A client presents to the emergency department because he is coughing up blood. His wife reports that the client has cirrhosis of the liver and increased confusion. How should the nurse perform an abdominal assessment?

Rationale: A. The standard physical assessment sequence is usually inspection, auscultation, percussion, and palpation, not beginning with auscultation before inspection. Following the wrong sequence may lead to inaccurate assessment findings. B. In clients with cirrhosis and possible abdominal complications (e.g., ascites, tenderness), the abdominal assessment should begin with inspection, followed by auscultation before palpation and percussion. Palpation or percussion before auscultation can stimulate bowel activity and give false bowel sound readings. Since this client is also confused, careful auscultation first ensures accurate assessment while minimizing discomfort or distress. C. Palpation should begin away from painful areas to avoid causing guarding or spasm that can interfere with assessment. Starting with the most painful areas can increase patient discomfort and make it difficult to accurately assess abdominal findings. D. While inspection is first, auscultation should be performed before palpation and percussion to obtain accurate bowel sounds. Simply ending with palpation without auscultation first does not follow best-practice assessment protocols.