found to be distended. At which location would the nurse begin palpating?

At the symphysis pubis

Jim is a 60-year-old man who presents with vomiting. He denies any blood in his emesis, which has been present for 2 days. He does note a dark granular substance resembling the coffee left in the filter after brewing. What should the nurse suspect?

Bleeding from a peptic ulcer

While auscultating a client's abdomen, the nurse hears the client's stomach growling. The nurse knows that this is which type of bowel sound?

Borborygmus

When palpating a client's abdomen, the nurse notes that the liver has a firm edge. What is the likely cause of his abnormal characteristic?

Cirrhosis

The nurse is assessing a client and notes dullness to percussion in the lowest point of the abdomen. When rolling the client to the left, the nurse notes that there is now dullness on the left side. This indicates ascites, which can be caused by

Cirrhosis and nephrosis

A college student presents to the health care clinic with reports no bowel movement for four (4) days, bloating, and generalized abdominal discomfort. She states she has not been eating and drinking correctly and is stressed because she has a final exam in two (2) days. A nurse assesses the abdomen and finds positive bowel sounds in all four quadrants, tenderness in the left lower quadrant with a few small round, firm masses. Rovsing's sign and the Psoas sign are negative. What nursing diagnosis can the nurse confirm for this client?

Constipation related to decrease in fluid intake

The nurse assess for kidney tenderness at what location?

Costovertebral angle

An older client presents with symptoms of pain on urinating. The nurse recognizes that older adults are at increased risk for urinary tract infections for which of the following reasons?

Decreased activity of protective bacteria in the urinary tract

A client is told by another care provider that his liver was enlarged. Although the client is a lifelong smoker with a history of emphysema, the client has never used drugs or alcohol, nor does the client have any knowledge of liver disease. Upon examination by the nurse, a liver edge is palpable 4 cm below the costal arch. Which intervention would provide the most relevant information to determine liver status at this time?

Determine liver span by percussion.

During deep palpation of the abdomen, the nurse identifies a soft, nontender, solid mass extending 2 to 3 cm below the right costal margin. Which of the following would be most appropriate?

Document the position of the liver.

The nurse is performing percussion on a client's abdomen. What would the nurse expect to hear over the liver of the right upper quadrant?

Dullness

Mr. Kruger, 84 years old, presents with a smooth lower abdominal mass in the midline, which is minimally tender. There is dullness to percussion up to 6 cm above the symphysis pubis. What does this most likely represent?

Enlarged bladder

Which action by the nurse will facilitate relaxation of the abdominal muscles during examination of the abdomen?

Flex the client's legs by placing a pillow under the knees

On inspection of the abdomen, a nurse notes that the client's skin appears pale and taut. The nurse recognizes that this finding is most likely due to what process occurring within the abdominal cavity?

Fluid accumulation

Which of the following people need to be vaccinated for hepatitis A and B?

Food-service workers

A client is complaining of pain in the right upper quadrant and also in the right shoulder. Which organ would the nurse suspect as being involved?

Gallbladder

A client complains of epigastric pain and tarry stools. The nurse should suspect which of the following as the underlying cause?

Gastric ulcer

A daycare worker presents to the office with jaundice. She denies IV drug use, blood transfusion, and travel, and has not been sexually active for the past 10 months. Which type of hepatitis is most likely?

Hepatitis A

What term would the nurse use to document a client's report of pain in the lower-middle area of the abdomen?

Hypogastric

A client presents to the emergency department with reports of new onset of abdominal pain for the past 3 days. The client states there is also a pulling feeling on the right side. Upon examination, the nurse notices a 5-cm transverse scar in the right lower quadrant. The nurse recognizes that this client may be experiencing what type of process?

Internal adhesions from previous surgery

Monique is a 33-year-old administrative assistant who has had intermittent lower abdominal pain approximately one week a month for the past year. It is not related to her menses. She notes relief with defecation, and a change in form and frequency of her bowel movements with these episodes. Which of the following is most likely?

Irritable bowel syndrome

The nurse is auscultating a client's abdomen and is unable to discern any bowel sounds. How should the nurse proceed with assessment?

Listen for five minutes before documenting an absence of bowel sounds.

