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The nurse is caring for a 33-year-old male client who has visited the primary healthcare provider for several months stating that he is experiencing "heartburn" after lunch and dinner. He reports that these episodes last about an hour after eating, and are much worse if he lays down to sleep after a meal. Most of the time, he also experiences belching and bloating with "heartburn" that feels like chest pain. He has been taking over-the-counter antacids with minimal relief. He says that his wife sent him today because she was getting concerned about the number of antacids he has been using. Reading the electronic health record, the nurse notes:
id="exhibits">Exhibits

What subjective assessment information in this client situation is the most important and immediate concern for the nurse?

Belching

chest pain

Flatulence

Pain with position

Answer and Explanation

The Correct Answer is B

A. Belching: Belching is a common symptom associated with GERD or indigestion, but it is not as critical as chest pain.

B. Chest pain: Chest pain is the priority because it can sometimes be a sign of serious conditions, such as gastroesophageal reflux disease (GERD) mimicking angina, or even cardiac issues. This must be ruled out before considering other symptoms.

C. Flatulence: This is also a typical symptom with digestive issues but does not present an immediate concern compared to chest pain.

D. Pain with position: Although positional pain is common with GERD, it does not warrant immediate concern like chest pain, which could indicate a potential cardiac issue.

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Correct Answer is B

Explanation

A. Belching: Belching is a common symptom associated with GERD or indigestion, but it is not as critical as chest pain.

C. Flatulence: This is also a typical symptom with digestive issues but does not present an immediate concern compared to chest pain.

D. Pain with position: Although positional pain is common with GERD, it does not warrant immediate concern like chest pain, which could indicate a potential cardiac issue.

A. Percussion, inspection, palpation, auscultation. B. Inspection, palpation, percussion, auscultation. C. Inspection, auscultation, percussion, palpation. D. Auscultation, inspection, palpation, percussion.

Correct Answer is C

Explanation

A. Percussion, inspection, palpation, auscultation: This sequence could disturb bowel sounds by percussing before auscultation, making it difficult to assess them accurately.

B. Inspection, palpation, percussion, auscultation: Palpating before auscultating can alter bowel sounds, so it’s not the correct order.

C. Inspection, auscultation, percussion, palpation: This sequence is recommended for abdominal assessment to avoid altering bowel sounds. Inspection is done first to observe any visible abnormalities, followed by auscultation to listen to bowel sounds before palpating or percussing, which could disrupt the sounds.

D. Auscultation, inspection, palpation, percussion: Inspection should always be first, making this option incorrect as it begins with auscultation.

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Naxlex Comprehensive Predictor Exams

Correct Answer is B

Explanation

Select the sequence of techniques used during an examination of the abdomen.

Correct Answer is C

Explanation

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