1. Which heart rate would be found in a 4-month-old infant with bradycardia?
1. 50
2. 70
3. 80
4. 90:
Answer 1. 50
2. Which soft, lobulated gland is located behind the stomach?
1. Liver
2. Spleen
3. Pancreas
4. Gallbladder:
Answer 3. Pancreas
The pancreas is a soft, lobulated gland located behind the stomach. It stretches obliquely
acrossthe posterior abdominal wall to the left upper quadrant.The liver fills most of the right
upper quadrant and extends over to the left midclavicular line.The spleen is a soft mass of
lymphatic tissue on the posterolateral wall of the abdominal cavity. It lies just under the
diaphragm.The gallbladder rests under the posterior surface of the liver, just lateral to the
right midclavicular line.
3. Which is the nurse performing when placing the stethoscope over the xiphoid process
while lightly stroking the skin with one finger up the midclavicular line from the right lower
quadrant (RLQ)?
1. Liverspan
2. Scratch test
3. Splenic dullnessscreening
4. Detecting voluntary guarding:
Answer 2. scratch test
The scratch test is a traditional technique to detect the lower border of the liver.The nurse
placesthe stethoscope over the xiphoid process while lightly stroking the skin with one
finger up the midclavicular line fromthe right lower quadrant (RLQ), parallel to the liver
border. As the nurse reaches the liver edge, the sound magnifies in the stethoscope.The
percussion method detects the liver span. Splenic dullness is the method of detecting the
spleen. Often, the stomach obscures the spleen.Voluntary guarding occurs when the person
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