HEALTH EXAM 4

During a health history, the patient states "I have pain all the time in my stomach. Its worse 2 hours after I eat, but it gets better if I eat again" Based on these symptoms, the nurse suspects that the patient has which condition?

• appendicitis

• gastric ulcer

• duodenal ulcer

• cholecystitis

Answer explanation

pain with duodenal ulcers occur 2-3 hours after eating and its relieved by eating more food!

The nurse is preparing to examine a patient who has been complaining of right lower quadrant pain. Which technique is correct during the assessment?

• examine the tender area first

• examine the tender area last

• avoid palpating the tender area

• palpate the tender area first, then auscultate for bowel sounds

Answer explanation

save the pain for later because muscle rigidity would obscure deep palpation later on during the exam

During an abdominal assessment, the nurse tests for a fluid wave. A positive fluid wave test occurs with:

• splenomegaly

• distended bladder

• constipation

• ascites

Answer explanation

ascites = fluid in the abdomen is present

During an assessment, the nurse notices that a patients umbilicus is enlarged and everted. It is positioned midline with no change in skin color. The nurse recognizes that the patient may have which condition?

• intra-abdominal bleeding

• constipation

• umbilical hernia

• abdominal tumor

Answer explanation

umbilicus is normally midline and inverted. A hernia is enlarged and everted

During reporting, the student nurse hears that a patient has hepatomegaly and recognizes that this term refers to:

• enlarged liver

• enlarged spleen

• distended bowel

• excessive diarrhea

Answer explanation

hepatomegaly = enlarged liver (hepatic = liver)

splenomegaly = enlarged spleen

The nurse is assessing a patient for possible peptic ulcer disease. Which condition or history often causes this problem?

• hypertension

• streptococcal infections

• recurrent constipation with frequent laxative use

• frequent use of NSAIDs

Answer explanation

peptic ulcer disease occurs with frequent use of NSAIDs, alcohol, drugs, smoking, and helicobacter pylori infection

The nurse is reviewing statistics for lactose intolerance. In the US, the incidence of lactose intolerance is higher in adults of which ethnic group?

• blacks

• hispanics

• whites

• asians

Answer explanation

highest incidence of lactose intolerance in blacks, then Hispanics, then whites

When palpating the abdomen of a 20 year old patient, the nurse notices the presence of tenderness in the left upper quadrant with deep palpation. Which of these structures is most likely to be involved?

• spleen

• sigmoid colon

• appendix

• gallbladder

Answer explanation

spleen is located in the left upper quadrant of the abdomen

Which of these percussion findings would the nurse expect to find in a patient with a large amount of ascites?

• dullness across the abdomen

• flatness in the right upper quadrant

• hyperresonance in the left upper quadrant

• tympany in the right and left lower quadrants

Answer explanation

a lot of ascites = a lot of fluid = dullness!!

A patient is suspected of having inflammation of the gallbladder, or cholecystitis. The nurse should conduct which of these techniques to assess for this condition?

• obturator test

• test for murphy sign

• assess for rebound tenderness

• iliopsoas muscle test

Answer explanation

inflammation of the gallbladder (cholecystitis) = it hurts to breathe so they feel sharp pain and stop breathing midway