When conducting a physical examination, the nurse is assessing a client's abdomen and identifies a centrally localized distention that is pulsating. This finding should direct the nurse to consider which pathology?

Hernia.

Aneurysm.

Tympany.

Appendicitis.

Answer and Explanation

The Correct Answer is B

A.   A hernia may present as a bulge in the abdomen, but it is not typically pulsating. It is usually a soft, non-pulsatile mass.
B.   A pulsating centrally localized abdominal distention is characteristic of an abdominal aneurysm, which occurs when the wall of the aorta weakens and bulges. The pulsation is often palpable and can be dangerous if ruptured.
C.   Tympany refers to a sound produced during percussion, which is typically heard over air-filled structures like the stomach, but it doesn’t cause pulsating distention.
D.   Appendicitis typically presents with localized pain in the lower right abdomen and is not associated with pulsating abdominal distention.

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Correct Answer is A

Explanation

A. The bell of the stethoscope is best for detecting low-pitched sounds like murmurs or extra heart sounds.
B. A Doppler ultrasound is not necessary for routine auscultation of heart sounds.
C. Pulse oximetry does not provide relevant information about heart sounds.
D. Auscultating with the diaphragm is better for high-pitched sounds, so the bell is preferred for extra heart sounds.

A. "It doesn't take much activity before I'm out of breath." B. "I sleep on three pillows at night." C. "I cough a lot at night and it keeps me up half the night." D. "I have multiple attacks of wheezing almost daily."

Correct Answer is B

Explanation

A. This statement could indicate exercise intolerance or shortness of breath with exertion, but it doesn't specifically relate to orthopnea. Orthopnea refers to difficulty breathing when lying flat, not with activity.
B. This statement is indicative of orthopnea. People with orthopnea often need to sleep with multiple pillows or sit up to relieve the shortness of breath they experience when lying flat, often due to heart failure or other respiratory conditions.
C. Nighttime coughing can be a symptom of various conditions, such as asthma or postnasal drip, but it is not specific to orthopnea. Orthopnea is more about difficulty breathing while lying down.
D. Wheezing is a sign of asthma or other respiratory conditions but does not directly correlate with orthopnea. Orthopnea is specifically about the inability to breathe comfortably when lying down, not about wheezing.

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When conducting a physical examination, the nurse is assessing a client's abdomen and identifies a centrally localized distention that is pulsating. This finding should direct the nurse to consider which pathology?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse detects a possible extra heart sound while assessing an adult client. To verify this finding, which action should the nurse take?

Correct Answer is A

Explanation

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Correct Answer is B

Explanation

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