When preparing a female client for an abdominal examination, the nurse should provide her with which instruction?

"Refrain from eating or drinking for at least thirty minutes."

"Lie in a prone position with slightly flexed knees."

"Exhale slowly through your mouth then hold your breath."

"Empty your bladder just prior to the examination."

Answer and Explanation

The Correct Answer is D

A.   The client should refrain from eating or drinking for other procedures but not specifically for an abdominal examination unless indicated for tests like ultrasounds.
B.   A prone position is not necessary for an abdominal exam; lying on the back is preferred.
C.   The client should not hold their breath during the abdominal exam unless asked to assist with specific maneuvers.
D.   Having the bladder empty before the examination reduces discomfort and allows for better visualization of the abdominal organs.

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Correct Answer is C

Explanation

A. While it is important to palpate the correct quadrant, this is unlikely the cause if the gallbladder cannot be located. The gallbladder is typically located in the right upper quadrant, and the nurse would have been palpating this area. This option does not address the most likely cause.
B. A normal gallbladder might not always be palpable, especially if the client is obese. However, inability to palpate the gallbladder does not necessarily indicate a problem; this is a common finding in obese individuals where fat tissue can obscure the gallbladder.
C. Obesity can make it more difficult to palpate internal structures such as the gallbladder. Excess adipose tissue in the abdominal area can prevent the nurse from feeling the gallbladder during palpation. This is the most likely explanation for the failure to locate the gallbladder.
D. While deeper palpation might be necessary in obese clients, the inability to palpate the gallbladder is more likely due to the obscuring effects of fat, rather than a technique issue. It's a common finding that obesity hinders the ability to palpate organs like the gallbladder.

A. Listen to the heart sounds using the bell of a stethoscope. B. Use a Doppler ultrasound to hear the heartbeat. C. Obtain a pulse oximeter reading from two extremities. D. Auscultate for one minute with the stethoscope's diaphragm.

Correct Answer is A

Explanation

A. The bell of the stethoscope is best for detecting low-pitched sounds like murmurs or extra heart sounds.
B. A Doppler ultrasound is not necessary for routine auscultation of heart sounds.
C. Pulse oximetry does not provide relevant information about heart sounds.
D. Auscultating with the diaphragm is better for high-pitched sounds, so the bell is preferred for extra heart sounds.

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When preparing a female client for an abdominal examination, the nurse should provide her with which instruction?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

While assessing a client who is obese, the nurse is unable to locate the gallbladder when palpating below the liver margin at the lateral border of the rectus abdominal muscle. Which is the most likely explanation for failure to locate the gallbladder by palpation?

Correct Answer is C

Explanation

The nurse detects a possible extra heart sound while assessing an adult client. To verify this finding, which action should the nurse take?

Correct Answer is A

Explanation

When performing a skin and nail exam on an older adult female client, the nurse notes that she has longitudinal ridges on her fingernails. What does this finding indicate?

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