While auscultating a client’s abdomen, the nurse hears a low-pitched blowing sound in the upper midline area. Which is the likely indication of this finding?

A minor variation.

Normal borborygmus sounds.

Possible renal artery stenosis.

Hyperactive bowel sounds.

Answer and Explanation

The Correct Answer is C

Choice A rationale
A minor variation may refer to a benign finding or a slight deviation from the norm. However, a low-pitched blowing sound in the upper midline area would not typically be considered a minor variation and may warrant further investigation.
Choice B rationale
Borborygmi are normal bowel sounds characterized by gurgling, rumbling, or growling noises produced by the movement of gas and fluid in the intestines. However, a low-pitched blowing sound in the upper midline area would not typically be described as normal borborygmi.
Choice C rationale
A low-pitched blowing sound in the upper midline area could indicate a renal artery bruit, which is a sign of renal artery stenosis. Renal artery stenosis is a narrowing of the renal artery, often due to atherosclerosis, which can lead to decreased blood flow to the kidneys. A renal artery bruit may be auscultated over the renal arteries and is indicative of turbulent blood flow through the narrowed artery.
Choice D rationale
Hyperactive bowel sounds are typically characterized by loud, high-pitched gurgles heard throughout the abdomen. They are often associated with increased intestinal motility, such as in gastroenteritis or diarrhea, rather than a low-pitched blowing sound in the upper midline area.

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Correct Answer is B

Explanation

Choice A rationale
A benign variation would not typically present with a pattern of dullness extending from the 5th left intercostal space to the 2nd left intercostal space at the sternal border. This pattern suggests an abnormality rather than a benign variation.
Choice B rationale
Cardiac enlargement is indicated by an area of dullness extending from the 5th left intercostal space to the 2nd left intercostal space at the sternal border. This finding suggests an enlarged heart, which can be due to conditions such as cardiomegaly or left ventricular hypertrophy.
Choice C rationale
Cardiac atrophy refers to a decrease in the size or mass of the heart muscle, resulting in a smaller than normal heart. The described findings indicate dullness extending upward, suggesting an enlargement rather than atrophy of the heart.
Choice D rationale
An expected finding would not typically present with the described pattern of dullness. The normal area of cardiac dullness is more limited and does not extend as described.

A. Cornea are jaundiced. B. Face is flushed and diaphoretic. C. Oral mucosa is cyanotic. D. Eyelids are matted and crusted.

Correct Answer is C

Explanation

Choice A rationale
Jaundiced corneas indicate liver dysfunction or other serious conditions that require medical attention, but they do not require immediate intervention compared to cyanosis.
Choice B rationale
A flushed and diaphoretic face can indicate fever, heat exhaustion, or other conditions, but it is not as immediately life-threatening as cyanosis.
Choice C rationale
Cyanotic oral mucosa indicates a lack of oxygen in the blood, which is a medical emergency requiring immediate intervention.
Choice D rationale
Matted and crusted eyelids can indicate an eye infection or other conditions, but they do not require immediate intervention compared to cyanosis.

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While auscultating a client’s abdomen, the nurse hears a low-pitched blowing sound in the upper midline area. Which is the likely indication of this finding?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

While percussing the borders of the heart, the nurse picks up an area of dullness beginning at the 5th left intercostal space and moving upward to the 2nd left intercostal space at the sternal border. What do these findings indicate?

Correct Answer is B

Explanation

While observing a client’s face, which assessment finding requires immediate intervention by the nurse?

Correct Answer is C

Explanation

The nurse should anticipate difficulty locating the point of maximal impulse (PMI) in which client?

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