NURS 612 Exam 4 Questions Solved Correctly Latest 2025 (Rated A+)

NURS 612 Exam 4 Questions Solved Correctly Latest 2025 (Rated A+) HPI questions for abdominal issues - Answers 1. Where is the pain located? 2. Do you have diarrhea? 3. Can you describe the characteristics of your bowel movements? 4. Have you been taking NSAIDs? 5. Do antacids help? Abdomen inspection - Answers surface, contour, movement abdomen auscultation- friction rubs - Answers high in pitch- indicate inflammation, infection, tumor or infarct abdomen auscultation venous hums - Answers soft, low pitch, continuous- indicate increased collateral circulation between portal and systemic venous system abdomen auscultation- bruits - Answers harsh musical sound- indicates blood flow turbulence and vascular disease Why auscultate before palpation & percussion? - Answers percussion and palpation can stimulate bowel activity, creating false bowel sounds light abdominal palpation - Answers looking for muscle resistance, tenderness and large masses moderate abdominal palpation - Answers used to palpate liver and spleen on inspiration deep abdominal palpation - Answers looking for masses and tenderness percussion of abdomen - Answers - percuss lightly on all 4 quadrants - tympany should dominate b/c air rises to GI surface when pt is supine *dullness occurs over a distended bladder, adipose tissue, fluid, or a mass *hyperresonance is present with gastric distention liver and spleen palpation - Answers liver should be firm, smooth, nontender and without nodules spleen should not be palpable (unless enlarged) kidney palpation - Answers right is more easily palpable, it is round, smooth and firm. left is not palpable ascites - Answers inspection- glistening, taut appearance with striae, protuberant abdomen, bulging flanks percussion- dullness that shifts when turned onto side palpation- fluid wave (have pt hold arm against abdomen, place hands on both sides of abdomen, strike one side and feel for fluid wave) What does ascites indicate? - Answers increased fluid in the peritoneal cavity (caused by liver failure, advanced CHF) Psoas test - Answers raise R thigh against resistance (appendicitis) obturator test - Answers bend right knee, laterally and medially rotate. pain = pelvic abscess or ruptured appendix aaron test - Answers abdominal or chest pain while palpating mcburney's point Ballottement of abdomen - Answers push inward toward organ or mass. if it is freely movable it will move upward and other surrounding structures will be displaced Rovsing's sign - Answers Pain in RLQ with palpation of LLQ (appendicitis) Murphy's sign - Answers Pain with palpation of gallbladder (seen with cholecystitis) Cullen's sign - Answers bruising around umbilicus (pancreatitis, ectopic pregnancy or blood in the peritoneum) kehr sign - Answers abdominal pain radiating to left shoulder (renal calculi, splenic rupture, ectopic pregnancy) ballance sign - Answers Fixed dullness to percussion in left flank, and dullness in right flank that disappears on change of position (Peritoneal irritation) blumberg sign - Answers rebound tenderness (peritoneal irritation) dance sign - Answers absence of bowel sounds in RLQ (intussusception) gray turner sign - Answers ecchymotic areas on the flank (retroperitoneal bleed, hemorrhagic pancreatitis, blood in peritoneum) markle sign - Answers pain in abdomen when the standing patient drops from standing on toes to the heels with a jarring landing (appendicitis, peritoneal irritation) Romberg-Howship sign - Answers pain down medial aspect of thigh to knees (strangulated obturator hernia) HPI questions musculoskeletal - Answers Joint pain- swelling, redness, stiffness, limited ROM, worse with weather changes Muscle pain- limited ROM, tremors, alleviated with ice/heat, spasms, aching Skeletal symptoms- difficulty walking, numbness/tingling, crepitus, recent injury, medications Injury- clicks, mechanism of injury, ability to bear weight, swelling, numbness/tingling Back pain- character of pain, associated events, better/worse with activity, medications, alleviating/worsening factors musculoskeletal inspection - Answers Size and contour of joint; inspect skin and tissues over joints for color, swelling, and any masses or deformity Presence of swelling signals joint irritation Posture, gait, coordination, balance, symmetry Atrophy Musculoskeletal palpation - Answers palpate for heat, tenderness, swelling, crepitus, pain and resistance to movement. muscles should be firm. assess for synovial thickening ROM and muscle tone (joints and upper extremities) - Answers assess for pain, limitation of movement, spasticity, joint instability, deformity or contracture. measure angle of greatest flexion and extension and compare with expected values with goniometer ROM and muscle tone (head and neck) - Answers flexion (chin to chest), extension (look up at ceiling), rotation (look over each shoulder), lateral bending (ear to shoulder) TMJ ROM - Answers open and close, side to side, protrude and retract shoulder ROM - Answers flexion (arms over head), extension (arms behind), abduction (arms out to sides), adduction (cross over body), internal rotation (hands behind back), external rotation (hands behind head) wrist and fingers ROM - Answers wrist- flexion, extension, ulnar deviation, radial deviation fingers- flex down, extend up, spread wide, thumb in, fist elbow ROM - Answers flexion, extension, supination, pronation