A nurse is preparing to perform an abdominal assessment on a client. Identify the sequence of steps the nurse should take to conduct the assessment.

(Move the steps into the box on the right, placing them in the selected order of performance. Use all the steps.)

Inspect the abdomen for skin integrity.

Ask the client about having a history of abdominal pain.

Auscultate the abdomen for bowel sounds.

Percuss the abdomen in each of the four quadrants.

Palpate the abdomen gently for tenderness.

Answer and Explanation

The Correct Answer is A,B,C,D,E

1.   a) Inspect the abdomen for skin integrity: The first step in an abdominal assessment is inspection. The nurse should visually examine the abdomen for any abnormalities such as skin changes, scars, distention, or masses.
2.   b) Ask the client about having a history of abdominal pain: Gathering a history of abdominal pain is crucial as it provides context for the physical findings. This step helps identify any underlying conditions that may influence the assessment.
3.   c) Auscultate the abdomen for bowel sounds: Auscultation should be performed before palpation and percussion to avoid altering the bowel sounds. The nurse listens for the presence, frequency, and character of bowel sounds in all four quadrants.
4.   d) Percuss the abdomen in each of the four quadrants: Percussion helps to assess the presence of fluid, air, or masses in the abdomen. The nurse taps on the abdomen to listen for sounds that indicate the underlying structures.
5.   e) Palpate the abdomen gently for tenderness: Palpation is the final step and involves gently pressing on the abdomen to check for tenderness, masses, or organ enlargement. This step should be done last to avoid causing discomfort or altering the findings of the other steps.

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Correct Answer is A

Explanation

Choice A reason:

Metoprolol is a beta-blocker commonly used to treat high blood pressure (hypertension). One of its primary therapeutic effects is the reduction of blood pressure. By blocking beta-adrenergic receptors, metoprolol decreases the heart rate and the force of contraction, leading to lower blood pressure.

Choice B reason:

While metoprolol can help manage certain types of dysrhythmias by slowing the heart rate and stabilizing the heart’s rhythm, the primary therapeutic effect for which it is most commonly prescribed is the reduction of blood pressure.

Choice C reason:

Increased urine output is not a direct therapeutic effect of metoprolol. This effect is more commonly associated with diuretics, which are often used in conjunction with beta-blockers to manage hypertension and heart failure.

Choice D reason:

Decreased pulse is a potential effect of metoprolol, as it slows the heart rate. However, this is not the primary therapeutic goal. The main therapeutic effect is the reduction of blood pressure.

A. Ice packs to affected area 15 minutes on, 15 minutes off B. Intravenous fluids (IVF) at maintenance rate C. Ketorolac IV for pain D. Ambulate in hallway with supervision E. Meperidine IV for pain

Correct Answer is {"A":{"answers":"B"},"B":{"answers":"A"},"C":{"answers":"A"},"D":{"answers":"B"},"E":{"answers":"B"}}

Explanation

Choice A: Ice packs to affected area 15 minutes on, 15 minutes off

Reason: Ice packs are generally contraindicated for patients with sickle cell disease (SCD). The use of ice packs can cause vasoconstriction, which narrows blood vessels and reduces blood flow. This can exacerbate the pain and potentially trigger a vaso-occlusive crisis (VOC) by further restricting blood flow to the already compromised areas. Studies have shown that cold exposure can worsen pain in SCD patients, making ice packs an unsuitable option.

Choice B: Intravenous fluids (IVF) at maintenance rate

Reason: Intravenous fluids are anticipated for patients with SCD, especially during a pain crisis. Hydration is crucial as it helps to reduce the viscosity of the blood, thereby improving blood flow and reducing the likelihood of sickling. Adequate hydration can help to alleviate pain and prevent further complications. The administration of IV fluids is a standard practice in managing acute pain episodes in SCD patients.

Choice C: Ketorolac IV for pain

Reason: Ketorolac, a nonsteroidal anti-inflammatory drug (NSAID), is anticipated for managing pain in SCD patients. It provides effective pain relief without the risks associated with opioids, such as respiratory depression and dependence. Ketorolac works by inhibiting the production of prostaglandins, which are involved in the inflammatory process and pain signaling. It is particularly useful for acute pain management in SCD patients.

Choice D: Ambulate in hallway with supervision

Reason: Ambulation during a pain crisis is generally contraindicated for SCD patients. Movement can increase pain and stress on the affected areas, potentially worsening the condition. During a VOC, patients are often advised to rest and avoid activities that could exacerbate the pain. While physical activity is important for overall health, it should be carefully managed and avoided during acute pain episodes.

Choice E: Meperidine IV for pain

Reason: Meperidine is contraindicated for pain management in SCD patients due to its potential for serious side effects. Meperidine can accumulate in the body and produce a toxic metabolite called normeperidine, which can cause seizures and other adverse effects. Additionally, meperidine is less effective than other opioids and has a higher risk of causing dependency and other complications. Therefore, it is not recommended for managing pain in SCD patients.

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A nurse is preparing to perform an abdominal assessment on a client. Identify the sequence of steps the nurse should take to conduct the assessment. (Move the steps into the box on the right, placing them in the selected order of performance. Use all the steps.)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is assessing a client who is receiving metoprolol. Which of the following indicates a therapeutic effect?

Correct Answer is A

Explanation

A nurse is caring for an oldest patient. Exhibits For each potential provider’s prescription, click to specify if the potential prescription is anticipated or contraindicated for the client.

Correct Answer is {"A":{"answers":"B"},"B":{"answers":"A"},"C":{"answers":"A"},"D":{"answers":"B"},"E":{"answers":"B"}}

Explanation

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A nurse is preparing to perform an abdominal assessment on a client. Identify the sequence of steps the nurse should take to conduct the assessment.

(Move the steps into the box on the right, placing them in the selected order of performance. Use all the steps.)