A nurse is checking a client's bowel sounds. At which of the following times should the nurse auscultate the client's abdomen?
Prior to percussing the abdomen
Prior to inspecting the abdomen
After checking int kidney tenderness
After palpating the abdomen
The Correct Answer is A
A. Prior to percussing the abdomen
Bowel sounds are typically auscultated before performing any other abdominal assessments. This allows the nurse to get an accurate representation of the client's bowel activity without any interference from other assessment techniques.
B. Prior to inspecting the abdomen
Inspecting the abdomen involves observing for any visible abnormalities, such as distension or lesions. Bowel sounds are auscultated first to get an initial sense of the client's gastrointestinal activity.
C. After checking for kidney tenderness
Kidney tenderness assessment is not directly related to bowel sounds. These assessments are separate and do not impact each other's sequence.
D. After palpating the abdomen
Palpating the abdomen should be done after auscultation. Palpation can stimulate bowel activity, potentially altering the natural bowel sounds. Therefore, it is essential to auscultate the abdomen before palpating it.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A,B,C,D
Explanation
A. Confirm the client's identity by checking her wristband.
B. Provide for the client's privacy by closing the curtains.
C. Assist the client into the Sims' position.
D. Insert the tip of the enema tubing into the client's rectum.
Correct Answer is A
Explanation
A. Prior to percussing the abdomen:Auscultation should be performed before percussing or palpating the abdomen. Percussion and palpation can alter bowel activity, potentially leading to inaccurate assessment of bowel sounds.
B. Prior to inspecting the abdomen:Inspection should always be performed before auscultation when assessing the abdomen. This allows the nurse to observe any visible abnormalities, such as distention or skin changes, without altering bowel activity. Auscultation should follow inspection.
C. After checking for kidney tenderness:Checking for kidney tenderness (e.g., costovertebral angle tenderness) involves percussing the back and is not part of the sequence of a standard abdominal exam. It does not precede auscultation.
D. After palpating the abdomen:
Palpation can stimulate or alter bowel sounds, potentially leading to an inaccurate assessment. Therefore, auscultation should always occur before palpation.
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