MARYVILLE AHA NURS 612 EXAM 3 QUESTIONS WITH
VERIFIED ANSWERS
HPI questions for chief complaint of abdominal issue - Answers - ○Abdominal pain-
OLDCARTS
○When did the pain start?
○Where is the pain in your stomach?
○Does the pain radiate to other locations?
○Have experience nausea/vomiting, indigestion or increase in belching.
○What medications have you used to treat your symptoms?
○Have you had any diarrhea or constipation?
○Do you have to use laxative frequently?
○What is your regular dietary habits?
inspection of abdomen - Answers - -Abdominal contour
-Symmetry
-Umbilicus
-Skin Color
-Vascularity
-Scars
-Striae
-Lesions or rashes
-Abdominal movement when breathing
-Aortic pulsation
-Have patient raise head while laying down and look for masses hernia or muscle
separation
Abdominal assessment order - Answers - inspection, auscultation, percussion, palpation
Always auscultate prior to percussion and palpation as it can change sound.
Abdomen Auscultation - Answers - Bowel sounds in all four quadrants- note frequency
and character
listen for friction rubs over liver and spleen
listen for bruits over the aortic, renal, illiac and femoral arteries
listen for venous hum around epigastric area above the belly button
Abdominal findings abdomen - Answers - ○Bruits- A swishing sound heard over the
aortic, renal iliac, and femoral arteries, indicating narrowing or aneurysm.
, ○Pop/Tinkles- High pitch sound suggesting intestinal fluid and air under pressure, as in
early obstruction.
○Rushes- Rushes of high-pitched sounds that coincide with cramping suggests
intestinal obstruction.
○Borborygmi- Increased prolonged gurgles occur with gastroenteritis, early intestinal
obstruction, and hunger.
○Rubs- Grating sounds that vary with respiration. Indicate inflammation of the peritoneal
surface of an organ from tumor, infection, or splenic infarct.
○Venous Hum- A soft humming noise often heard in hepatic cirrhosis that is caused by
increased collateral circulation between portal and systemic venous system.
○Succussion splash- A splashing noise produced by shaking the body when there is
both gas and fluid in a cavity or free air in the peritoneum or thorax.
○Decreased/absent bowel sounds- Occurs with peritonitis or paralytic ileus.
How to percuss to estimate the liver span - Answers - o First, determine the lower
border of the liver by percussing up from an area of tympany along the right
midclavicular line. Mark the point where tympany changes to dullness, which usually
occurs at or slightly below the costal margin.
o Second, determine the upper border of the liver by percussing down from an area of
resonance along the right midclavicular line. Mark the point where resonance changes
to dullness, which usually is in the fifth intercostal space.
o Third, measure the distance between the marks. The vertical liver span usually ranges
from 6 to 12 cm.
Blumberg Sign - Answers - Rebound tenderness, RLQ, appendicitis, peritoneal irritation
Cullen sign - Answers - ecchymosis around umbilicus
-hemoperitoneum, pancreatitis, ectopic pregnancy
Dance sign - Answers - Absence of bowel sounds, RLQ, intussusception, bowel
obstruction
Grey Turner's sign - Answers - Ecchymosis of the flanks. Possible rupture of the spleen.
Hemoperitoneum, pancreatitis, pain may radiate to the left shoulder
Kehr's sign - Answers - Abdominal pain radiated to the left shoulder, splenic rupture,
renal calculi, ectopic pregnancy
VERIFIED ANSWERS
HPI questions for chief complaint of abdominal issue - Answers - ○Abdominal pain-
OLDCARTS
○When did the pain start?
○Where is the pain in your stomach?
○Does the pain radiate to other locations?
○Have experience nausea/vomiting, indigestion or increase in belching.
○What medications have you used to treat your symptoms?
○Have you had any diarrhea or constipation?
○Do you have to use laxative frequently?
○What is your regular dietary habits?
inspection of abdomen - Answers - -Abdominal contour
-Symmetry
-Umbilicus
-Skin Color
-Vascularity
-Scars
-Striae
-Lesions or rashes
-Abdominal movement when breathing
-Aortic pulsation
-Have patient raise head while laying down and look for masses hernia or muscle
separation
Abdominal assessment order - Answers - inspection, auscultation, percussion, palpation
Always auscultate prior to percussion and palpation as it can change sound.
Abdomen Auscultation - Answers - Bowel sounds in all four quadrants- note frequency
and character
listen for friction rubs over liver and spleen
listen for bruits over the aortic, renal, illiac and femoral arteries
listen for venous hum around epigastric area above the belly button
Abdominal findings abdomen - Answers - ○Bruits- A swishing sound heard over the
aortic, renal iliac, and femoral arteries, indicating narrowing or aneurysm.
, ○Pop/Tinkles- High pitch sound suggesting intestinal fluid and air under pressure, as in
early obstruction.
○Rushes- Rushes of high-pitched sounds that coincide with cramping suggests
intestinal obstruction.
○Borborygmi- Increased prolonged gurgles occur with gastroenteritis, early intestinal
obstruction, and hunger.
○Rubs- Grating sounds that vary with respiration. Indicate inflammation of the peritoneal
surface of an organ from tumor, infection, or splenic infarct.
○Venous Hum- A soft humming noise often heard in hepatic cirrhosis that is caused by
increased collateral circulation between portal and systemic venous system.
○Succussion splash- A splashing noise produced by shaking the body when there is
both gas and fluid in a cavity or free air in the peritoneum or thorax.
○Decreased/absent bowel sounds- Occurs with peritonitis or paralytic ileus.
How to percuss to estimate the liver span - Answers - o First, determine the lower
border of the liver by percussing up from an area of tympany along the right
midclavicular line. Mark the point where tympany changes to dullness, which usually
occurs at or slightly below the costal margin.
o Second, determine the upper border of the liver by percussing down from an area of
resonance along the right midclavicular line. Mark the point where resonance changes
to dullness, which usually is in the fifth intercostal space.
o Third, measure the distance between the marks. The vertical liver span usually ranges
from 6 to 12 cm.
Blumberg Sign - Answers - Rebound tenderness, RLQ, appendicitis, peritoneal irritation
Cullen sign - Answers - ecchymosis around umbilicus
-hemoperitoneum, pancreatitis, ectopic pregnancy
Dance sign - Answers - Absence of bowel sounds, RLQ, intussusception, bowel
obstruction
Grey Turner's sign - Answers - Ecchymosis of the flanks. Possible rupture of the spleen.
Hemoperitoneum, pancreatitis, pain may radiate to the left shoulder
Kehr's sign - Answers - Abdominal pain radiated to the left shoulder, splenic rupture,
renal calculi, ectopic pregnancy
