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NUR 643E ADVANCED HEALTH ASSESSMENT
FINAL EXAM QUESTIONS WITH CORRECT VERIFIED
SOLUTIONS | 100% GUARANTEED PASS (LATEST UPDATE
2026/2027)
You are admitting a patient in the ER. She complains of "horrible" abdominal
pain. You perform an abdominal exam - the patient is cringing, abdomen rigid,
and you do not hear any bowel sounds. What do you do next? - ANS ✓Send to
surgery, this acute abdomen is an emergency
Purple and pink striae on the abdomen may indicate what syndrome? - ANS
✓Cushings
"Absent bowel sounds" is after how many minutes? - ANS ✓5 minutes
Your 35 y/o male patient with hypertension refractory to medications. You are
performing an abdominal exam and notice a "whoosing" sound over the renal
arteries. What is high on your differential? - ANS ✓Renal artery stenosis
What is an epigastric venous hum? - ANS ✓Soft, low pitched continuous sound that
occurs with increased collateral circulation between portal and systemic venous
systems
With what part of the stethoscope do you use to listen for bruits? - ANS ✓Bell
What is a friction rub? - ANS ✓High-pitched, scratching, grating sound heard with
the diaphragm of the stethoscope
Listen over the liver and spleen
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What does an abdominal friction rub indicate? - ANS ✓Inflammation of the
peritoneal surface of the organ from a tumor, abscess, or infarct
Why do you percuss the abdomen? - ANS ✓Helps you assess the amount and
distribution of gas in the abdomen, possible masses, and size of liver and spleen
What is the scratch test? - ANS ✓Put diaphragm of stethoscope just above right
costal margin at the midclavicular line. With fingernail,
lightly scratch the skin of the abdomen along the midclavicular line, moving
from below the umbilicus toward the costal margin. When your scratching
finger reaches the liver's edge, you will hear a change in the scratching sound as
it passes through the liver to your stethoscope
How do you percuss the spleen? - ANS ✓Percuss the left lower anterior chest wall
from the border of the cardiac dullness at the 6th rib to the anterior axillary line and
down to the costal margin (Traube's Space)
Should be dull in Traube's space
How do you assess for CVA tenderness? - ANS ✓Put a flat hand down over where
the kidney is and tap on your flat hand with your other fist
Ask your patient if it's tender
How do you percuss for ascites? - ANS ✓Fluid assumes a dependent position and
produces a dull tones around the flank
Air rises to the top and you hear tympany around the umbilicus
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Have patient turn on side
How do you test for fluid wave during an abdominal exam? - ANS ✓Ask your
patient to press the edge of hand firmly down the midline of the abdomen
Tap on one flank sharply with your fingertips and feel on the opposite flank for
the impulse transmitted through the fluid
Useful for determining ascites
What is ballottment during an abdominal exam? - ANS ✓A mass will move
upward in the presence of ascites, will be felt at your fingertips when you push inward
at 90 degree angle
You are palpating a patient's abdomen and you feel a mass. What do you want to
note about the mass? - ANS ✓Location
Size
Shape
Consistency
Tenderness
Pulsations
Mobility
Movement with respiration
You are performing a physical on a 66 y/o male patient. On abdominal exam you
notice a bounding abdominal pulsation in the epigastric region. You auscultate
and hear a bruit. What are you worried about? - ANS ✓Abdominal aortic
aneurysm
You are assessing a patient with a past medical history of alcohol abuse. You
palpate her liver and feel hard sharp edges. What are you thinking? - ANS
✓Alcoholic cirrhosis
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How do you palpate the liver? - ANS ✓
Guarding, rigidity, tenderness, and a positive cough test on abdominal exam
indicates what? - ANS ✓Peritonitis (acute abdomen)
How do you percuss the abdomen? What is normal? - ANS ✓Percuss all four
quadrants
Tympany predominates stomach and intestines (air filled)
Dullness over liver and spleen (solid organs)
Too much tympany (hyperresonance) = gas, fluid
Too much dull = distended bladder, mass, ascites
How do you percuss liver span? - ANS ✓- Right midclavicular line
- Below umbilicus, percuss upward (tympany to dullness)
- Over lung, percuss downward (resonance to dullness)
- Distance between two lines = liver span (2.5 inches/6-12 cm)
What does a normal liver feel like? - ANS ✓Firm, smooth, and even
An unusually soft feeling liver may indicate what? - ANS ✓Non-alcoholic fatty
liver disease
What are you looking for when you palpate your patient's liver? - ANS
✓Consistency - nodularity, firmness, etc
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