Complete the following sentence using the list of options.
When performing a physical assessment, the first technique the nurse will always use is?

Choice A rationale

The "prn" abbreviation stands for "pro re nata," which is Latin for "as needed.”. This indicates that the medication should be administered based on the patient's symptoms or specific needs, rather than on a fixed schedule. The nurse assesses the patient and administers the medication only when the patient exhibits the conditions for which the medication is prescribed, adhering to the minimum 6-hour interval for safety and therapeutic efficacy. This allows for individualized pain management.

Choice B rationale

This statement is incorrect because a "prn" order does not imply around-the-clock administration. Around-the-clock dosing is typically for scheduled medications where a consistent drug level is desired to manage chronic conditions or prevent symptoms, regardless of the patient's immediate need. Administering a prn medication routinely could lead to unnecessary drug exposure or adverse effects.

Choice C rationale

While waiting 6 hours between doses is crucial to prevent drug accumulation and toxicity, stating "I must wait 6 hours before administering this medication to you" is an incomplete explanation for a PRN order. The primary determinant for administration is the patient's need, not simply the passage of time. The 6-hour interval is a safety parameter to ensure adequate drug clearance and prevent exceeding therapeutic thresholds.

Choice D rationale

Administering a medication "over 6 hours" refers to the duration of infusion, not the frequency of administration. This statement is typically relevant for intravenous infusions where the drug is diluted and infused slowly over a specific period. A prn order for oral medication generally means an immediate dose is given when needed, and the interval between doses is 6 hours, not the infusion time.

Choice A rationale

Determining areas of tenderness is typically done through palpation, which should follow auscultation to avoid altering bowel sounds. Performing palpation first could elicit guarding or muscle rigidity, making subsequent auscultation less accurate and potentially increasing patient discomfort.

Choice B rationale

Auscultation precedes percussion and palpation of the abdomen to ensure that bowel sounds are not artificially stimulated or inhibited. Mechanical manipulation of the abdomen through percussion and palpation can alter the frequency and character of bowel sounds, leading to inaccurate assessment of intestinal motility.

Choice C rationale

While patient comfort is important, the primary reason for the sequence of abdominal assessment is scientific accuracy. Manipulating the abdomen prior to auscultation can stimulate peristalsis, creating false-positive bowel sounds or increasing existing ones, thus obscuring the true baseline activity.

Choice D rationale

Distortion of vascular sounds like bruits and hums is less likely to be significantly affected by percussion and palpation compared to bowel sounds. Vascular sounds originate from blood flow dynamics, which are not as readily influenced by external mechanical manipulation as the peristaltic activity of the intestines.