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ADVANCED HEALTH ASSESSMENT (NUR 605) 2025/2026
UPDATE WITH RATIONALE Q&A- UAH
1. Describe the proper positioning and preparation of the patient for the examination.
PT should make sure bladder is emptied. Keep room warm. Position in supine, head on
pillow, knees bent or on pillow, arms at the side or across chest. (Hands or arms over
head should be discouraged causes the abdomen muscles to tense). Avoid abdominal
tensing; stethoscope earpiece should be warm, hands warm, fingernails short. Inquire
about painful areas. Examine painful area last to avoid any muscle guarding. Learn to use
distraction. Enhance muscle relaxation through breathing exercises, emotive imagery;
low soothing voice; engage in conversation; have pt. relate his/her abdominal history
while you palpate
2. Discuss inspection of the abdomen, including findings that should be noted.
a. Contour = stand at right side and look down. Describes the nutritional state and
normally ranges from flat to rounded
b. Symmetry = shine a light across abdomen toward you or lengthwise across person.
Should be symmetric bilaterally. Not any localized bulging, visible mass or asymmetric
shape. Small bulges will also be highlighted by shadow. Step to foot of exam table
recheck. Ask pt. to take a deep breath to further highlight any change. Abdomen should
stay smooth and symmetric. As person to perform a sit-up without pushing up with his
or her hands
c. Umbilicus = normally midline and inverted, with no sign of discoloration, inflammation,
or hernia. Becomes everted and pushed upward with pregnancy. Umbilicus is a common
site foe piercings in young women. Site should not be red or crusted.
3. State the rationale for performing auscultation of the abdomen before palpation or percussion.
Palpation and percussion can increase peristalsis, which would give a false interpretation
of bowel sounds.
4. Describe the procedure for auscultation of bowel sounds.
Use diaphragm and press lightly to skin
Begin in the RLQ at the ileocecal valve area... listen to all 4 quads
Absent BS- listen for >5 minutes in each quad
Vascular sounds use bell to listen for bruits- aorta, renal, iliac, femoral (ARIF)
5. Differentiate the following abdominal sounds: normal, hyperactive, and hypoactive bowel
sounds; bruit.
Hyperactive: Loud, high pitched, rushing, tinkling, gurgling sounds, "borborygmi," signal
increased motility. They occur with early mechanical bowel obstruction, gastroenteritis,
brisk diarrhea, laxative use, and subsiding paralytic ileus
Hypoactive: Diminished or absent bowel sounds signal decreased motility as a result of
inflammation as seen with peritonitis, pneumonia, surgery or late bowel obstruction
Bruit: blowing, swooshing sound heard through a stethoscope when an artery is partially
occluded
6. List 4 conditions that may alter normal percussion notes heard over the abdomen.
Obesity: Tympany. Scattered dullness over adipose tissue.
Air or Gas: Tympany over large area.
ADVANCED HEALTH ASSESSMENT (NUR 605) 2025/2026
UPDATE WITH RATIONALE Q&A- UAH
1. Describe the proper positioning and preparation of the patient for the examination.
PT should make sure bladder is emptied. Keep room warm. Position in supine, head on
pillow, knees bent or on pillow, arms at the side or across chest. (Hands or arms over
head should be discouraged causes the abdomen muscles to tense). Avoid abdominal
tensing; stethoscope earpiece should be warm, hands warm, fingernails short. Inquire
about painful areas. Examine painful area last to avoid any muscle guarding. Learn to use
distraction. Enhance muscle relaxation through breathing exercises, emotive imagery;
low soothing voice; engage in conversation; have pt. relate his/her abdominal history
while you palpate
2. Discuss inspection of the abdomen, including findings that should be noted.
a. Contour = stand at right side and look down. Describes the nutritional state and
normally ranges from flat to rounded
b. Symmetry = shine a light across abdomen toward you or lengthwise across person.
Should be symmetric bilaterally. Not any localized bulging, visible mass or asymmetric
shape. Small bulges will also be highlighted by shadow. Step to foot of exam table
recheck. Ask pt. to take a deep breath to further highlight any change. Abdomen should
stay smooth and symmetric. As person to perform a sit-up without pushing up with his
or her hands
c. Umbilicus = normally midline and inverted, with no sign of discoloration, inflammation,
or hernia. Becomes everted and pushed upward with pregnancy. Umbilicus is a common
site foe piercings in young women. Site should not be red or crusted.
3. State the rationale for performing auscultation of the abdomen before palpation or percussion.
Palpation and percussion can increase peristalsis, which would give a false interpretation
of bowel sounds.
4. Describe the procedure for auscultation of bowel sounds.
Use diaphragm and press lightly to skin
Begin in the RLQ at the ileocecal valve area... listen to all 4 quads
Absent BS- listen for >5 minutes in each quad
Vascular sounds use bell to listen for bruits- aorta, renal, iliac, femoral (ARIF)
5. Differentiate the following abdominal sounds: normal, hyperactive, and hypoactive bowel
sounds; bruit.
Hyperactive: Loud, high pitched, rushing, tinkling, gurgling sounds, "borborygmi," signal
increased motility. They occur with early mechanical bowel obstruction, gastroenteritis,
brisk diarrhea, laxative use, and subsiding paralytic ileus
Hypoactive: Diminished or absent bowel sounds signal decreased motility as a result of
inflammation as seen with peritonitis, pneumonia, surgery or late bowel obstruction
Bruit: blowing, swooshing sound heard through a stethoscope when an artery is partially
occluded
6. List 4 conditions that may alter normal percussion notes heard over the abdomen.
Obesity: Tympany. Scattered dullness over adipose tissue.
Air or Gas: Tympany over large area.
