A nurse performs an abdominal assessment on a patient presenting with abdominal pain. In what sequential order should the four physical examination techniques be conducted on the abdomen to avoid altering bowel motility?

Answer and explanation

Correct answer: A. Inspection, Auscultation, Percussion, Palpation

  1. Step 1: In abdominal physical examination, the standard sequence is Inspection followed immediately by Auscultation, and then Percussion and Palpation.
  2. Step 2: Auscultation must precede percussion and palpation because mechanical palpation or percussion can stimulate artificial bowel motility and alter the frequency of bowel sounds.
Answer
Inspection, Auscultation, Percussion, Palpation.
Why not the others: 'Inspection, Palpation, Percussion, Auscultation' is the sequence used for the chest/pulmonary examination, which is incorrect for the abdomen; 'Palpation first' stimulates spurious peristalsis; 'Auscultation before inspection' skips initial visual inspection of contour, scars, and pulsations.

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