A nurse is checking a client's bowel sounds.
At which of the following times should the nurse auscultate the client's abdomen?
Prior to inspecting the abdomen.
After palpating the abdomen.
After checking for kidney tenderness.
Prior to percussing the abdomen.
The Correct Answer is A
Choice A rationale
Auscultation of the abdomen for bowel sounds should be performed prior to any manipulation such as inspection, palpation, or percussion. Palpation and percussion can stimulate or inhibit bowel motility, potentially altering the sounds heard and leading to an inaccurate assessment of baseline bowel activity.
Choice B rationale
Palpating the abdomen involves applying pressure, which can stimulate bowel motility and increase bowel sounds. Auscultating after palpation might not reflect the client's true baseline bowel sounds.
Choice C rationale
Checking for kidney tenderness involves percussing the costovertebral angle, which is located on the back and does not directly impact bowel sounds. However, it is still a form of manipulation that should ideally occur after auscultation of the abdomen to avoid any potential influence on bowel sounds.
Choice D rationale
Percussion of the abdomen involves tapping the abdominal surface to assess underlying structures. This manipulation can also alter bowel motility and the characteristics of bowel sounds. Therefore, auscultation should precede percussion for an accurate assessment.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale
A BMI of 30 or higher is classified as obese. Class 1 obesity is defined as a BMI between 30 and 34.9. Chelsea's BMI of 17 is significantly lower than this range.
Choice B rationale
Class 2 obesity is defined as a BMI between 35 and 39.9. Chelsea's BMI of 17 is considerably below this classification.
Choice C rationale
A BMI below 18.5 is classified as underweight. Chelsea's BMI of 17 falls within this range, indicating that her weight is lower than what is considered healthy for her height.
Choice D rationale
A normal weight range is typically defined as a BMI between 18.5 and 24.9. Chelsea's BMI of 17 is below this healthy range.
Correct Answer is ["2"]
Explanation
Step 1: The physician ordered 10 mg per dose.
Step 2: The available tablet strength is 5 mg per tablet.
Step 3: To find the number of tablets per dose, divide the ordered dose by the tablet strength: 10 mg ÷ 5 mg/tablet = 2 tablets.
Step 4: The nurse will administer 2 tablets per dose.
Final answer: 2 tablets.
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