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University of Maine at Fort Kent

Division of Nursing
NUR 309: Holistic Health Assessment
Quiz #4: Abdomen, Respiratory, Cardiac, & Peripheral Vascular System

Please use this document to help you answer questions as you go through your reading
assignments. You will still need to upload the answers on Blackboard for Quiz #4 for grading
and to see the correct responses.

1. To detect diastasis recti, the nurse should have the patient perform which of these maneuvers?
A) Relax in the supine position.
B) Raise the arms in the left lateral position.
C) Raise the arms over the head while supine.
D) Raise the head while remaining supine.

2. A 22-year-old man comes to the clinic for an examination after falling off his motorcycle and
landing on his left side on the handlebars. The nurse suspects that he may have injured his
spleen. Which of the following would be important to note? Select all that apply
a. If the spleen is enlarged, it should not be palpated because it can rupture easily.
b. The spleen is located in the epigastric area
c. If there is internal bleeding, the Cullen’s sign might be present
d. The spleen is normally palpable
e. Percussion over the spleen would yield a tympanic sound

3. A patient has hypoactive bowel sounds. The nurse knows that a potential cause of hypoactive
bowel sounds is:
A) peritonitis
B) diarrhea.
C) laxative use.
D) gastroenteritis.

4. The nurse notices that a patient has had a black, tarry stool and recalls that a possible cause
would be:
a. gallbladder disease
b. overuse of laxatives
c. gastrointestinal bleeding
d. localized bleeding around the anus

5. During an abdominal assessment, the nurse is unable to hear bowel sounds in a patient’s
abdomen. Before reporting this finding as “silent bowel sounds” the nurse should listen for at
least:
a. 1 minute
b. 5 minutes
c. 10 minutes
d. 2 minutes in each quadrant
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6. The nurse suspects that a patient has appendicitis. Which of these procedures are appropriate for
use when assessing for appendicitis or a perforated appendix? Select all that apply
A) Test for Murphy’s sign.
B) Perform obturator muscle test.
C) Test for shifting dullness.
D) Perform iliopsoas muscle test.
E) Test for fluid wave.

7. The nurse is assessing a client with reports of right upper quadrant pain that radiates toward the
right upper portion of the back. The client states, “This has been happening more often after I
eat rich, high-fat foods.” The nurse would suspect which of the following?
a. Duodenal ulcer
b. Gastritis
c. Pancreatitis
d. Cholecystitis

8. The nurse is performing an abdominal assessment on the client. Rank the following steps of
assessment in the order that they should be performed. Click and drag the options below to
move them up or down.
Choice 1. Percuss the abdomen.
Choice 2. Visualize the quadrants of the abdomen.
Choice 3. Palpate the abdomen.
Choice 4. Auscultate the abdomen.
Choice 5. Encourage the client to void.

9. A 20-year-old male college student has had abdominal pain for 3 days. It started at his
umbilicus and was associated with nausea and vomiting. He was unable to find a comfortable
position. Yesterday, the pain became more severe and constant. Now, he hesitates to walk,
because any motion makes the pain much worse. It is localized just medial and inferior to his
iliac crest on the right lower abdominal quadrant. Which of the following is most likely?
a. Peptic ulcer
b. Cholecystitis
c. Pancreatitis
d. Appendicitis

10. The nurse is percussing over the lungs of a patient with pneumonia. The nurse knows that
percussion over an area of atelectasis in the lungs would reveal:
a. resonance.
b. tympany
c. dullness.
d. hyperresonance
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11. A 65-year-old patient with a history of heart failure comes to the clinic with complaints of
“being awakened from sleep with shortness of breath.” Which action by the nurse is most
appropriate?
a. Obtain a detailed history of the patient’s allergies and history of asthma
b. Tell the patient to sleep on his or her right side to facilitate ease of respirations
c. Assess for other signs and symptoms of paroxysmal nocturnal dyspnea
d. Assure the patient that this is normal and will probably resolve within the next week

12. A patient with pleuritis has been admitted to the hospital and complains of pain with breathing.
What other key assessment finding would the nurse expect to find upon auscultation?
a. Wheezing
b. Crackles
c. Stridor
d. Friction rub

13. Which of the following occurs in respiratory distress?

a. Skin between the ribs moves inward with inspiration
b. Speaking in sentences of 10–20 words
c. Neck muscles are relaxed
d. Patient torso leans posteriorly

14. During an assessment of a healthy adult, where would the nurse expect to palpate the apical
impulse?
A) Third left intercostal space at the midclavicular line
B) Fourth left intercostal space at the sternal border
C) Fifth left intercostal space at the midclavicular line
D) Fourth left intercostal space at the anterior axillary line

15. During the cardiac auscultation the nurse hears two sounds when listening to S2 at the second
left intercostal space. To further assess this sound, what should the nurse do?
a. Ask the patient to hold his breath while the nurse listens again
b. No further assessment is needed because the nurse knows it is an S3
c. Have the patient turn to the left side while the nurse listens with the bell
d. Watch the patient’s respirations while listening for effect on the sound

16. A 57-year-old maintenance worker comes to your office for evaluation of pain in his legs. He
has smoked two packs per day since the age of 16, but he is otherwise healthy. Which of the
following symptoms would indicate peripheral vascular disease?
a. Intermittent claudication
b. Chest pressure with exertion
c. Shortness of breath
d. Knee pain
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17. You are performing a routine check-up on an 81-year-old retired cotton farmer in the vascular
surgery clinic. You note that he has a history of chronic arterial insufficiency. Which of the
following physical examination findings in the lower extremities would be expected with this
disease?
a. Normal pulsation
b. Thin, shiny, atrophic skin
c. Normal temperature
d. Marked edema

18. The nurse is assessing the pulses of a patient who has been admitted for untreated
hyperthyroidism. The nurse should expect to find a(n) _____ pulse.
A) normal
B) absent
C) bounding
D) weak, thready

19. To hear extra heart sounds or murmurs, the nurse should ask patients to:
a. Lie on their back
b. Lie on their left side
c. Lie on their right side
d. Sit up and take a deep breath

20. A palpable rushing vibration over the base of the heart at the is called a:
a. Heave
b. Lift
c. Thrill
d. Thrust