When using an otoscope to assess the nasal cavity, which of the following would the nurse need to do?

A. Has a hernia and awaiting surgery: A hernia presents as a localized bulge that may be reducible and is often accentuated with coughing or straining. A generally bulging, stretched abdomen with dullness on percussion does not specifically indicate a hernia.

B. Has a protuberant abdomen, which requires further investigation: A protuberant abdomen refers to one that is distended or bulging outward, which fits the findings of stretching and bulging. Dullness on percussion suggests the presence of fluid or mass, meaning further diagnostic evaluation is warranted.

C. The person is obese and on a weight loss program: Obesity can cause a rounded abdomen, but percussion would reveal more tympany than dullness. The clinical note of dullness in the lower quadrant suggests something other than simple obesity, such as ascites or mass.

D. Has a scaphoid abdomen and there are no concerns: A scaphoid abdomen is sunken inward, the opposite of bulging or protuberant. This description does not match the nurse’s findings of a stretched, outwardly bulging abdomen.

A. resonance, hyper-resonance, and flatness: These percussion sounds are typically associated with the thoracic cavity during lung assessment. Resonance and hyper-resonance are expected over lung fields, while flatness is heard over bone.

B. flatness, resonance, and dullness: Flatness is usually heard over areas of bone or muscle, and resonance is a lung sound, not an abdominal one. Dullness can be present in the abdomen over solid organs like the liver, but the other sounds do not fit this context.

C. tympany, hyper-resonance, and dullness: Tympany is the most common sound heard during abdominal percussion, caused by air in the stomach and intestines. Hyper-resonance may be present with gaseous distension, and dullness is expected over solid organs or masses.

D. resonance, dullness, and tympany: While dullness and tympany are appropriate abdominal sounds, resonance is not typically associated with the abdomen. It is most often heard in lung assessments, so this combination is less accurate.