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    HEALTH ASSESSMENT PROCTORED EXAM

    The nurse is percussing the patient's abdomen. Which percussion tone should be heard over the liver?

    Explanation & Rationale

    A. Hyperresonance: This lower-pitched, booming sound is typically elicited over hyperinflated lung tissue, such as in emphysema or pneumothorax. It occurs when an abnormally large amount of air is trapped. It is not the physiological sound produced by solid abdominal viscera. B. Borborygmus: This term refers to the audible hyperactive bowel sounds produced by the movement of gas and fluid through the intestines. It is an auscultatory finding rather than a percussion tone. It does not describe the sound produced by percussing the liver. C. Dullness: This medium-pitched, thud-like sound is the standard percussion note over solid organs. The liver, being a dense parenchymal organ, absorbs sound waves rather than reflecting them. It is the expected finding when percussing the right upper quadrant. D. Tympany: This high-pitched, drum-like sound is heard over air-filled structures like the stomach or intestines. It predominates in the abdomen due to presence of gas. It would be an abnormal finding if heard directly over the solid liver.

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