Chapter 17 Test Questions

Question 1

Pain to palpation of the costovertebral angle is MOST suggestive of:

A. pyelonephritis.

B. diverticulitis.

C. pancreatitis.

D. cholecystitis.

Answer 1

A. pyelonephritis.

Question 2

Which of the following illnesses or conditions would MOST likely predispose a patient to chronic renal failure?

A. Staph infection

B. Kidney stones

C. Strep throat

D. Pericarditis

Answer 2

C. Strep throat

Question 3

The _____________ is a retroperitoneal abdominal organ.

A. liver

B. spleen

C. bladder

D. kidney

Answer 3

D. kidney

Question 4

The primary role of the large intestine is to:

A. complete the reabsorption of water.

B. break down food so it can be digested.

C. receive bile and begin the digestion process.

D. receive digestive enzymes from the pancreas.

Answer 4

A. complete the reabsorption of water.

Question 5

Your general impression of a 50-year-old man with acute abdominal pain reveals that he is confused and has pale, diaphoretic skin. After correcting any problems with airway, breathing, and circulation, your main focus should be on:

A. assessing his vital signs.

B. administering IV fluid boluses.

C. prompt transport to the hospital.

D. performing a secondary assessment.

Answer 5

C. prompt transport to the hospital.

Question 6

The liver secretes ________, which is an enzyme that the body uses to:

A. bile, dissolve fats into solution.

B. glucagon, convert glycogen to glucose.

C. chyme, remove waste products.

D. hydrochloric acid, break down foods.

Answer 6

A. bile, dissolve fats into solution.

Question 7

The ____________ is a solid organ.

A. gallbladder

B. ovary

C. stomach

D. urinary bladder

Answer 7

B. ovary

Question 8

A 69-year-old male with a history of hypertension and insulin-dependent diabetes complains of an acute onset of tearing pain in the lower quadrants of his abdomen that radiates to the back. His blood pressure is 90/50 mm Hg, pulse is 110 beats/min and thready, and respirations are 24 breaths/min and shallow. This clinical presentation is MOST consistent with:

A. inflammation of the liver or spleen.

B. acute inflammation of the pancreas.

C. rupture of the vermiform appendix.

D. ruptured or dissecting aortic aneurysm.

Answer 8

D. ruptured or dissecting aortic aneurysm.

Question 9

A 27-year-old male complains of an acute onset of abdominal pain. He is found curled in a fetal position with his right knee drawn up into his abdomen. This position is MOST commonly seen in patients with acute:

A. pancreatitis.

B. cholecystitis.

C. appendicitis.

D. gastroenteritis.

Answer 9

C. appendicitis.

Question 10

Which of the following blood pressure readings indicates orthostatic hypotension?

A. BP lying down, 112/60 mm Hg; BP sitting up, 100/54 mm Hg

B. BP lying down, 116/66 mm Hg; BP standing up, 114/68 mm Hg

C. BP lying down, 122/82 mm Hg; BP sitting up, 118/78 mm Hg

D. BP lying down, 134/84 mm Hg; BP standing up, 136/72 mm Hg

Answer 10

A. BP lying down, 112/60 mm Hg; BP sitting up, 100/54 mm Hg

Question 11

Which of the following causes of an acute abdomen would be LEAST likely to present with fever?

A. Appendicitis prior to rupture and abscess formation

B. Inflammation of the small pockets in the large intestine

C. Acute cholecystitis caused by the presence of gall stones

D. Acute pancreatitis secondary to an infectious process

Answer 11

A. Appendicitis prior to rupture and abscess formation

Question 12

You are dispatched to an office complex for a middle-aged male with acute abdominal pain. Your assessment reveals that he is conscious, restless, and in severe pain. His airway is patent, his breathing is adequate, and his vital signs are stable. Treatment for this patient should include all of the following, EXCEPT:

