Abdominal

Question 1

What is the preferred order for examination of the abdomen?

Answer 1

Inspection, auscultation, percussion, palpation

Question 2

You are in the ER assessing a patient with abdominal pain and fever. You are performing an abdominal examination to assess for peritoneal signs. Which one of the following is not a peritoneal sign?

Answer 2

CVA tenderness

Signs: rebound tenderness, involuntary guarding, rigidity of the abdomen

Question 3

A 15 year old high school student presents to the clinic with a 1 day history of nausea and anorexia. He describes the pain as generalized yesterday, but today it has localized to the right lower quadrant. You palpate the LLQ and the patient experiences pain in the RLQ. What is the name of this sign?

Answer 3

Rovsing’s sign

Question 4

A patient presents to the ER after a motor vehicle accident. The patient sustained blunt trauma to the abdomen and complains of pain in the upper left quadrant that radiates to the left shoulder. What organ is most likely injured?

Answer 4

Spleen

Question 5

Patients presenting with ascites, jaundice, cutaneous spider veins, and nonpalpable liver exhibit signs of:

Answer 5

Cirrhosis

Question 6

Percussion of the abdomen begins with establishing

Answer 6

Overall dullness and tympany in all quadrants.

Question 7

Urinary incontinence that occurs from the inability to hold urine when the stimulus to urinate is perceived is called……incontinence.

Answer 7

Urge

Question 8

When examining a patient with tense abdominal musculature, a helpful technique is to have the patient

Answer 8

Flex his or her knees

Question 9

When palpating the aorta, a prominent lateral pulsation suggests

Answer 9

Aortic aneurysm

Question 10

You ask the patient to raise the head and shoulders while lying in a supine position. A midline abdominal ridge rises. You chart this observation as:

Answer 10

Diastasis recti

Question 12

Which abdominal structures are contained within the right upper quadrant?

Answer 12

Liver, gallbladder, pylorus, duodenum, hepatic flexure of colon, and head of pancreas.

Question 14

Which abdominal structures are contained within the left upper quadrant?

Answer 14

Spleen, splenic flexure of the colon, stomach, and the body and tail of pancreas.

Question 15

Which abdominal structures are contained within the left lower quadrant?

Answer 15

Sigmoid colon, descending colon, and left ovary

Question 16

Which abdominal structures are contained within the right lower quadrant?

Answer 16

Cecum, appendix, ascending colon, terminal ileum, and right ovary.

Question 17

What should the NP suspect in a patient with pain disproportionate to physical findings?

Answer 17

Intestinal mesenteric ischemia

Question 18

What are some key signs of peritonitis?

Answer 18

• a steady aching pain that is usually more severe than visceral pain and more precisely localized over the involved structure
• typically aggravated by movement or coughing
• patients with parietal pain usually prefer to lie still

Question 19

What is a key sign in patients with colicky pain from a renal stone?

Answer 19

Patient moving around frequently trying to find a comfortable position

Question 20

Referred pain

Answer 20

• pain felt at distant sites from disordered structures
• palpation at the site of referred pain often does not result in tenderness
• pain of duodenal or pancreatic origin may be referred to the back
• pain from the biliary tree to the right scapular region or the right posterior thorax
• pain from pleurisy or inferior wall MI may be referred to the epigastric area