Where should the advanced practice registered nurse (APRN) examine for kidney tenderness?
Suprapubic area
Periumbilical area
Costovertebral angle
Epigastric area
The Correct Answer is C
A. Suprapubic area is incorrect because this region is located just above the bladder. Tenderness here usually indicates bladder pathology, such as cystitis, bladder distention, or other lower urinary tract issues, rather than kidney problems. While suprapubic pain may coexist with kidney disease if infection spreads, it does not reliably indicate renal tenderness.
B. Periumbilical area is incorrect because this area surrounds the navel and is typically evaluated for abdominal and gastrointestinal conditions such as early appendicitis, bowel obstruction, or gastroenteritis. Kidney pain originates higher in the back, near the costovertebral angle, and periumbilical assessment does not provide information about renal involvement.
C. Costovertebral angle is correct because the costovertebral angle (CVA) is located at the junction of the 12th rib and the vertebral column on each side of the back. It is the standard anatomical landmark for assessing kidney tenderness. The APRN typically uses percussion (CVA punch) or gentle palpation to evaluate for pain. Tenderness in this area is associated with upper urinary tract conditions such as pyelonephritis, renal calculi, or hydronephrosis. CVA tenderness helps distinguish kidney pathology from lower urinary tract or abdominal causes.
D. Epigastric area is incorrect because this area is located just above the stomach and below the sternum, and it is assessed for gastric, pancreatic, cardiac, or hepatobiliary issues, not kidney disease. Tenderness in the epigastric region does not provide information about renal function or pathology.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Bilateral tympanic membranes erythematous, flat, with good cone of light is incorrect because, although erythema is present, the TM is flat, landmarks are intact, and the cone of light is visible, which suggests no middle ear effusion and does not meet criteria for AOM. This may indicate mild irritation, viral upper respiratory infection, or early inflammation.
B. Left tympanic membrane erythematous, bulging and non-mobile, with loss of landmarks is correct because these findings reflect the classic presentation of acute otitis media. Bulging occurs due to pressure from pus or fluid in the middle ear, and non-mobility on pneumatic testing confirms the presence of middle ear effusion, which differentiates AOM from viral pharyngitis or external ear infections.
C. Bilateral tympanic membranes intact and mobile, with good cone of light is incorrect because these are normal otoscopic findings, indicating no acute infection, normal TM integrity, and proper mobility.
D. Right tympanic membrane erythematous and flat, with blood-tinged discharge is incorrect because the blood-tinged discharge suggests trauma, tympanic membrane perforation, or chronic otitis media with perforation, rather than typical AOM. While erythema is consistent with inflammation, the presence of discharge and flat TM points to a different pathology.
Correct Answer is D
Explanation
A. Atherosclerosis is incorrect because it is a common cause of carotid bruits. Plaque buildup in the carotid arteries leads to turbulent blood flow, which produces the characteristic whooshing sound heard during auscultation.
B. Carotid artery stenosis is incorrect because it directly causes narrowing of the carotid artery, resulting in turbulent blood flow and an audible bruit. This is one of the most classic causes of a carotid bruit.
C. Aortic stenosis is incorrect because although it is a valvular heart condition, it can produce a systolic murmur that radiates to the carotid arteries, which may be mistaken for or contribute to a carotid bruit on auscultation.
D. Tricuspid valve regurgitation is correct because it is least likely to cause a carotid bruit. This condition involves the right side of the heart and produces a holosystolic murmur best heard at the left lower sternal border, without radiation to the carotid arteries. It does not create turbulent flow in the carotid vessels.
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