A 45-year-old female states that her abdominal pain feels similar to a previous small bowel obstruction. What sign would support her assessment?

Decreased bowel sounds in the lower quadrants would support the assessment of a small bowel obstruction in this case. In the context of a small bowel obstruction, it is common to experience a reduction in bowel sounds as the intestine struggles to move contents past the obstruction. This phenomenon occurs because the normal peristaltic movement is impaired, leading to a less active bowel.

In contrast, increased bowel sounds might suggest an early stage of intestinal obstruction or a different type of digestive issue rather than confirming a significant obstruction. Abdominal distension can be a sign of many abdominal conditions and, while it may accompany a bowel obstruction, it is not a specific indicator. Visible peristalsis might occur in cases of obstruction but often indicates a severe or prolonged situation; it is not as reliable as the assessment of bowel sounds for confirming obstructions. Therefore, the diminished bowel sounds in the lower quadrants align closely with the clinical picture of a small bowel obstruction.