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 A

Explanation

A) Instruct the patient on Tripod positioning: Tripod positioning, where the patient leans forward with hands on their knees or a table, is beneficial for COPD patients. It helps improve ventilation by allowing the diaphragm to work more efficiently and aiding in the expansion of the lungs. This position also utilizes accessory muscles, which can help ease breathing and reduce the work of respiration.
B) Restrict the client's fluid intake to less than 2 L/day: Restricting fluid intake is generally not advisable for COPD patients unless there is a specific condition such as severe heart failure where fluid restriction is necessary. Adequate fluid intake helps to thin mucus, making it easier to expectorate and thus supports better lung function and overall respiratory health.
C) Provide the client with a low-protein diet: COPD patients typically require a higher-protein diet to maintain muscle mass and strength, which are crucial for overall health and respiratory function. A low-protein diet can lead to muscle wasting, including the respiratory muscles, which can worsen respiratory symptoms and functional status.
D) Have the client use the early-morning hours for exercise and activity: While regular exercise is important, the timing should be based on the client's individual preferences and tolerance. For some patients, early morning might not be the best time due to morning symptoms or fatigue. The exercise plan should be customized to fit the patient’s daily routine and energy levels.

A. to check radial pulses B. to assess pedal pulses C. to assess jugular filling pressure D. to auscultate lung sounds

Correct Answer is C

Explanation

A) To check radial pulses: Radial pulses are typically assessed by palpation at the wrist. A gooseneck lamp is not necessary for this task; standard lighting and direct palpation are usually sufficient.
B) To assess pedal pulses: Pedal pulses are assessed by palpation on the top of the foot. A gooseneck lamp is not needed for this purpose, as the lighting conditions are generally adequate for palpation in a well-lit room.
C) To assess jugular filling pressure: Assessing jugular venous pressure (JVP) requires good lighting to clearly see the pulsations in the jugular veins. A gooseneck lamp provides focused and adjustable lighting, which is helpful for this assessment. This ensures accurate observation of the jugular veins and helps in evaluating the severity of heart failure.
D) To auscultate lung sounds: Auscultating lung sounds involves using a stethoscope and does not typically require a gooseneck lamp. Proper lighting is not essential for auscultation, as the focus is on auditory assessment rather than visual inspection.

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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

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Correct Answer is A

Explanation

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Correct Answer is C

Explanation

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