Assessment of a client reveals a distended abdomen with some bulging of the flanks. Which test would be most accurate in confirming nurse's suspicions?
Abdominal x-ray
Shifting dullness
Fluid wave
Ultrasound
The Correct Answer is D
A. Abdominal x-ray: While it can show gas or bowel obstructions, it is less effective for confirming fluid presence.
B. Shifting dullness: This physical exam technique can indicate fluid but is less accurate than ultrasound.
C. Fluid wave: This physical exam can help suggest the presence of fluid, but it is also less reliable than imaging studies.
D. Ultrasound: An ultrasound is the most accurate and non-invasive way to confirm the presence of fluid, such as ascites, in the abdomen. It provides detailed imaging and confirmation without invasive procedures.
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Correct Answer is B
Explanation
A. Intake and output: Although helpful, intake and output measurements can sometimes be inaccurate, as not all fluid retention may be recorded.
B. Daily weight: Daily weight measurements are the most reliable way to assess fluid retention because changes in body weight accurately reflect gains or losses in body fluid, especially in clients with chronic kidney disease.
C. Sodium level: Sodium levels can indicate fluid imbalances, but they do not directly measure fluid volume excess.
D. Skin tenting: Skin tenting is used to assess dehydration, not fluid retention, and is not a reliable measure in chronic kidney disease.
Correct Answer is D
Explanation
A. A client who has pneumonia: Pneumonia typically requires droplet precautions, not airborne.
B. A client who has shigella: Shigella is transmitted through the fecal-oral route, so contact precautions would be appropriate.
C. A client who has strep throat: Streptococcal infections are spread by droplets, so droplet precautions are indicated, not airborne.
D. A client who has tuberculosis: Tuberculosis (TB) is spread via airborne droplets, so airborne precautions are necessary to prevent transmission.