NUR 216 EXAM 4 – VERIFIED QUESTIONS AND
CORRECT ANSWERS (LATEST 2025/2026
EDITION)
◉ A&P. Answer: Abdomen is complex andchallenging region of the
body thatcommunicates with many differentsystems that can tell
you about theoverall health status of the patient.• There are many
vital organscontained in the abdominal cavitythat require thorough
assessment.• All four assessment techniquesmust be performed in a
specificorder: inspection, auscultation,percussion, and palpation
(IAPP
◉ HEALTH HX. Answer: ROS: patients may note a wide variety
ofsymptoms related to abdomen.• Weight: Have you gained or lost
weight recently?Intentional or unintentional?• Appetite: Any
changes in your appetite? Whathave you eaten in the last 24 hours?•
Dysphagia: Any difficulty swallowing foods orliquids? Do you ever
feel like food gets stuck inyour throat?• Nausea/Vomiting: When did
it start? What colorwas the vomit?• Indigestion/Heartburn: Do you
experienceheartburn? Do you take any meds forindigestion? Any
chest pain after eating? Askabout Chronic Pyrosis or
GastroesophagealReflux Disease (GERD)
◉ HEALTH HX CONT. Answer: Abdominal/Pelvic Pain: Use
OLDCARTS• Constipation/Diarrhea: What are your normalbowel
habits? Do you feel constipated? Anyblood in your stool? Do you use
,laxatives?• Flatulence: Any issues with gas? Do you feelbloated? Do
you burp?• Urination: Do you have frequency or urgency?Do you
have back pain? Painful or difficulturination? Any incontinence or
leaking? Whatcolor is your urine?• Skin: Any change in skin color or
whites of eyes?• Out of Country Travel: Have you traveled out ofthe
country?
◉ EQUIPMENTFORASSESSMENT. Answer: Gloves
StethoscopeMeasuringTapePen/SkinMarker
◉ SEQUENCE OFASSESSMENT. Answer:
InspectionAuscultationPercussionPalpation (light anddeep)
◉ ABDOMINALMAPPING. Answer: Right Upper
Quadrant (RUQ): liver
• Right Lower
Quadrant (RLQ)
• Left Upper Quadrant
(LUQ): spleen
• Left Lower Quadrant
(LLQ)
◉ ABDOMINAL MAPPING. Answer:
,◉ INSPECTION. Answer: Assess abnormalities in shape, skin
ormovement of the abdomen• Normal: round contour,
symmetrical,umbilicus midline, skin smooth and intactwithout
pulsations or visible peristalsis, striae• Abnormal: scaphoid,
distended orprotuberant abdomen seen with cancer,weight loss,
hernia or accumulation of fluid• Ascites: abnormal accumulation of
fluid inperitoneal cavity• Diastasis Recti: a bulging which occurswith
separation of the two halves of rectusabdominis muscles in midline
at linea alba.
◉ INSPECTION CONT.. Answer: Hernia: abdominal wall weakensand
causes a loop of intestineor abdominal tissue to protrudethrough an
opening in theperitoneum.• Cullen's Sign: superficialbleeding under
the skin aroundthe umbilicus and may indicateintra-abdominal
bleeding.
◉ AUSCULTATING BOWELSOUNDS. Answer: Assess pattern of bowel
sounds causedby peristalsis• Normal: 5-34 clicks or gurgles/min•
Abnormal:• Hyperactive: loud, high pitched, incperistalsis or early
bowel obstruction• Hypoactive: soft, dec peristalsis related
toconstipation• No sounds: constipation, bowelobstruction or
paralytic ileus. Listen for afull 3-5 minutes.
◉ NO SOUND. Answer: LISTEN FOR 3 TO 5 MINUTES
◉ AUSCULTATINGVASCULAR SOUNDS. Answer: Normal: no bruits
heardover arteries• Abnormal: bruits areturbulent blowing
, soundheard over an obstructedartery; usually buildup ofplaque. Do
not want topalpate over this area.Why?
◉ WHY DO WE NOT PALPATE OVER A BRUITS IN ABDOMEN.
Answer: Risk of Dislodging Clots or Causing Rupture: Palpating over
an area with a bruit, especially if it's related to an aneurysm or a
weakened blood vessel, can potentially dislodge a clot or cause the
vessel to rupture. This is particularly a concern in cases of
abdominal aortic aneurysms (AAA), where the artery is already
weakened.
◉ PERCUSSINGABDOMEN. Answer: Assess density and size of
abdominalstructures, air, solid or fluid filled masses in
theabdomen.• Normal: tympany in all four quadrants anddullness
over organs.• Abnormal:Excessive, high pitched tympanic sounds
mayindicate distention.Dullness may indicate inc tissue density
fromorgan enlargement or underlying mass.Pain may indicate
peritoneal inflammation.
