While auscultating a client's abdomen, the nurse hears a low-pitched blowing sound in the upper midline area. Which is the likely indication of this finding?

Hyperactive bowel sounds.

A minor variation.

Normal borborygmic sounds.

Possible renal artery stenosis.

Answer and Explanation

The Correct Answer is D

Choice A Reason:
Hyperactive bowel sounds are incorrect. Hyperactive bowel sounds refer to increased or loud gurgling noises heard during auscultation of the abdomen, which may indicate increased intestinal motility or bowel obstruction. These sounds are typically high-pitched and occur in various abdominal quadrants, rather than specifically in the upper midline area.
Choice B Reason:
A minor variation is incorrect. A minor variation in abdominal sounds may occur and could be considered normal. However, a low-pitched blowing sound in the upper midline area is not typically categorized as a minor variation but rather as an abnormal finding that warrants further investigation.
Choice C Reason:
Normal borborygmic sounds is incorrect. Borborygmic refers to the normal rumbling or gurgling sounds produced by the movement of gas and fluid in the intestines. While borborygmic sounds may be heard during abdominal auscultation, they are typically described as high-pitched and occur in various abdominal quadrants, not specifically in the upper midline area. Therefore, they are not likely to be the indication of the finding described in the scenario.
Choice D Reason:
Possible renal artery stenosis is correct. Renal artery stenosis is a condition characterized by the narrowing of one or both renal arteries, which can lead to reduced blood flow to the kidneys. When auscultating the abdomen, a low-pitched blowing sound (bruit) heard over the upper midline area could indicate turbulence of blood flow in the renal arteries. This bruit is typically associated with renal artery stenosis and reflects the increased velocity of blood passing through a narrowed arterial lumen. Identifying a renal artery bruit during abdominal auscultation warrants further investigation, such as imaging studies or referral to a specialist for evaluation and management of renal artery stenosis.

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Correct Answer is B

Explanation

Choice A Reason:
Coronary heart disease is incorrect. Coronary heart disease is primarily associated with cardiovascular symptoms such as chest pain, shortness of breath, and fatigue. While some nail changes may occur in individuals with coronary heart disease due to decreased oxygenation, brittle, concave nails are not a typical manifestation of this condition. Therefore, this option is less likely to explain the appearance of the nails.
Choice B Reason:
Iron deficiency anemia is correct. Iron deficiency anemia is characterized by a lack of iron in the body, leading to decreased production of hemoglobin and red blood cells. One of the classic nail findings associated with iron deficiency anemia is koilonychia, which presents as brittle, concave nails with a spoon-like appearance. This is due to structural changes in the nails caused by the deficiency of iron. Therefore, this option is the most likely explanation for the observed nail changes.
Choice C Reason:
Diabetes mellitus is incorrect. Diabetes mellitus can lead to various dermatologic manifestations, including nail changes such as thickening, discoloration, and slow nail growth. However, brittle, concave nails with a spoon-like appearance are not typically associated with diabetes mellitus. Therefore, while diabetes mellitus may affect the nails, it is less likely to explain the specific appearance observed in this case.
Choice D Reason:
Recent candida infection is incorrect. Candida infections, particularly in the nail folds (paronychia), can lead to changes in the nails such as discoloration, thickening, or separation from the nail bed. However, brittle, concave nails with a spoon-like appearance are not typical findings of candida infections. Therefore, while recent candida infection may affect the nails, it is less likely to explain the specific appearance observed in this case.

A. Test feet for a positive Babinski reflex. B. Observe color of the feet and toes. C. Measure skin elasticity around the ankles. D. Assess volume of the pedal pulses. E. Palpate dorsal surface of feet for warmth.

Correct Answer is ["B","D","E"]

Explanation

Choice A Reason:
Testing feet for a positive Babinski reflex is wrong. The Babinski reflex is a neurological test that assesses upper motor neuron function, particularly in the lower extremities. However, it is not relevant to assessing cold feet, and testing for the Babinski reflex would not provide useful information in this situation.
Choice B Reason:
Observing color of the feet and toes is wright. Observing the color of the feet and toes can provide important information about circulation. Pallor, cyanosis, or mottling may indicate inadequate blood flow or perfusion to the extremities, which could contribute to cold feet.
Choice C Reason:
Measuring skin elasticity around the ankles is wrong. Skin elasticity assessment is more relevant for evaluating hydration status or tissue turgor. While it may be useful in certain contexts, it is not directly related to assessing cold feet and peripheral circulation. Therefore, it is not necessary before covering the client's feet in this scenario.
Choice D Reason:
Assessing volume of the pedal pulses is wright. Assessing the volume of the pedal pulses (such as dorsalis pedis and posterior tibial pulses) provides information about peripheral vascular status. Weak or absent pulses may indicate compromised circulation, contributing to cold feet.
Choice E Reason:
Palpating dorsal surface of feet for warmth is wright. palpating the dorsal surface of the feet for warmth helps assess peripheral perfusion. Coolness to touch may indicate decreased blood flow to the extremities, while warmth suggests adequate circulation.

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While auscultating a client's abdomen, the nurse hears a low-pitched blowing sound in the upper midline area. Which is the likely indication of this finding?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse observes the presence of brittle, concave curves to the nails of a client on assessment. Which information should the nurse obtain from the client that may explain the appearance of the nails?

Correct Answer is B

Explanation

An older male client reports to the nurse that his feet are cold. Before covering the client's feet, which assessment(s) should the nurse complete? Select all that apply.

Correct Answer is ["B","D","E"]

Explanation

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