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Exam (elaborations)

NUR2092 Exam 2 Quiz Bank | Questions and Answers with Rationale

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NNUR2092 Exam 2 Quiz Bank | Questions and Answers with Rationale UR2092 Exam 2 Quiz Bank | Questions and Answers with Rationale

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NUR2092 Exam 2 QuizBank | Questions and Answers
with Rationale




 The nurse is preparing to percuss the abdomen of a patient. The
purpose of the percussion is to assess the of the underlying tissue.
a. Turgor
b. Texture
c. Density
d. Consistency


RAT: Percussion yields a sound that depicts the location, size,
and density of the underlying organ. Turgor and texture are
assessed with palpation.
 The nurse would use bimanual palpation technique in which situation?
a. Palpating the thorax of an infant
b. Palpating the kidneys and uterus
c. Assessing pulsations and vibrations
d. Assessing the presence of tenderness and pain


RAT: Bimanual palpation requires the use of both hands to envelop
or capture certain body parts or organs such as the kidneys, uterus, or
adnexa. The other situations are not appropriate for bimanual
palpation.


 The nurse is reviewing percussion techniques with a newly
graduated nurse. Which technique, if used by the new nurse,
indicates that more review is needed?
a. Percussing once over each area
b. Quickly lifting the striking finger after each stroke

,NUR2092 Exam 2 QuizBank | Questions and Answers
with Rationale
c. Striking with the fingertip, not the finger pad
d. Using the wrist to make the strikes, not the arm


RAT: For percussion, the nurse should percuss two times over each
location. The striking finger should be quickly lifted because a resting
finger damps off vibrations. The tip of the striking finger should make
contact, not the pad of the finger. The wrist must be relaxed and is used
to make the strikes, not the arm.

,NUR2092 Exam 2 QuizBank | Questions and Answers
with Rationale

 When percussing over the liver of a patient, the nurse notices a dull
sound. The nurse should:
a. Consider this a normal finding.
b. Palpate this area for an underlying mass.
c. Reposition the hands, and attempt to percuss in this area again.
d. Consider this finding as abnormal, and refer the patient for additional
treatment.


RAT: Percussion over relatively dense organs, such as the liver or
spleen, will produce a dull sound. The other responses are not correct.


 The nurse is preparing to use a stethoscope for auscultation. Which statement
is true
regarding the diaphragm of the stethoscope? The diaphragm:
a. Is used to listen for high-pitched sounds.
b. Is used to listen for low-pitched sounds.
c. Should be lightly held against the person’s skin to block out low-pitched
sounds.
d. Should be lightly held against the person’s skin to listen for extra
heart sounds and murmurs.


RAT: The diaphragm of the stethoscope is best for listening to high-
pitched sounds such as breath, bowel, and normal heart sounds. It
should be firmly held against the person’s skin, firmly enough to leave
a ring. The bell of the stethoscope is best for soft, low- pitched sounds
such as extra heart sounds or murmurs.


 Before auscultating the abdomen for the presence of bowel sounds on a

, NUR2092 Exam 2 QuizBank | Questions and Answers
with Rationale
patient, the nurse should:
a. Warm the endpiece of the stethoscope by placing it in warm water.
b. Leave the gown on the patient to ensure that he or she does not
get chilled during the examination.
c. Ensure that the bell side of the stethoscope is turned to the “on” position.
d. Check the temperature of the room, and offer blankets to the
patient if he or she feels cold.

RAT: The examination room should be warm. If the patient shivers,
then the involuntary muscle contractions can make it difficult to hear
the underlying sounds. The end of the stethoscope should be warmed
between the examiner’s hands, not with water. The nurse should never
listen through a gown. The diaphragm of the stethoscope should be
used to auscultate for bowel sounds.



 During an examination of a patient’s abdomen, the nurse notes that
the abdomen is rounded and firm to the touch. During percussion, the
nurse notes a drumlike quality of


the sounds across the quadrants. This type of sound indicates:
a. Constipation.
b. Air-filled areas.
c. Presence of a tumor.
d. Presence of dense organs.

RAT: A musical or drum-like sound (tympany) is heard when
percussion occurs over an air-filled viscus, such as the stomach or
intestines.


 The nurse is preparing to examine a 6-year-old child. Which action is most

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