While completing an admission assessment for a client with fatigue, weakness, and unexplained weight loss, the nurse notes scleral jaundice. Which finding during percussion of the abdomen should the nurse document indicating hepatomegaly?

Areas of tympany within the liver region.

Tympany noted boarding the margins of the liver. C. A hollow sound over the lower abdomen.

A dull percussion tone outside the costal margins.

Answer and Explanation

The Correct Answer is D

A.   Tympany indicates the presence of gas within the intestines. This would not be expected over the liver area if there is hepatomegaly.
B.   This is not an expected finding in hepatomegaly. Tympany is associated with air-filled structures, which would not be present over an enlarged liver.
C.   A hollow sound is also indicative of air-filled organs like the intestines. It is not a sign of hepatomegaly, which would be characterized by dullness on percussion.
D.   Dullness upon percussion outside the costal margins suggests an enlarged liver (hepatomegaly). This is due to the liver becoming larger and filling the space that normally contains air-filled organs like the intestines.

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Correct Answer is C

Explanation

A. Nicotine’s impact on REM sleep is not as direct as this option suggests. REM sleep can be reduced, but
it is not directly linked to a decreased need for REM sleep.
B. This option may be true for some individuals, but smoking typically causes disruptions throughout the night, not just in the second half.
C. Smoking has been shown to increase sleep latency (the time it takes to fall asleep) and reduce total sleep time due to nicotine’s stimulant effect and withdrawal symptoms during sleep.
D. Difficulty falling asleep and light sleep with frequent arousals are common effects of smoking due to
nicotine’s stimulant properties and withdrawal during the night.

A. Conduct an assessment of functional capacity and environmental hazards. B. Obtain a medication history including prescription and non prescription drugs. C. Distinguish between symptoms caused by disease and those due to aging. D. Emphasize the need to place advance directives in the medical record.

Correct Answer is A

Explanation

A. Assessing the client's functional capacity and identifying potential environmental hazards is essential, especially in older adults, as they may face physical limitations or risks in their environment that could impact their safety and quality of life.
B. Medication history is always important, particularly in older adults who may be taking multiple medications for chronic conditions. However, while relevant, it is not the most critical aspect in this scenario.
C. Differentiating between symptoms of aging and those caused by disease is important for accurate diagnosis and treatment. However, the priority should be to assess the client's overall health and risks related to their daily function and environment.
D. While discussing advance directives is essential for future care planning, it is not the immediate priority in this health history assessment. The focus should be on addressing any current health issues that impact the client’s quality of life.

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While completing an admission assessment for a client with fatigue, weakness, and unexplained weight loss, the nurse notes scleral jaundice. Which finding during percussion of the abdomen should the nurse document indicating hepatomegaly?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

An adult male client tells the nurse that he smokes approximately one pack of cigarettes daily. How can the nurse expect smoking to affect this client's sleep?

Correct Answer is C

Explanation

Correct Answer is A

Explanation

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