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Advanced Physical Assessment - The abdomen Exam Questions and Complete Solutions Graded A+
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Advanced Physical Assessment - The abdomen Exam Questions and Complete Solutions Graded A+
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Advanced PhysicalAssessment - The
abdomen Exam
Questions and Complete
Solutions Graded A+
Denning [Date] [Course title]
,1. The nurse admits a client with intermittent colicky pain at the left lower quadrant of the abdomen.
Which type of pain is the client referring to?
a. Muscular pain
b. Visceral pain
c. Referred pain
d. Parietal pain - Answer: Ans: (B)
Visceral pain occurs when hollow abdominal organs such as the intestine or biliary tree contract
unusually forcefully or are distended or stretched. Solid organs such as the liver can also become painful
when their capsules are stretched. Visceral pain may be difficult to localize. It is typically palpable near
the midline at levels that vary according to the structure involved. Visceral pain varies in quality and may
be gnawing, burning, cramping, or aching. When it becomes severe, it may be associated with sweating,
pallor, nausea, vomiting, and restlessness.
1. A client with chest pain tells the nurse that he also feels the pain on the jaw and the shoulder. The
nurse understands that this type of pain is called
a. Referred pain
b. Parietal pain
c. Muscular pain
d. Visceral pain - Answer: Ans: (A)
Referred pain is felt in more distant sites that share the same innervations as the source of pain.
Referred pain often develops as the initial pain becomes more intense and thus seems to radiate or
travel from the initial site. It may be felt superficially or deeply but is usually well localized.
1. The nurse is doing the history of a patient with pain that ifs felt in the epigastric area. Which of the
following cluster of client manifestations are considered "alarm symptoms" for gastric cancer?
a. Dysphagia, odynophagia, coffee ground emesis
b. Weight loss, diarrhea, dehydration
c. Recurrent vomiting, 2cm x 2cm lump on the upper right quadrant, fever
d. Hematochezia, hematemesis, epistaxis - Answer: Ans: (A)
Red flags or alarm symptoms for gastric cancer include: difficulty swallowing (dysphagia), pain with
swallowing (odynophagia), recurrent vomiting, and evidence of gastrointestinal bleeding (coffee ground
emesis), weight loss and anemia.
,1. A 21-year old woman is being seen at the emergency department due to right lower abdominal pain.
She has missed her period for two consecutive months. She feels weak and dizzy. The nurse knows to
prioritize which of the following nursing actions?
a. Continue assessing by palpating the abdomen
b. Perform a pregnancy test
c. Apply hot compress to the affected area.
d. Inspect the abdomen for ascites - Answer: Ans: (B)
With the given findings of lower abdominal pain and missed periods, the nurse suspects ectopic
pregnancy especially if accompanied by other symptoms like rigidity of abdominal muscles, weakness
and dizziness. Palpating the abdomen is contraindicated as the risk of rupturing the fallopian tube is
high.
1. A nurse is reviewing the client's records from an earlier shift and notes that the result of the barium
enema revealed "apple core" lesions on the sigmoid colon. The client is passing pencil-like stools. Which
disorder is the nurse most likely considering?
a. Gastric cancer
b. Colon cancer
c. Diverticulitis
d. Chron disease - Answer: Ans: (B)
Thin, pencil-like stool occurs in an obstructing "apple core" lesion of the sigmoid colon. The nurse
considers colon cancer if the above are accompanied by the following: melena, hematochezia, diarrhea,
constipation, feeling of incomplete bowel emptying, bloating, cramps weight loss and fatigue.
1. The nurse is doing a health teaching on a client with colon cancer. She is explaining the different types
of bleeding manifestations. Of particular interest to her is the type of bleeding associated with colon
cancer and that is passing of fresh blood or maroon-colored stool. The client understands the teaching if
he replies with which answer?
a. Hematemesis
b. Steatorrhea
c. Hematochezia
d. Melena - Answer: Ans: (C)
Hematochezia is passing of blood-streaked stools, stools that are bright or dark red in color. This is
caused by lower gastrointestinal bleeding. Hematemesis is vomiting of fresh blood or of occult blood of
, 'coffee-grounds' consistency. Steatorrhea is passing of fatty malodorous stools. Melena is presence of
occult blood in the stool.
1. A client with hepatitis is asking the nurse why his skin turned yellow. Which response is the most
accurate to explain why jaundice happens?
a. Decreased production of bilirubin
b. Increased uptake of bilirubin by the hepatocytes
c. Increased ability of the liver to conjugate bilirubin
d. Decreased excretion of bilirubin into the bile, resulting in absorption of conjugated bilirubin back into
the blood - Answer: Ans: (D)
Jaundice or the yellowing of the skin is caused by several factors: increased production of bilirubin,
decreased uptake of bilirubin by the hepatocytes, decreased ability of the liver to conjugate bilirubin,
decreased excretion of bilirubin into the bile, resulting in absorption of conjugated bilirubin back into
the blood
1. A client presenting with upper right quadrant steady pain is getting frantic about his stools that has
turned grey. Which of the following nursing response will correctly address the client's concern?
a. "Your body cannot digest food properly because it lacks the enzymes that turn stools brownish or
greenish"
b. "Bile, the substance in your gallbladder that gives color to the stool, has been totally blocked from
flowing to your intestines"
c. "The bacteria that are causing your infection have spread to affect your bowels as well."
d. "You are deficient in an important mineral that is affected by your disorder." - Answer: Ans: (B)
When excretion of bile into the intestine is completely obstructed, the stools become gray or light
colored, or acholic, without bile.
1. The nurse is asking this series of questions to assess a client: "Do you have trouble starting your
stream? Do you have to stand closer to the toilet to void? Is there a change in the force or size of your
stream, or straining to void? Do you hesitate or stop in the middle of voiding?" The nurse is eliciting
information about which disorder?
a. Pyelonephritis
b. Colon cancer
c. Benign prostatic hypertrophy
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