A. avoiding giving him anything to drink.

B. placing him supine and elevating his legs.

C. 100% oxygen via nonrebreathing mask.

D. A large-bore IV set to keep the vein open.

Answer 12

B. placing him supine and elevating his legs.

Question 13

When assessing a patient with acute atraumatic abdominal pain, you should:

A. place the patient supine with his or her knees flexed.

B. vigorously palpate the abdomen to assess for rigidity.

C. encourage the patient to keep his or her legs straight.

D. auscultate bowel sounds for at least 2 to 3 minutes.

Answer 13

A. place the patient supine with his or her knees flexed.

Question 14

A 29-year-old pregnant woman complains of severe vomiting, which has persisted for 2 days. During your assessment, she vomits a large amount of blood and begins to develop signs of shock. You should suspect:

A. esophagitis.

B. gastroenteritis.

C. esophageal varices.

D. Mallory-Weiss syndrome.

Answer 14

D. Mallory-Weiss syndrome.

Question 15

Which of the following pain patterns is MOST consistent with kidney stones?

A. Retropubic pain without radiation

B. Flank pain that radiates to the groin

C. Flank pain with referred pain to the shoulders

D. Localized costovertebral angle tenderness

Answer 15

B. Flank pain that radiates to the groin

Question 16

In contrast to visceral pain, somatic pain:

A. is difficult to localize.

B. is generally well localized.

C. occurs when an organ is stretched.

D. is described as burning or gnawing.

Answer 16

B. is generally well localized.

Question 17

A 19-year-old female presents with severe pain to the left lower quadrant of her abdomen. She is restless, tachypneic, and tachycardic. When you inquire about her last menstrual period, she tells you that it was approximately 2 months ago. You should suspect:

A. a ruptured ectopic pregnancy.

B. pelvic inflammatory disease.

C. acute abruption of the placenta.

D. acute rupture of an ovarian cyst.

Answer 17

A. a ruptured ectopic pregnancy.

Question 18

A 67-year-old male complains of burning sensation in his abdomen and hematemesis. During your assessment, you note pain to palpation of his left upper quadrant; his vital signs are suggestive of shock. Which of the following conditions should you suspect?

A. Chronic hepatitis

B. Bleeding peptic ulcer

C. Viral gastroenteritis

D. Acute cholecystitis

Answer 18

B. Bleeding peptic ulcer

Question 19

Disease or inflammation of organs that lie behind or beneath the abdominal cavity can cause signs of peritonitis because the:

A. organs become significantly enlarged due to the disease process.

B. visceral peritoneum is highly vascular and prone to hemorrhage.

C. large volumes of fluid accumulate in the retroperitoneal space.

D. parietal peritoneum is richly supplied with very sensitive nerves.

Answer 19

D. parietal peritoneum is richly supplied with very sensitive nerves.

Question 20

Peritonitis is almost always associated with nausea and vomiting because:

A. the smooth muscles in the intestine are usually hyperactive.

B. excessive bile produced by the liver is irritating to the stomach.

C. the patient is typically anorexic and vomits bile from the stomach.

D. absent peristalsis prevents movement of food through the GI tract.

Answer 20

D. absent peristalsis prevents movement of food through the GI tract.

Question 21

You are treating a 50-year-old female with severe abdominal pain. She is conscious but restless, and is begging you for pain medication. Her blood pressure is 136/88 mm Hg, pulse is 120 beats/min and strong, and respirations are 24 breaths/min with adequate tidal volume. After administering 100% oxygen, you should:

A. request a paramedic to administer analgesia to the patient.

B. give her small sips of water, but only if she is not nauseated.

C. start a large-bore IV and set it at a keep the vein open rate.

D. administer 20 mL/kg fluid boluses through two large-bore IVs.

Answer 21

C. start a large-bore IV and set it at a keep the vein open rate.

Question 22

Peritonitis typically causes ileus, which is the result of:

