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The nurse suspects that a patient has appendicitis. Which of these procedures are appropriate for use when assessing for appendicitis or a perforated appendix? (Select all that apply)

Test for the Murphy sign

Test for shifting dullness

Perform the obturator test

Test for the Blumberg sign

Perform the iliopsoas muscle test

Test for fluid wave

Answer and Explanation

Correct Answer : C,D,E

A. Murphy sign: This is used to assess for gallbladder inflammation, not appendicitis.

B. Shifting dullness: This is used to detect ascites, not appendicitis.

C. Obturator test: This test involves flexing the patient's right hip and knee and rotating the leg internally, causing pain if the appendix is inflamed.

D. Blumberg sign: This test for rebound tenderness indicates peritoneal irritation, commonly associated with appendicitis.

E. Iliopsoas muscle test: This test involves extending the right leg against resistance, which can elicit pain in cases of appendicitis.

F. Fluid wave: This is used to assess for ascites, not appendicitis.

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Correct Answer is B

Explanation

A. Shield the lips: Shielding the lips ensures the patient is not lip-reading but should not muffle the sound.

B. Whisper random numbers and letters: The whisper test involves standing behind the patient, whispering a series of numbers and letters, and asking the patient to repeat them.

C. Occlude outside noise: Asking the patient to occlude one ear may alter test results.

D. Stand approximately 4 feet away: The whisper test is typically performed from 1-2 feet behind the patient.

A. "We need to determine the areas of tenderness before using percussion and palpation." B. "Auscultation allows the patient more time to relax and therefore be more comfortable with the physical examination." C. "Auscultation prevents distortion of bowel sounds that might occur after percussion and palpation." D. "Auscultation prevents distortion of vascular sounds, such as bruits and hums, that might occur after percussion and palpation."

Correct Answer is C

Explanation

A. Determine areas of tenderness: While identifying tenderness is important, it is not the reason for auscultating first.

B. Allows the patient to relax: Relaxation is helpful but not the primary reason for the sequence.

C. Prevents distortion of bowel sounds: Percussion and palpation can stimulate or suppress bowel sounds, leading to inaccurate findings if performed before auscultation.

D. Prevents distortion of vascular sounds: Vascular sounds (bruits) are less likely to be affected by percussion or palpation.

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The nurse suspects that a patient has appendicitis. Which of these procedures are appropriate for use when assessing for appendicitis or a perforated appendix? (Select all that apply)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

In performing a voice test to assess hearing, which of these actions would the nurse perform?

Correct Answer is B

Explanation

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Correct Answer is C

Explanation

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