NURS 251 Portage Study Guide 4

NURS 251 Portage Study Guide 4
x x x x x x

x

To xpercuss xthe xupper xborder xof xthe xliver xof xan xadult xclient, xwhere xshould xthe
xnurse x
x
begin xthe xassessment? xAt xthe xclient's x.
x. x.
x

A. Right xMCL, x5th xICS x x
B. Right xMCL, xbelow xumbilicus x x
C. Left xMCL, x5th xICS x x
D. Left xMCL, xbelow xumbilicus x- xA. x
x

To xpalpate xfor xtenderness xof xan xadult xclient's xappendix, xthe xnurse xshould xbegin
xthe x
x
abdominal xassessment xat xthe xclient's x.
x. x.
x x

A. left xupper xquadrant x x
B. left xlower xquadrant x x
C. right xupper xquadrant x xD. xright xlower xquadrant x- xD. x
x

The xnurse xis xplanning xto xassess xthe xabdomen xof xan xadult xmale xclient. xBefore
xthe x
x
nurse xbegins xthe xassessment, xthe xnurse xshould x.
x. x.
x
x x
A. xask xthe xclient xto xempty xhis
xbladder
x x
B. xplace xthe xclient xin xa xside-lying x.

xposition
x
x

C. xask xthe xclient xto xhold xhis xbreath xfor xa xfew The xnurse xis xassessing xthe
xseconds x xabdomen xof xan xadult xclient


D. xtell xthe xclient xto xraise xhis xarms xabove xhis xhead xand xobserves xa xpurple
x- xA xdiscoloration xat xthe xflanks.

xThe xnurse xshould xrefer xthe

xclient xto xa xphysician xfor xwhich xpossible xcondition? x
x x
x x
A. xliver

xdisease


B. xabdominal

xdistention x


C. xCushing's

xsyndrome


D. xinternal xbleeding x-
xD.
x

The xnurse xis xassessing xthe xbowel xsounds xof xan xadult xclient. xAfter xlistening xto
xeach xquadrant, xthe xnurse xdetermines xthat xbowel xsounds xare xnot xpresent. xThe

xnurse xshould xrefer xthe xclient xto xa xphysician xfor xpossible x. x. x. x
x x

, A. aortic xaneurysm x x
B. paralytic xileus x x
C. gastroentertitis x x
D. fluid xand xelectrolyte ximbalances x- xB. x
x

During xa xphysical xexamination xof xan xadult xclient, xwhen xshould xthe xnurse
xauscultate x
x
the xclient's

xabdomen?
x x

A. xAfter xpalpating xthe xabdomen xbut xbefore
xpercussion x
x x
B. xAfter xpercussing xthe

xabdomen

C. xAfter xinspection xof xthe xabdomen xand xbefore xpalpation
x xD. xFirst, xbefore xInspection, xPalpation, xand xPercussion x-

xC. x
x

The xnurse xis xplanning xto xassess xa xclient's xabdomen xfor xrebound xtenderness.
xThe x
x
nurse xshould x. x.
x.
x x

A. perform xthis xabdominal xassessment xfirst x x
B. ask xthe xclient xto xassume xa xside-lying xposition x x
C. palpate xlightly xwhile xslowly xreleasing xpressure x x
D. palpate xwhile xquickly xreleasing xpressure x- xD. x
x

Match xthe xsigns xbelow xto xthe xpossible xcondition xthey xrepresent. x
x

Rebound xtenderness xwhen xRLQ xpalpated; xappendicitis x- xMcBurney's xsign x
x

Match xthe xsigns xbelow xto xthe xpossible xcondition xthey xrepresent. x
x

Abdominal xpain xradiating xto xleft xshoulder; xspleen x- xKehr's xsign x
x

Match xthe xsigns xbelow xto xthe xpossible xcondition xthey xrepresent. x
x

Abrupt xstopping xof xbreathing xwhen xpalpating xRUQ; xgallbladder x- xMurphy's xsign x
x

Match xthe xsigns xbelow xto xthe xpossible xcondition xthey xrepresent. x
x

Ecchymosis xof xflanks; xinternal xbleeding x- xGrey-Turner's xsign x
x

Match xthe xsigns xbelow xto xthe xpossible xcondition xthey xrepresent. x
x

Ecchymosis xaround xumbilicus; xinternal xbleeding x- xCullen's xsign x
x

Which xone xof xthe xfollowing xis xa xrisk xfactor xfor xbreast xcancer? x
x

A. xConsuming x2 xor xmore xdrinks xof xAlcohol xper
xday x
x x
B. xBeginning xmenopause xat x45 xyears xof
xage