◉ NORMAL SOUNDS. Answer: TYMPANY IN ALL FOUR QUADRANTS
AND DULLNESS OVER ORGANS
◉ PERCUSS KIDNEYS. Answer: Need to assess forCVA tenderness.•
Normal: nodiscomfort• Abnormal: pain withpercussion-
kidneystones, pyelonephritis
CORRECT ANSWERS (LATEST 2025/2026
EDITION)
◉ A&P. Answer: Abdomen is complex andchallenging region of the
body thatcommunicates with many differentsystems that can tell
you about theoverall health status of the patient.• There are many
vital organscontained in the abdominal cavitythat require thorough
assessment.• All four assessment techniquesmust be performed in a
specificorder: inspection, auscultation,percussion, and palpation
(IAPP
◉ HEALTH HX. Answer: ROS: patients may note a wide variety
ofsymptoms related to abdomen.• Weight: Have you gained or lost
weight recently?Intentional or unintentional?• Appetite: Any
changes in your appetite? Whathave you eaten in the last 24 hours?•
Dysphagia: Any difficulty swallowing foods orliquids? Do you ever
feel like food gets stuck inyour throat?• Nausea/Vomiting: When did
it start? What colorwas the vomit?• Indigestion/Heartburn: Do you
experienceheartburn? Do you take any meds forindigestion? Any
chest pain after eating? Askabout Chronic Pyrosis or
GastroesophagealReflux Disease (GERD)
◉ HEALTH HX CONT. Answer: Abdominal/Pelvic Pain: Use
OLDCARTS• Constipation/Diarrhea: What are your normalbowel
habits? Do you feel constipated? Anyblood in your stool? Do you use
,laxatives?• Flatulence: Any issues with gas? Do you feelbloated? Do
you burp?• Urination: Do you have frequency or urgency?Do you
have back pain? Painful or difficulturination? Any incontinence or
leaking? Whatcolor is your urine?• Skin: Any change in skin color or
whites of eyes?• Out of Country Travel: Have you traveled out ofthe
country?
◉ EQUIPMENTFORASSESSMENT. Answer: Gloves
StethoscopeMeasuringTapePen/SkinMarker
◉ SEQUENCE OFASSESSMENT. Answer:
InspectionAuscultationPercussionPalpation (light anddeep)
◉ ABDOMINALMAPPING. Answer: Right Upper
Quadrant (RUQ): liver
• Right Lower
Quadrant (RLQ)
• Left Upper Quadrant
(LUQ): spleen
• Left Lower Quadrant
(LLQ)
◉ ABDOMINAL MAPPING. Answer:
,◉ INSPECTION. Answer: Assess abnormalities in shape, skin
ormovement of the abdomen• Normal: round contour,
symmetrical,umbilicus midline, skin smooth and intactwithout
pulsations or visible peristalsis, striae• Abnormal: scaphoid,
distended orprotuberant abdomen seen with cancer,weight loss,
hernia or accumulation of fluid• Ascites: abnormal accumulation of
fluid inperitoneal cavity• Diastasis Recti: a bulging which occurswith
separation of the two halves of rectusabdominis muscles in midline
at linea alba.
◉ INSPECTION CONT.. Answer: Hernia: abdominal wall weakensand
causes a loop of intestineor abdominal tissue to protrudethrough an
opening in theperitoneum.• Cullen's Sign: superficialbleeding under
the skin aroundthe umbilicus and may indicateintra-abdominal
bleeding.
◉ AUSCULTATING BOWELSOUNDS. Answer: Assess pattern of bowel
sounds causedby peristalsis• Normal: 5-34 clicks or gurgles/min•
Abnormal:• Hyperactive: loud, high pitched, incperistalsis or early
bowel obstruction• Hypoactive: soft, dec peristalsis related
toconstipation• No sounds: constipation, bowelobstruction or
paralytic ileus. Listen for afull 3-5 minutes.
◉ NO SOUND. Answer: LISTEN FOR 3 TO 5 MINUTES
◉ AUSCULTATINGVASCULAR SOUNDS. Answer: Normal: no bruits
heardover arteries• Abnormal: bruits areturbulent blowing
, soundheard over an obstructedartery; usually buildup ofplaque. Do
not want topalpate over this area.Why?
◉ WHY DO WE NOT PALPATE OVER A BRUITS IN ABDOMEN.
Answer: Risk of Dislodging Clots or Causing Rupture: Palpating over
an area with a bruit, especially if it's related to an aneurysm or a
weakened blood vessel, can potentially dislodge a clot or cause the
vessel to rupture. This is particularly a concern in cases of
abdominal aortic aneurysms (AAA), where the artery is already
weakened.
◉ PERCUSSINGABDOMEN. Answer: Assess density and size of
abdominalstructures, air, solid or fluid filled masses in
theabdomen.• Normal: tympany in all four quadrants anddullness
over organs.• Abnormal:Excessive, high pitched tympanic sounds
mayindicate distention.Dullness may indicate inc tissue density
fromorgan enlargement or underlying mass.Pain may indicate
peritoneal inflammation.
◉ NORMAL SOUNDS. Answer: TYMPANY IN ALL FOUR QUADRANTS
AND DULLNESS OVER ORGANS
◉ PERCUSS KIDNEYS. Answer: Need to assess forCVA tenderness.•
Normal: nodiscomfort• Abnormal: pain withpercussion-
kidneystones, pyelonephritis
