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Which finding indicates the possibility of liver disease in the neonate?
A. Absence of right lower quadrant (RLQ) bowel sounds
B. Epigastric pulsation
C. Spider nevi
D. Cullen sign - C: Correct- Superficial veins are usually visible in the thin
infant; however, distended veins across the abdomen are an unexpected
finding suggestive of vascular obstruction or abdominal distention or
obstruction. Spider nevi may indicate liver disease.
Mr. Walker is a 46-year-old patient who presents for a routine monthly
appointment. You note that the midclavicular liver span is 18 cm. With
,palpation, you note that the liver is enlarged with a firm, nontender border.
Which problem do these findings suggest?
A. Diverticulitis
B. Ulcerative colitis
C. Hepatitis
D. Cirrhosis - D: Correct- Cirrhosis is a condition marked by diffuse
hepatic processes characterized by fibrosis and alteration of normal liver
architecture into structurally abnormal nodules. The examiner's findings
are objective signs of this condition.
Mr. Goldstein is a 56-year-old patient who presents to your office. On
examination, you are unable to palpate his liver or kidneys. Which
technique will help assess tenderness to these organs?
A. Direct, continuous, firm pressure over the organ for several minutes
B. Percussion for tympany
C. Percussion for size
D. Indirect fist percussion - D: Correct- To check for liver tenderness when
the liver is not palpable, use indirect fist percussion. Place the palmar
surface of one hand over the lower right rib cage, and then strike your
, hand with the ulnar surface of the fist of your other hand. To assess each
kidney for tenderness, ask the patient to assume a sitting position.
Place the palm of your hand over the right costovertebral angle and
strike your hand with the ulnar surface of the fist of your other hand.
Repeat the maneuver over the left costovertebral angle. Direct
percussion with the fist over each costovertebral angle may also be used.
In which age group does abdominal palpation become easier and more
accurate?
A. Young children
B. Adolescents
C. Young adults
D. Older adults - D: Correct- The techniques of examination are the same
as those used for younger adults. The abdominal wall of the older adult
becomes thinner and less firm as a result of the loss of connective tissue
and muscle mass that accompanies aging. Palpation, therefore, may be
relatively easier and yield more accurate findings.
You are on the scene of an accident and have completed your primary
assessment. After the initial primary assessment is conducted, how often
should it be repeated?
, A. Every 30 seconds
B. Every 2 minutes
C. Every 5 minutes
D. Every time the patient's condition changes - C: Correct- Perform the
primary survey every 5 minutes and compare the results with those
obtained in previous assessments.
An examiner may wish to use a bimanual technique for abdominal
palpation when:
A. palpating superficial organs.
B. validating abdominal tenderness in the infant.
C. meeting muscle resistance while performing deep palpation.
D. determining the presence of excessive peritoneal fluid. - C: Correct deep
palpation is difficult because of obesity or muscular resistance, you can
use a bimanual technique with one hand atop the other. Exert pressure
with the top hand while concentrating on sensation with the other hand.
Some examiners prefer to use the bimanual technique for all
patients.
Which is an expected finding related to bowel sounds in the neonate?