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 D

Explanation

Choice A Reason:
Audible thud without pain is incorrect. An audible thud without pain would not be an expected response when percussing the costovertebral angle (CVA) in a client with pyelonephritis. Pyelonephritis typically presents with tenderness upon percussion of the CVA due to inflammation or infection of the kidneys. The absence of pain in this scenario would not be consistent with the expected response.
Choice B Reason:
Rigidity and firmness are incorrect. Rigidity and firmness upon percussion of the costovertebral angle (CVA) may suggest muscle tension or guarding, rather than the tenderness typically associated with kidney inflammation or infection such as pyelonephritis. While guarding can occur in response to pain, it is not the expected response when assessing for kidney tenderness.
Choice C Reason:
Rebound tenderness is incorrect. Rebound tenderness refers to the exacerbation of pain upon release of pressure, typically observed in conditions such as peritonitis. While rebound tenderness may be present in some abdominal conditions, it is not the expected response when percussing the costovertebral angle (CVA) to assess for kidney tenderness in pyelonephritis. In pyelonephritis, tenderness upon initial percussion is more indicative of the condition.
Choice D Reason:
Sharp, severe pain is correct. Sharp, severe pain upon percussing the CVA suggests tenderness, which can be indicative of kidney inflammation or infection, such as pyelonephritis. This finding would support the diagnosis and help guide further assessment and treatment.

A. An adult male presents with fears that he has "lung cancer." B. Describes having a body-wracking dry cough" of 6 weeks duration. C. Expresses concern of "lung cancer" symptoms for last 6 weeks. D. Presents with a hacking non-productive cough of 6 weeks duration.

Correct Answer is B

Explanation

Choice A Reason:
An adult male presents with fears that he has "lung cancer." Is appropriate. This choice accurately captures the client's expressed fear of having lung cancer. However, it lacks specificity regarding the duration of symptoms (six weeks) and the nature of the symptom (dry cough). Therefore, while it acknowledges the client's concern, it does not provide comprehensive documentation of the client's reported symptoms.
Choice B Reason:
This option accurately captures the client's primary concern, which is the persistent dry cough lasting for six weeks. It avoids assuming a diagnosis (such as lung cancer) and instead focuses on the client's reported symptom. This type of documentation allows for an objective record of the client's statement while avoiding speculation about specific diagnoses. It also provides important information that can guide further assessment and diagnostic evaluation by healthcare providers.
Choice C Reason:
This option documents the client's expressed concern about having symptoms consistent with lung cancer for the past six weeks. While it accurately reflects the client's fear, it may lead to premature assumptions about the diagnosis before a thorough assessment and diagnostic workup are conducted. It's important for documentation to focus on the client's reported symptoms rather than presumptive diagnoses to maintain objectivity and guide appropriate evaluation and management..
Choice D Reason:
Presents with a hacking non-productive cough of 6 weeks duration. This choice accurately describes the client's reported symptom of a "hacking non-productive cough" and includes the duration of the symptom (six weeks). However, it does not explicitly mention the client's expressed fear of having lung cancer, which is an important aspect of the client's presentation that should be documented. Additionally, the term "hacking" may not fully capture the severity or character of the client's reported cough, as the client described it as "body-wracking." Therefore, while it provides some relevant information, it does not fully capture the client's concerns and presentation.

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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 is performing an admission assessment for a client with pyelonephritis who has urgency and burning while urinating. Which finding indicates an expected response when the nurse percusses the costovertebral angle?

Correct Answer is D

Explanation

Correct Answer is B

Explanation

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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?