Chapter 22: Abdomen
Jarvis: Physical Examination and Health Assessment, 8th Edition
MULTIPLE CHOICE
1. 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
2. Which structure is located in the left lower quadrant of the abdomen?
a.
Liver
b.
Duodenum
c.
Gallbladder
d.
Sigmoid colon
3. A patient is having difficulty swallowing medications and food. How should the nurse
document this?
a.
Aphasia
b.
Anorexia
c.
Dysphasia
d.
Dysphagia
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
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
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.
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
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
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
10. A patient has hypoactive bowel sounds. What is a possible cause of this finding?
a.
Diarrhea
b.
Peritonitis
c.
Laxative use
d.
Gastroenteritis
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.”
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
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
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
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
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
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 time
d.
Increased gastrointestinal emptying time
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
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
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
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
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 condition is more common.
d.
The older adult with an acute abdominal condition complains more about pain than
the younger person.
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
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.
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
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
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.”
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
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.”
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.
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
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
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
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
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
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
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.
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
MULTIPLE RESPONSE
1. 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
