While auscultating a client’s abdomen, the nurse hears a low-pitched blowing sound in the upper midline area. Which is the likely indication of this finding?
A minor variation.
Normal borborygmus sounds.
Possible renal artery stenosis.
Hyperactive bowel sounds.
The Correct Answer is C
Choice A rationale
A minor variation may refer to a benign finding or a slight deviation from the norm. However, a low-pitched blowing sound in the upper midline area would not typically be considered a minor variation and may warrant further investigation.
Choice B rationale
Borborygmi are normal bowel sounds characterized by gurgling, rumbling, or growling noises produced by the movement of gas and fluid in the intestines. However, a low-pitched blowing sound in the upper midline area would not typically be described as normal borborygmi.
Choice C rationale
A low-pitched blowing sound in the upper midline area could indicate a renal artery bruit, which is a sign of renal artery stenosis. Renal artery stenosis is a narrowing of the renal artery, often due to atherosclerosis, which can lead to decreased blood flow to the kidneys. A renal artery bruit may be auscultated over the renal arteries and is indicative of turbulent blood flow through the narrowed artery.
Choice D rationale
Hyperactive bowel sounds are typically characterized by loud, high-pitched gurgles heard throughout the abdomen. They are often associated with increased intestinal motility, such as in gastroenteritis or diarrhea, rather than a low-pitched blowing sound in the upper midline area.
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Correct Answer is D
Explanation
Choice A rationale
Esophagitis refers to inflammation of the esophagus, often due to reflux of gastric contents into the esophagus. Symptoms may include heartburn, difficulty swallowing, and chest pain, but the pain is typically not related to hunger and food intake as described in the scenario.
Choice B rationale
Chronic pancreatitis typically presents with persistent, dull abdominal pain that may radiate to the back, often aggravated by eating rather than relieved by it. The pain associated with chronic pancreatitis is not typically described as gnawing or relieved by eating.
Choice C rationale
Gastroesophageal reflux disease (GERD) involves the reflux of gastric contents into the esophagus, leading to symptoms such as heartburn, regurgitation, and chest pain. While GERD can cause epigastric discomfort, the described pattern of pain worsening with hunger and improving after eating is more indicative of peptic ulcer disease (PUD).
Choice D rationale
Peptic ulcer disease (PUD) is the correct answer. The symptoms described, including gnawing epigastric pain that worsens when hungry and improves after eating, are classic manifestations of peptic ulcer disease (PUD). Peptic ulcers are erosions in the mucosal lining of the stomach or duodenum, often caused by Helicobacter pylori infection or nonsteroidal anti- inflammatory drugs (NSAIDs)5.
Correct Answer is B
Explanation
Choice A rationale
Asking the client to describe any other related symptoms is important for a comprehensive assessment but does not objectively confirm the presence of fever.
Choice B rationale
Placing the dorsum of the hand on the client’s forehead is a quick and practical method to assess for fever. It provides an initial subjective assessment of the client’s temperature before taking an accurate measurement with a thermometer.
Choice C rationale
Using both hands to hold and palpate the client’s hands may help assess for other symptoms such as clamminess or coldness but does not objectively confirm the presence of fever.
Choice D rationale
Lightly pinching a fold of skin over the client’s sternum assesses skin turgor and hydration status but does not objectively confirm the presence of fever.