A nurse cares for a client with a duodenal ulcer. The nurse knows that which characteristic of pain is generally associated with the client's condition?

May awaken the client at night

A client has sought care because of chronic constipation. During the health history interview, the nurse should address what potential contributing factor?

Overuse of laxatives

A client comes to the emergency department complaining of pain in the right lower quadrant. Rebound tenderness is present and the nurse assesses the client for referred rebound experiences. The client experiences pain the right lower quadrant. The nurse interprets this as which of the following?

Positive Rovsing's sign

An adult client states that his mother has been living with peptic ulcer disease, and he is motivated to ensure that he does not develop the disease as he ages. What health promotion advice should the nurse provide?

Quit smoking as soon as possible.

The nurse plans to assess a client's liver border. Which area of the abdomen is the nurse going to assess?

RUQ

A client complains of a sudden onset of pain in the back. On questioning the client further, the nurse learns that the cause of the pain is acute pancreatitis. The nurse recognizes that this type of pain is which of the following?

Referred pain

Which of the following is consistent with obturator sign?

Right hypogastric pain with the right hip and knee flexed, and the hip internally rotated

The nurse is evaluating a new nursing graduate's ability to perform a rebound tenderness test for suspected appendicitis. The nurse determines correct technique when the new graduate is observed pressing deeply at which anatomic location?

Right lower quadrant

Which nursing diagnosis is most appropriate for an elderly client with poor dentition?

Risk for Imbalanced Nutrition: Less Than Body Requirements

When inspecting a client's abdominal contour, the nurse observes the abdomen to be sunken with the lower edges of the ribs visible. The nurse documents this as which of the following?

Scaphoid

A group of students is reviewing information about the locations of various organs within the abdomen. The students demonstrate understanding of the material when they identify which organ as being found in the left upper quadrant?

Spleen

A nurse performs percussion beginning along the left midaxillary line and progressing downward until the sound changes from lung resonance to splenic dullness. The client reports tenderness. The nurse recognizes this as an abnormal finding for which organ?

Spleen

During palpation of the client's abdomen, the nurse feels a prominent, nontender, pulsating 6-cm mass above the umbilicus. What action should the nurse take?

Stop palpating and get medical assistance.

A 52-year-old secretary comes to the office complaining about accidentally leaking urine when she coughs or sneezes. She says this has been going on for about 1 year. She relates that she has not had a period for 2 years. She denies any recent illness or injuries. Her past medical history is significant for four spontaneous vaginal deliveries. She is married with four children. She denies alcohol, tobacco, or drug use. Pelvic examination reveals some atrophic vaginal tissue but the remainder of her pelvic, abdominal, and rectal examinations are unremarkable. Which type of urinary incontinence does she have?

Stress incontinence

A client reports severe pain in the left lower quadrant of 3 days' duration. How should the nurse conduct palpation of the abdomen due to this history?

The left lower quadrant is palpated last

Mrs. LaFarge, 60 years old, presents with urinary incontinence. She cannot get to the bathroom quickly enough when she senses the need to urinate. She has normal mobility. Which of the following is most likely?

Urge incontinence

When reviewing the medications currently taken by a 50-year-old client who is complaining of constipation, teaching is indicated when the nurse notes which medication?

Vitamin supplement with iron

The nurse plans to assess an adult client's kidneys for tenderness. The nurse should assess the area at the

costovertebral angle.

The nurse is assessing a client's abdomen. For which reason should the nurse perform deep palpation?

identify abdominal organs

While assessing the abdominal sounds of an adult client, the nurse hears high-pitched tinkling sounds throughout the distended abdomen. The nurse should refer the client to a health care provider for possible

intestinal obstruction.

A client is experiencing left lower quadrant (LLQ) abdominal pain that radiates to the groin. Which health problem should the nurse suspect this client is experiencing?

renal stone

When palpating the abdomen, the nurse may be able to feel the lower edge of the liver in which quadrant?

right upper

A client visits the clinic because she experienced bright hematemesis yesterday. The nurse should refer the client to a physician because this symptom is indicative of

stomach ulcers.

Visceral pain is associated with a hollow abdominal organ such as the intestine. Visceral pain is

usually difficult to localize