A. a laceration to the small intestine.

B. an obstruction of the large bowel.

C. a necrotic loop of the large intestine.

D. absent peristalsis in the intestine.

Answer 22

D. absent peristalsis in the intestine.

Question 23

During your assessment of an elderly woman, you note a shunt on her left forearm. This indicates that she:

A. has had peritoneal dialysis in the past.

B. has had numerous IVs in her forearm.

C. receives chemotherapy for cancer.

D. receives hemodialysis treatments.

Answer 23

D. receives hemodialysis treatments.

Question 24

It is important to avoid giving anything by mouth to a patient with acute abdominal pain because:

A. the stomach must be empty prior to surgical intervention.

B. IV analgesia given by paramedics typically cause nausea.

C. absent peristalsis will cause rapid digestion and diarrhea.

D. food or drink will irritate the gastric lining of the stomach.

Answer 24

A. the stomach must be empty prior to surgical intervention.

Question 25

Most of the digestive process occurs in the:

A. stomach.

B. small intestine.

C. large intestine.

D. cecum.

Answer 25

B. small intestine.

Question 26

All of the following are common signs and symptoms of chronic renal failure, EXCEPT:

A. hematuria.

B. jaundice.

C. oliguria.

D. uremic frost.

Answer 26

A. hematuria.

Question 27

During your assessment of a 39-year-old female with acute abdominal pain, you note the presence of diffuse pain while palpating her abdomen. With this information, you:

A. cannot identify the underlying organ that is causing the pain.

B. can conclude that the upper abdominal organs are inflamed.

C. should suspect that she has blood in the retroperitoneal space.

D. may be able to localize the problem organ or area causing her pain.

Answer 27

A. cannot identify the underlying organ that is causing the pain.

Question 28

A 56-year-old male complains of pain to the right upper quadrant of his abdomen and pain to his right shoulder; however, he denies pain in between his abdomen and shoulder. This is characteristic of:

A. colic pain.

B. referred pain.

C. radiating pain.

D. splenic irritation.

Answer 28

B. referred pain.

Question 29

Shortly following a meal, a 49-year-old female complains of acute pain to the right upper quadrant of her abdomen with referred pain to her right shoulder. This is MOST suggestive of acute:

A. cholecystitis.

B. pancreatitis.

C. appendicitis.

D. pyelonephritis.

Answer 29

A. cholecystitis.

Question 30

A 33-year-old female complains of acute intense pain in both lower abdominal quadrants. She is conscious and alert, tachycardic, and has a fever of 102.5ºF. You should suspect:

A. acute bacterial cystitis.

B. a ruptured ectopic pregnancy.

C. pelvic inflammatory disease.

D. a bacterial urinary tract infection.

Answer 30

C. pelvic inflammatory disease.

Question 31

Which of the following MOST accurately describes an acute abdomen?

A. Acute abdominal pain that is usually the result of blunt trauma.

B. Sudden onset of abdominal pain that indicates peritoneal irritation.

C. Sudden onset of abdominal pain that indicates blood in the peritoneum.

D. Progressive abdominal pain as a result of peritoneal inflammation

Answer 31

B. Sudden onset of abdominal pain that indicates peritoneal irritation

Question 32

A young female with severe lower abdominal pain presents with a decreased level of consciousness, tachypnea, and shallow breathing. Her blood pressure is 88/48 mm Hg and her pulse is 130 beats/min and weak. You should:

A. cover her with a blanket to keep her warm.

B. administer 20 mL/kg normal saline boluses.

C. elevate her legs and reassess her blood pressure.

D. assist her ventilations with a bag-mask device.

Answer 32

D. assist her ventilations with a bag-mask device.

Question 33

A 38-year-old male with an inguinal hernia complains of increased pain and nausea. He tells you that he has been able to reduce the hernia himself in the past, but it will not reduce today. This patient is at GREATEST risk for:

A. decreased peristalsis.

B. diaphragmatic rupture.

C. intra-abdominal bleeding.

D. strangulation of the bowel.

Answer 33

D. strangulation of the bowel.