Chapter 19

Question 1

Question 1
A 29-year-old pregnant woman has had severe vomiting for the last 2 days. Today, she is vomiting large amounts of blood. Her skin is cool and pale, and she is tachycardic. The EMT should suspect:
acute pancreatitis.
esophageal varices.
esophagitis.
Mallory-Weiss tear.

Answer 1

Mallory-Weiss tear

Question 2

Question 2
A 30-year-old woman with a history of alcoholism presents with severe upper abdominal pain and is vomiting large amounts of bright red blood. Her skin is cool, pale, and clammy; her heart rate is 120 beats/min and weak; and her blood pressure is 70/50 mm Hg. Your MOST immediate action should be to:
give her high-flow supplemental oxygen.
rapidly transport her to the hospital.
keep her supine and keep her warm.
protect her airway from aspiration.

Answer 2

protect her airway from aspiration

Question 3

Question 3
A 35-year-old obese woman is complaining of localized pain in the right upper quadrant with referred pain to the right shoulder. The MOST likely cause of her pain is:
acute cystitis.
acute cholecystitis.
appendicitis.
pancreatitis.

Answer 3

acute cholecystitis

Question 4

Question 4
A 47-year-old male presents with severe abdominal pain of 3 hours’ duration. His abdomen is distended and guarded. Your MOST important consideration for this patient should be to:
assess his blood pressure to determine perfusion adequacy.
determine the exact location and cause of his pain.
transport him in a supine position.
be alert for signs and symptoms of shock.

Answer 4

be alert for signs and symptoms of shock

Question 5

Question 5
A 59-year-old male presents with sudden-onset severe lower back pain. He is conscious and alert, but very restless and diaphoretic. Your assessment reveals a pulsating mass to the left of his umbilicus. You should:
administer oxygen and prepare for immediate transport.
place the patient in a sitting position and transport at once.
vigorously palpate the abdomen to establish pain severity.
request a paramedic unit to give the patient pain medication.

Answer 5

administer oxygen and prepare for immediate transport

Question 6

Question 6
A 60-year-old female presents with a tearing sensation in her lower back. Her skin is sweaty, and she is tachycardic. The EMT should suspect:
acute pancreatitis.
kidney stones.
strangulated hernia.
aortic aneurysm.

Answer 6

aortic aneurysm

Question 7

Question 7
An important aspect in the treatment of a patient with severe abdominal pain is to:
give 100% oxygen only if signs of shock are present.
provide emotional support en route to the hospital.
administer analgesic medications to alleviate pain.
encourage the patient to remain in a supine position.

Answer 7

provide emotional support en route to the hospital

Question 8

Question 8
Chronic renal failure is a condition that:
is often caused by hypertension or diabetes.
can be reversed with prompt treatment.
causes dehydration from excessive urination.
occurs from conditions such as dehydration.

Answer 8

is often caused by hypertension or diabetes

Question 9

Question 9
Esophageal varices MOST commonly occur in patients who:
have weak immune systems.
consume a lot of alcohol.
have uncontrolled diabetes.
have a history of esophagitis.

Answer 9

consume a lot of alcohol

Question 10

Question 10
Functions of the liver include:
release of amylase, which breaks down starches into sugar.
production of hormones that regulate blood sugar levels.
secretion of bile and filtration of toxic substances.
absorption of nutrients and toxins.

Answer 10

secretion of bile and filtration of toxic substances

Question 11

Question 11
Injury to a hollow abdominal organ would MOST likely result in:
pain secondary to blood in the peritoneum.
leakage of contents into the abdominal cavity.
impairment in the blood’s clotting abilities.
profound shock due to severe internal bleeding.

Answer 11

leakage of contents into the abdominal cavity

Question 12

Question 12
Most patients with abdominal pain prefer to:
lie on their side with their knees drawn into the abdomen.
sit in a semi-Fowler position with their knees slightly bent.
lie in a supine position with their knees in a flexed position.
sit fully upright because it helps relax the abdominal muscles.

Answer 12

lie on their side with their knees drawn into the abdomen

Question 13

Question 13
Older patients with abdominal problems may not exhibit the same pain response as younger patients because of:
age-related deterioration of their sensory systems.
progressive deterioration of abdominal organ function.
interactions of the numerous medications they take.
chronic dementia, which inhibits communication.

Answer 13

age-related deterioration of their sensory systems

Question 14

Question 14
Pain that radiates to the right lower quadrant from the umbilical area, nausea and vomiting, and lack of appetite are MOST indicative of:
pancreatitis.
appendicitis.
cholecystitis.
gastroenteritis.

Answer 14

appendicitis

Question 15

Question 15
Patients with acute abdominal pain should not be given anything to eat or drink because:
substances in the stomach increase the risk of aspiration.
it will create referred pain and obscure the diagnosis.
food will rapidly travel through the digestive system.
digestion prevents accurate auscultation of bowel sounds.

Answer 15

substances in the stomach increase the risk of aspiration

Question 16

Question 16
The MOST common and significant complication associated with an acute abdomen is:
internal bleeding.
high fever.
severe pain.
peritonitis.

Answer 16

peritonitis

Question 17

Question 17
When assessing a patient with abdominal pain, you should:
palpate the abdomen in a clockwise direction, beginning with the quadrant after the one the patient indicates is painful.
visually assess the painful area of the abdomen, but avoid palpation because this could worsen his or her condition.
ask the patient to point to the area of pain or tenderness and assess for rebound tenderness over that specific area.
observe for abdominal guarding, which is characterized by sudden relaxation of the abdominal muscles when palpated.

Answer 17

palpate the abdomen in a clockwise direction

Question 18

Question 18
Which of the following conditions is more common in women than in men?
Cystitis
Pancreatitis
Cholecystitis
Hepatitis.

Answer 18

Cystitis

Question 19

Question 19
You are transporting a 49-year-old male with ‘tearing’ abdominal pain. You are approximately 30 miles away from the closest hospital. During your reassessment, you determine that the patient’s condition has deteriorated significantly. You should:
immediately perform a rapid physical examination.
consider requesting a rendezvous with an ALS unit.
assist his ventilations with a bag-valve mask.
continue transporting and alert the receiving hospital.

Answer 19

consider requesting a rendezvous with an ALS unit

Question 20

Question 20
You respond to the residence of a 70-year-old male who complains of weakness and severe shortness of breath. His wife tells you that he is a dialysis patient, but has missed his last two treatments. After applying oxygen, you auscultate his lungs and hear diffuse rhonchi. The patient is conscious, but appears confused. His blood pressure is 98/54 mm Hg, his pulse rate is 120 beats/min and irregular, and his respirations are 24 breaths/min and labored. You should:
perform a detailed secondary assessment and then transport him to a dialysis center.
place him in a supine position, elevate his lower extremities, and transport at once.
leave him in a sitting position, keep him warm, and prepare for immediate transport.
treat for shock and request a paramedic unit to respond to the scene and assist you.

Answer 20

leave him in a sitting position