NUR 5461/NUR5461 Module 5 V2 |
Digestive System Q&A with Rationale |
William Paterson University
1. When performing an abdominal physical assessment, which sequence should the advanced
practice nurse follow?
A. Percussion, Auscultation, Inspection, Palpation
B. Inspection, Palpation, Percussion, Auscultation
C. Auscultation, Inspection, Palpation, Percussion
D. Inspection, Auscultation, Percussion, Palpation
Correct Answer: D
Expert Explanation: The correct clinical sequence for an abdominal assessment is
inspection, followed by auscultation, percussion, and finally palpation. This specific order is
necessary because physical manipulation of the abdomen through percussion or palpation
can stimulate peristalsis. Altering the sequence might lead to the assessment of false or
hyperactive bowel sounds that do not represent the patient’s resting state.
2. A patient presents with sharp pain in the right upper quadrant (RUQ) that radiates to the
right scapula. Which clinical sign is most likely to be positive?
A. Murphy’s sign
B. Psoas sign
,C. Rovsing’s sign
D. Grey Turner’s sign
Correct Answer: A
Expert Explanation: Murphy’s sign is a clinical test used during an abdominal exam to
help diagnose acute cholecystitis. The nurse asks the patient to inhale while palpating the
area of the gallbladder under the liver border. If the patient experiences sharp pain and
abruptly stops inspiration, the sign is considered positive for gallbladder inflammation.
3. Which physical exam finding is characteristic of appendicitis when palpating the left lower
quadrant results in pain in the right lower quadrant?
A. Blumberg sign
B. Rovsing’s sign
C. McBurney’s point tenderness
D. Cullen’s sign
Correct Answer: B
Expert Explanation: Rovsing’s sign is identified when pressure applied to the left lower
quadrant (LLQ) of the abdomen causes pain in the right lower quadrant (RLQ). This
phenomenon occurs due to the displacement of gas and the stretching of the peritoneum
over the inflamed appendix. It is a classic indicator used in the assessment of acute
appendicitis.
, 4. A patient with suspected acute pancreatitis displays a bluish discoloration around the
umbilicus. What is this finding called?
A. Cullen’s sign
B. Grey Turner’s sign
C. Murphy’s sign
D. Kehr’s sign
Correct Answer: A
Expert Explanation: Cullen’s sign is the clinical manifestation of superficial edema and
bruising in the subcutaneous fatty tissue around the umbilicus. This finding is often
associated with severe acute pancreatitis or intra-abdominal hemorrhage. It indicates that
blood has tracked from the retroperitoneum to the anterior abdominal wall.
5. While assessing a patient with chronic liver disease, the nurse notes flapping tremors of
the hands when the arms are extended. What is the clinical term for this?
A. Ascites
B. Asterixis
C. Caput medusae
D. Scleral icterus
Correct Answer: B
Digestive System Q&A with Rationale |
William Paterson University
1. When performing an abdominal physical assessment, which sequence should the advanced
practice nurse follow?
A. Percussion, Auscultation, Inspection, Palpation
B. Inspection, Palpation, Percussion, Auscultation
C. Auscultation, Inspection, Palpation, Percussion
D. Inspection, Auscultation, Percussion, Palpation
Correct Answer: D
Expert Explanation: The correct clinical sequence for an abdominal assessment is
inspection, followed by auscultation, percussion, and finally palpation. This specific order is
necessary because physical manipulation of the abdomen through percussion or palpation
can stimulate peristalsis. Altering the sequence might lead to the assessment of false or
hyperactive bowel sounds that do not represent the patient’s resting state.
2. A patient presents with sharp pain in the right upper quadrant (RUQ) that radiates to the
right scapula. Which clinical sign is most likely to be positive?
A. Murphy’s sign
B. Psoas sign
,C. Rovsing’s sign
D. Grey Turner’s sign
Correct Answer: A
Expert Explanation: Murphy’s sign is a clinical test used during an abdominal exam to
help diagnose acute cholecystitis. The nurse asks the patient to inhale while palpating the
area of the gallbladder under the liver border. If the patient experiences sharp pain and
abruptly stops inspiration, the sign is considered positive for gallbladder inflammation.
3. Which physical exam finding is characteristic of appendicitis when palpating the left lower
quadrant results in pain in the right lower quadrant?
A. Blumberg sign
B. Rovsing’s sign
C. McBurney’s point tenderness
D. Cullen’s sign
Correct Answer: B
Expert Explanation: Rovsing’s sign is identified when pressure applied to the left lower
quadrant (LLQ) of the abdomen causes pain in the right lower quadrant (RLQ). This
phenomenon occurs due to the displacement of gas and the stretching of the peritoneum
over the inflamed appendix. It is a classic indicator used in the assessment of acute
appendicitis.
, 4. A patient with suspected acute pancreatitis displays a bluish discoloration around the
umbilicus. What is this finding called?
A. Cullen’s sign
B. Grey Turner’s sign
C. Murphy’s sign
D. Kehr’s sign
Correct Answer: A
Expert Explanation: Cullen’s sign is the clinical manifestation of superficial edema and
bruising in the subcutaneous fatty tissue around the umbilicus. This finding is often
associated with severe acute pancreatitis or intra-abdominal hemorrhage. It indicates that
blood has tracked from the retroperitoneum to the anterior abdominal wall.
5. While assessing a patient with chronic liver disease, the nurse notes flapping tremors of
the hands when the arms are extended. What is the clinical term for this?
A. Ascites
B. Asterixis
C. Caput medusae
D. Scleral icterus
Correct Answer: B
