24. A nurse is preparing to perform a physical assessment of a client's abdomen. Identify the sequence in which the nurse should perform the following steps.
(Move the steps into the box on the right, placing them in the order of performance. Use all the steps.)
Check for areas of tenderness by pressing fingers 1.3 cm (0.5 in) into the abdomen.
Listen to the abdominal arteries using the bell of a stethoscope.
Provide adequate lighting to inspect the abdomen.
Percuss all four quadrants of the abdomen to measure sound quality.
Locate liver and spleen borders by pressing hands 2.5 to 7.5 cm (1 to 3 in) into the
The Correct Answer is C,B,D,E,A
Choice A rationale:
Checking for areas of tenderness helps to identify any inflammation, infection, or injury in the abdominal cavity.
Choice B rationale:
Listening to the abdominal arteries helps to detect any bruits or abnormal sounds that may indicate vascular problems.
Choice C rationale:
Providing adequate lighting allows the nurse to inspect the abdomen for any abnormalities, such as distension, scars, or lesions.
Choice D rationale:
Percussing the abdomen helps to assess the size and density of the organs, as well as to detect any fluid or gas accumulation.
Choice E rationale:
Locating the liver and spleen borders helps to determine if they are enlarged or displaced.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale:
The statement is not accurate. Signing advance directives is typically voluntary, and it is the client's decision.
Choice B rationale:
Providing written information about advance directives before signing allows the client to make an informed decision about their preferences for care.
Choice C rationale:
The provider's signature is not required for the client to complete advance directives.
Choice D rationale:
The partner's presence is not mandatory when signing advance directives. It is a personal decision made by the client.
Correct Answer is ["A","D","E"]
Explanation
Choice A rationale:
Having a fire escape plan is an essential aspect of home safety.
Choice B rationale:
Setting the hot water heater to 140 degrees Fahrenheit is too high and can cause burns. Therefore, this statement indicates a misunderstanding.
Choice C rationale:
Applying tape over frayed areas of electrical cords is unsafe and can lead to electrical hazards. Therefore, this statement indicates a misunderstanding.
Choice D rationale:
Using grab bars when getting in and out of the bathtub promotes safety and prevents falls.
Choice E rationale:
Checking medications for expiration dates is crucial to ensure their effectiveness and safety.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today