A nurse assesses a patient’s abdomen. Which examination technique would aid the nurse in determining whether gas (air) in the bowel is causing distention rather than constipation?

Inspection

Auscultation

Percussion

Palpation

Answer and Explanation

The Correct Answer is C

Choice A reason: Inspection visually assesses abdominal shape and distention but cannot differentiate gas from constipation, as both may cause distention. It lacks the specificity to identify the cause, making it less effective for this purpose.

Choice B reason: Auscultation assesses bowel sounds but cannot directly distinguish gas from constipation. Hyperactive sounds may suggest gas, but this is indirect, and constipation can also alter sounds, making this less specific than percussion.

Choice C reason: Percussion produces a tympanic sound over gas-filled areas, indicating air in the bowel, versus a dull sound over solid masses like feces in constipation. This directly differentiates the cause of distention, making it the correct technique.

Choice D reason: Palpation assesses tenderness or masses but cannot reliably distinguish gas from constipation, as both may feel firm or distended. It lacks the specificity of percussion’s auditory cues, making it less effective for this purpose.

Nursing Test Bank

Quiz #1: RN Exams Pharmacology Exams Quiz #2: RN Exams Medical-Surgical Exams Quiz #3: RN Exams Fundamentals Exams Quiz #4: RN Exams Maternal-Newborn Exams Quiz #5: RN Exams Anatomy and Physiology Exams Quiz #6: RN Exams Obstetrics and Pediatrics Exams Quiz #7: RN Exams Fluid and Electrolytes Exams Quiz #8: RN Exams Community Health Exams Quiz #9: RN Exams Promoting Health across the lifespan Exams Quiz #10: RN Exams Multidimensional care Exams

Get 100+ Naxlex Exit Exams for $79 Try Naxlex NCLEX-RN (14 Day Free-Trial)

Naxlex Comprehensive Predictor Exams

Quiz #1: Naxlex RN Comprehensive online practice 2019 B with NGN Quiz #2: Naxlex RN Comprehensive Predictor 2023 Quiz #3: Naxlex RN Comprehensive Predictor 2023 Exit Exam A Quiz #4: Naxlex HESI Exit LPN Exam Quiz #5: Naxlex PN Comprehensive Predictor PN 2020 Quiz #6: Naxlex VATI PN Comprehensive Predictor 2020 Quiz #8: Naxlex PN Comprehensive Predictor 2023 - Exam 1 Quiz #10: Naxlex HESI PN Exit exam Quiz #11: Naxlex HESI PN EXIT Exam 2

Free Nursing Study Resources

Correct Answer is C

Explanation

Choice A reason: Homan sign tests for deep vein thrombosis, not balance. Swaying with eyes closed indicates a positive Romberg sign, so this is incorrect for the documented finding.

Choice B reason: Lack of coordination is vague and not specific to the Romberg test, which assesses proprioception. Positive Romberg sign describes the sway, so this is incorrect for documentation.

Choice C reason: A positive Romberg sign is documented when a patient sways or loses balance with eyes closed, indicating proprioceptive or cerebellar issues. This is the correct term for the finding.

Choice D reason: Ataxia describes general movement, not the specific Romberg test outcome. Swaying in this context is a Romberg sign, so this is incorrect for the nurse’s documentation.

A. White with prominent capillaries B. Pearly gray and transparent C. Pulled in at the base of the cone of light D. Light pink with a slight bulge

Correct Answer is B

Explanation

Choice A reason: A normal tympanic membrane is not white with prominent capillaries. Such an appearance may indicate inflammation or infection (e.g., otitis media), where increased vascularity or opacity occurs, making this an abnormal and incorrect characteristic.

Choice B reason: A normal tympanic membrane is pearly gray, slightly translucent, with a visible cone of light reflecting off its taut surface. This reflects healthy middle ear anatomy, with no fluid or inflammation, making this the correct description.

Choice C reason: A pulled-in tympanic membrane suggests negative middle ear pressure, often due to eustachian tube dysfunction, not a normal finding. The normal membrane is flat or slightly concave, making this an incorrect characteristic.

Choice D reason: Light pink with a slight bulge suggests inflammation or fluid (e.g., otitis media), not a normal tympanic membrane. Normal membranes are pearly gray and flat, not pink or bulging, making this an incorrect description.

View Question and Answer

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

A nurse assesses a patient’s abdomen. Which examination technique would aid the nurse in determining whether gas (air) in the bowel is causing distention rather than constipation?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

When the nurse asks an older patient to stand with feet together and arms at his side with his eyes closed, he starts to sway and moves his feet farther apart. How should the nurse document this finding?

Correct Answer is C

Explanation

A nurse examines a patient’s tympanic membranes with an otoscope. The nurse understands the normal tympanic membrane exhibits which normal characteristic?

Correct Answer is B

Explanation

What should the nurse do when assessing the carotid arteries of an older patient with cardiovascular disease?

Of the 33 vertebrae in the spinal column, which is correct?

Which is a normal characteristic of lymph nodes in a healthy adult patient?

While obtaining a health history of a 3-month-old infant from the mother, the nurse asks about the infant’s ability to suck and grasp the mother’s finger. What is the nurse assessing?

As a mandatory reporter of elder abuse, which of these statements must be present before a nurse notifies the authorities?

What is the best time for the nurse to measure a patient's respirations?

A nurse understands that a patient’s race is most related to which of the following?

A patient is being assessed for range-of-joint movement. The nurse asks him to move his arm in toward the center of his body. What is this movement called?