Certified Medical-Surgical Registered Nurse Practice Exam

Which sequence should a nurse follow during an abdominal assessment?

1. Auscultation, inspection, percussion, palpation

2. Inspection, auscultation, percussion, palpation

3. Palpation, auscultation, percussion, inspection

4. Percussion, palpation, auscultation, inspection

The correct answer is: Inspection, auscultation, percussion, palpation

The correct sequence for an abdominal assessment is to begin with inspection, followed by auscultation, percussion, and finally palpation. This order is crucial due to the physiological characteristics of the abdomen and the effects of examination techniques. Starting with inspection allows the nurse to assess the abdomen's shape, color, and any visible abnormalities such as lesions or distention. This step provides crucial visual information that can guide subsequent assessments. Auscultation comes next because it involves listening to bowel sounds, and performing this step after palpation might alter the sounds due to stimulation of the abdomen. By conducting auscultation before any manipulation, the nurse can obtain a more accurate assessment of the bowel activity and vascular sounds. Percussion is performed next to assess the size and density of underlying organs. This technique helps to identify areas of tenderness or abnormal mass characteristics without disturbing the organs or bowel sounds. Lastly, palpation is appropriate in this sequence since it involves physical manipulation of the abdomen. Palpation can cause discomfort or alteration in bowel sounds, which is why it is ideally performed after the other techniques. It allows the nurse to evaluate the abdominal organs' size, shape, and tenderness comprehensively. Understanding this sequence is vital for an effective and accurate abdominal assessment, ensuring