While conducting an abdominal physical examination, the client complains of pain with deep palpation of the right kidney. Which of the following should be the nurse's next step in the physical examination?

Light palpation of the abdominal right lower quadrant

Auscultate sounds in the abdominal left lower quadrant

Deep palpation of the abdominal left upper quadrant

First percussion of the costovertebral angles

Answer and Explanation

The Correct Answer is D

A) Light palpation of the abdominal right lower quadrant: While light palpation is generally the first step in an abdominal examination to assess for tenderness or abnormalities, the presence of pain with deep palpation of the right kidney indicates a more specific concern. This may warrant further investigation related to the kidney rather than focusing on the lower quadrant.
B) Auscultate sounds in the abdominal left lower quadrant: Auscultation is typically done before palpation to assess bowel sounds and other abnormalities. However, given the specific complaint of pain in the right kidney area, the priority should be addressing the suspected kidney issue rather than auscultating another quadrant.
C) Deep palpation of the abdominal left upper quadrant: Deep palpation in another quadrant is not immediately relevant to the complaint of pain in the right kidney. Instead, it’s crucial to focus on assessing the area directly related to the client's symptoms.
D) First percussion of the costovertebral angles: Percussion of the costovertebral angles (CVA) is a specific technique used to assess kidney tenderness and is appropriate for evaluating the potential causes of the pain in the right kidney. This examination can help determine if the pain is due to conditions like kidney infection or inflammation. Therefore, it is the most relevant next step in this situation.

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Correct Answer is C

Explanation

A. Glenohumeral joint: The glenohumeral joint is the shoulder joint. Pain with chewing is unlikely to be related to issues with the shoulder joint, as this joint is not involved in the chewing process.

B. Sternoclavicular joint: The sternoclavicular joint is where the clavicle meets the sternum. Problems here might affect shoulder and chest movement, but they would not typically cause pain specifically related to chewing.
C. Temporomandibular joint (TMJ): The TMJ is directly involved in the movement of the jaw, which is essential for chewing. Chronic pain during chewing often indicates a problem with the TMJ, such as TMJ disorder, which can cause pain, clicking, and other issues when moving the jaw.
D. Acromioclavicular joint: The acromioclavicular joint is located at the top of the shoulder where the clavicle meets the acromion of the scapula. This joint primarily affects shoulder movement, not chewing.

A. Bell's palsy B. Myxedema C. Cushing's syndrome D. Scleroderma

Correct Answer is C

Explanation

A. Bell's palsy: Bell's palsy is characterized by sudden, unilateral facial weakness or paralysis. It does not cause the specific physical signs described in the question, such as a "moon" face, buffalo hump, or velvety discoloration around the neck.

B. Myxedema: Myxedema is associated with severe hypothyroidism and can lead to symptoms such as facial swelling and changes in skin texture, but it does not typically cause a round face, buffalo hump, or velvety neck discoloration. The velvety discoloration around the neck is more characteristic of insulin resistance rather than hypothyroidism.

C. Cushing's syndrome: Cushing's syndrome is caused by excess cortisol and is known for the characteristic signs described. A "moon" face, buffalo hump, and skin changes such as velvety discoloration (often termed "acanthosis nigricans") are hallmark features of this condition. These symptoms align with the body’s response to prolonged high levels of cortisol.

D. Scleroderma: Scleroderma involves skin thickening and tightening, primarily affecting the hands and face, but it does not typically cause a "moon" face, buffalo hump, or velvety neck discoloration. The changes in scleroderma are more related to skin fibrosis and less to the specific physical features listed.

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While conducting an abdominal physical examination, the client complains of pain with deep palpation of the right kidney. Which of the following should be the nurse's next step in the physical examination?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse assesses a client who reports chronic pain with chewing. The nurse should assess which body area to investigate the client's problem further?

Correct Answer is C

Explanation

When assessing an adult client experiencing diarrhea, the nurse notes a round "moon" face, a buffalo hump at the nape of the neck, and a velvety discoloration around the neck. What is the possible cause of these signs?

Correct Answer is C

Explanation

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