The nurse examines a client admitted with a deep, constant pain in the abdomen that radiates to the back. Which finding is most important for the nurse to report to the healthcare provider?

Intermittent pain on deep inspiration.

An audible abdominal bruit.

A bulge over umbilicus when coughing.

Hypoactive bowel sounds in all quadrants.

Answer and Explanation

The Correct Answer is B

A.   Intermittent pain on deep inspiration could suggest pleuritic pain, which is related to the lungs or pleura rather than the abdomen. While this might be significant, it is less directly related to the client’s deep abdominal pain radiating to the back. This finding may be less urgent compared to other potential signs of serious abdominal pathology.

B.   An abdominal bruit is a sound heard over the abdomen due to turbulent blood flow, often associated with vascular abnormalities like aneurysms or significant arterial stenosis. An audible abdominal bruit, especially if associated with deep abdominal pain, could indicate a serious vascular condition such as an abdominal aortic aneurysm (AAA).
C.   A bulge over the umbilicus when coughing could indicate an umbilical hernia. While a hernia can be problematic and may require treatment, it is generally less urgent compared to findings that might suggest more acute or severe conditions like vascular issues.
D.   Hypoactive bowel sounds can indicate decreased gastrointestinal activity, which might be related to various conditions such as ileus or bowel obstruction. While this finding is significant and warrants attention, it is often less immediately critical compared to signs of serious vascular issues or acute abdominal pathology.

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Correct Answer is D

Explanation

A. Cloudy discharge is more commonly associated with infections or discharge from the genital area rather than residual urinary symptoms. While urinary tract infections (UTIs) can cause cloudy urine, this is not typically associated with suprapubic tenderness or the sensation of residual pressure alone.
B. An overactive bladder is characterized by symptoms such as frequent urination, urgency, and sometimes incontinence. However, it does not typically cause suprapubic tenderness or a sensation of residual pressure after urination. The described symptoms are more consistent with bladder outlet obstruction or incomplete bladder emptying rather than an overactive bladder.

C. Black tarry stools indicate upper gastrointestinal bleeding and are unrelated to urinary symptoms. This finding would suggest a different issue entirely, such as gastrointestinal bleeding, rather than a problem with the urinary tract or bladder. This is not consistent with the client's reported symptoms of suprapubic tenderness and sensation of residual pressure after urination.
D. A weak urinary stream is a common symptom associated with bladder outlet obstruction or conditions affecting urinary flow, such as benign prostatic hyperplasia (BPH) in older men. This finding aligns with the client's reported symptoms of suprapubic tenderness and feeling of residual pressure after urination.

A. Loud, at the apex, associated with a palpable thrill. B. Very loud, with no stethoscope, thrill easily palpable, heave visible. C. Soft, barely heard on auscultation in a quiet room. D. Moderately loud, machine-like rumble, not associated with a thrill.

Correct Answer is A

Explanation

A. A grade IV systolic murmur is considered loud and may be associated with a palpable thrill. In mitral valve regurgitation, the murmur is often best heard at the apex of the heart. A thrill, which is a vibration felt on the chest wall, is a sign of a more significant murmur. This description is consistent with a grade IV murmur, which is typically loud and may indeed be associated with a thrill.
B. Very loud, with no stethoscope, thrill easily palpable, heave visible.
B. A grade V systolic murmur is very loud and can be heard with the stethoscope barely touching the chest. It often comes with a palpable thrill and may be accompanied by a visible heave or lift of the

chest wall. This description is consistent with a grade V murmur, not grade IV. Therefore, it’s not the
correct description for a grade IV murmur.
C. A soft murmur, barely audible, describes a grade I or grade II systolic murmur. This does not match the characteristics of a grade IV murmur, which is louder and more easily heard. Therefore, this description does not support a grade IV murmur.
D. A moderately loud murmur, without a thrill, could describe a grade III murmur. Additionally, a "machine-like rumble" is more characteristic of a diastolic murmur, such as those heard in conditions like aortic regurgitation or mitral stenosis, rather than a systolic murmur associated with mitral valve regurgitation.

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The nurse examines a client admitted with a deep, constant pain in the abdomen that radiates to the back. Which finding is most important for the nurse to report to the healthcare provider?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is examining the abdomen of an older male client who expresses suprapubic tenderness on palpation. The client reports that it sometimes feels like there is still pressure in that area after urination. Which additional finding should the nurse expect with continued interview of the client?

Correct Answer is D

Explanation

The nurse auscultates the precordium of a client who is diagnosed with mitral valve regurgitation and hears a grade IV systolic murmur. When documenting the comparison of systolic murmurs, which characteristics should the nurse use to support this systolic finding?

Correct Answer is A

Explanation

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