ABDOMINAL EXAM PRE-TEST

1. Which of the following statements is/are true concerning the physical findings of a
patient with a mechanical bowel obstruction?
a. fever and tachycardia are usually present within the first 12 hours of the
obstruction.
b. Dehydration is rarely present before vomiting develops.
c. Even in the absence of peritonitis, palpation during attacs of pain may reveal
tenderness and cause guarding.
d. E!cept for instances in which blocage is incomplete, auscultatory findings
are sufficiently nonspecific that they do not assist in the evaluation of the
patient with a bowel obstruction.
2. "atch each of the terms in the left column with one or more associated types of
abdominal pain in the right.
a. diffuse, poorly locali#ed 1. visceral pain
b. hollow viscus wall tension 2. somatic pain
c. parietal peritoneum $. referred pain
d. convergence%pro&ection hypothesis
e. associated sweating, nausea, tachycardia
$. 'n the clinical evaluation of abdominal pain, which of the following characteristics of
pain is/are important to elicit?
a. character
b. severity
c. location
d. timing
e. aggravating and alleviation factors
(. )onstipation is not associated with which one or more of the following?
a. psychogenic factors
b. high%fiber diet
c. inflammatory bowel disease
d. spinal cord tumor
e. anal fissure
f. colorectal tumor
*. "atch each of the clinical situations in the left column with the cause of intestinal
obstruction most liely to be involved in the right column.
a. a *%year old boy with small bowel obstruction 1. +eoplasm
b. a ,-%year old man with colonic obstruction . no 2. /dhesive band
previous surgery $. 'ncarcerated hernia
c. a (0%year old woman with small bowel obstruction (. 1olvulus
$ years after abdominal hysterectomy for fibroids *. Diverticulitis
,. "atch each of the radiographic findings in the left column with one or more
associated forms of bowel obstruction in the right column
a. moderate gaseous dilatation of the 1. )olonic obstruction with
entire small and large bowel competent ileocecal valve
b. gaseous distension of the small bowel 2. 'leus
with no gas in the colon $. )omplete small bowel obstruction
c. gaseous distension of the small bowel (. 2artial small bowel obstruction
d. distended colon from cecum to descending
colon with no small bowel gas
3. Which of the following signs are not suggestive of an acute abdomen4
a. guarding
b. rebound
c. active bowel sounds
d. rigidity
-. 5an the following in order in which you should approach an abdominal e!am4
a. auscultation
b. percussion
c. inspection
d. palpation
6. 7ow should you approach a patient with abdominal pain4
a. the patient has pain . have the nurse give pain medication and then e!amine the
patient.
b. the patient has pain . e!amine the patient and then order pain medication.
c. order !%rays and labs and then e!amine the patient
d. as the nurse to e!amine the patient and report bac
10. 7ow do you characteri#e your ability to perform an abdominal e!am4
a. have no idea
b. now a few things to chec
c. understand the e!am but could be better
d. competent
e. ' am so good ' never need to order a )8 scan
/bdominal E!am 2re%8est /nswer 9ey
1. )
2. a. 1,$
b. 1
c. 2
d. $
e. 2
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*. a. (
b.1
c.2
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b. $
c. (
d. 1
3. )
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6. :
ABDOMINAL EXAM - POST-TEST
1. / $- year old female presents with a 12 hour history of epigastric and right upper
;uadrant abdominal pain, anore!ia, and dar colored urine. 8he best radiologic test
to determine the diagnosis is4
a. abdominal series
b. '12
c. <ltrasound
d. )8 scan
e. "5'
2. 8he most liely diagnosis of the patient described in ;uestion 1 is4
a. gastroenteritis
b. peptic ulcer disease
c. acute cholecystitis
d. appendicitis
e. pelvic inflammatory disease
$. / 61 year old female presents with mild nausea and abdominal distension. Which of
the following would be the least liely diagnosis.
a. colon cancer
b. bowel obstruction
c. ascites
d. esophageal cancer
e. perforated duodenal ulcer
(. Which of the following is usually not associated with significant pain4
a. anal fissure
b. perirectal abscess
c. internal hemorrhoids
d. e!ternal hemorrhoids
*. Which of the following physical signs most liely points to an acute abdomen4
a. pain on deep palpation
b. pain on light palpation
c. diffuse pain
d. locali#ed pain
e. rebound
,. Which of the following are possible causes of right lower ;uadrant pain4
a. appendicitis
b. ovarian torsion
c. cholecystitis
d. diverticulitis
e. inflammatory bowel disease
3. / "urphy=s sign suggests4
a. appendicitis
b. ectopic pregnancy
c. metastatic gastric cancer
d. cholecystitis
e. diverticulitis
-. 7ow should you approach a patient with abdominal pain4
a. the patient has pain . have the nurse order pain medication and then e!amine
the patient.
b. the patient has pain . e!amine the patient and then order pain medication.
c. order !%rays and labs and then e!amine the patient
d. as the nurse to e!amine the patient and report bac
6. 7ow do you characteri#e your ability to perform an abdominal e!am4
a. have no idea
b. now a few things to chec
c. understand the e!am but could be better
d. competent
e. ' am so good ' never need to order a )8 scan
10. 7ow would you rate today=s session4
a. a waste of my time
b. it could have been better
c. ade;uate
d. ' en&oyed myself and learned something
e. this was the best day of medical school so far
Abdominal Exam Post-Test Answer Ke
1. )
2. )
$. D
(. )
*. :
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3. D
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