A nurse is planning to collect data about the abdomen of a client who reports "stomach pain". Which of the following actions should the nurse take first?
Percuss
Auscultate.
Palpate.
Inspect
The Correct Answer is D
A. Percuss:
Percussion involves tapping the abdomen with the fingers to assess for areas of dullness or resonance. Dullness might indicate organ enlargement or mass, while resonance is the typical sound over air-filled structures. This step helps identify the borders and size of organs.
B. Auscultate:
Auscultation involves listening to the abdomen using a stethoscope. The nurse listens for bowel sounds, which are the noises made by the movement of the intestines. Absence or abnormal bowel sounds can indicate intestinal obstruction or other gastrointestinal issues.
C. Palpate:
Palpation involves gently pressing the abdomen to assess for tenderness, masses, or areas of discomfort. This step helps identify areas of pain or tenderness, guarding, or rigidity, which might indicate inflammation, infection, or other abdominal issues.
D. Inspect:
Inspection involves visually assessing the abdomen for any visible abnormalities such as scars, distention, pulsations, or visible masses. It's the first step in the abdominal assessment process as it provides initial information about the overall condition of the abdomen before physical contact.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Headache: Omeprazole is not primarily used to treat headaches. While it might indirectly alleviate headaches caused by acid reflux or heartburn, its primary purpose is to reduce stomach acid production.
B. Diarrhea: Omeprazole is not typically used to treat diarrhea. Diarrhea can have various causes, including infections or dietary issues, and treatment would depend on the underlying cause.
C. Nausea: While omeprazole may indirectly help with nausea caused by excessive stomach acid, its main role is to reduce acid production. If nausea is due to other causes, such as medications or infections, different treatments might be necessary.
D. Acid indigestion: This is the correct answer. Omeprazole is very effective at relieving symptoms of acid indigestion, heartburn, and gastroesophageal reflux disease (GERD). It works by reducing the production of stomach acid, thereby alleviating discomfort associated with excess acid.
Correct Answer is D
Explanation
A. Ecchymosis of the extremities: Ecchymosis refers to the medical term for a bruise. It's characterized by a discoloration of the skin resulting from bleeding underneath, typically caused by trauma to the blood vessels. This is not directly related to cholelithiasis.
B. Tenderness in the left upper abdomen: Tenderness in the left upper abdomen might be associated with conditions such as pancreatitis or splenic issues, not directly with obstruction and inflammation of the common bile duct due to cholelithiasis.
C. Straw-colored urine: Straw-colored urine is normal and healthy. Dark-colored or cloudy urine might indicate underlying issues, but straw-colored urine is generally a sign of proper hydration.
D. Fatty stools: When the common bile duct is obstructed due to cholelithiasis, proper digestion of fats doesn't occur, leading to the passage of fatty stools. This is due to the inability to properly digest and absorb fats, leading to their presence in the stool.
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