When percussing a protuberant abdomen, tympany is audible. This is consistent with all of the following conditions except:
intestinal obstruction.
... [Show More] increased intestinal gas production.
a large solid tumor.
a paralytic ileus.
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Stool that appears bloody, mucoid, or with pus, may indicate:
constipation.
a lesion in the sigmoid colon.
hemorrhoids.
Crohn's disease.
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A patient was recently diagnosed with gluten intolerance and needs instructions on what foods to eat. The patient should be told that a gluten restricted diet includes:
corn.
wheat.
barley.
rye.
Question:
A patient presents with symptoms of bloody stools, new onset constipation, and weight loss. These symptoms could be associated with:
hemorrhoids.
colon cancer.
ischemic colitis.
adenomatous polyps.
Question:
Spider angiomas, palmar erythema, and Terry's nails can be associated with:
chronic renal failure.
leukemia.
liver disease.
infective endocarditis.
Question:
Which is NOT a mode of transmission for hepatitis C?
Intravenous (IV) drug use
Transfusion of unscreened blood
Sexual intercourse
Breast milk
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In the abdominal assessment of a 2-year-old, which one of the following would be considered abnormal?
A pot belly.
Tinkling sounds audible every 10-20 seconds on auscultation.
The liver palpable 4 cm below the right costal margin (RCM).
A palpable spleen 2 cm below the left costal margin (LCM).
Question:
Percussion of the abdomen should be avoided when:
trying to determine if the bladder is full.
trying to detect the size of an abdominal organ.
assessing for feces-filled intestines.
an abdominal aneurysm is suspected.
Question:
Abdominal percussion is performed to assess:
local inflammation.
generalized tenderness.
density of tissues and organs.
size and placement of the kidneys.
Question:
When assessing the liver, have the patient inhale while palpating:
approximately 3 cm below the right costal region in the midclavicular line.
the lower left rib cage and adjacent soft tissue.
behind the patient just below and parallel to the twelve rib on the right side.
deep in the left upper quadrant.
Question:
A term used to describe the raising esophageal or gastric contents to the esophagus or mouth without nausea or retching is:
regurgitation.
retching.
bulimia.
indigestion.
Question:
Peritoneal inflammation produces abdominal pain and tenderness. What technique can be used to assess a tender abdomen suspected to be secondary to peritoneal inflammation?
Gentle palpation over the painful area
Ask the patient to cough prior to palpation
Listen for a bruit prior to palpation
Listen for normal bowel sounds after percussing the abdomen
Question:
A patient complains of severe epigastric pain that radiates to the posterior trunk and entire abdomen. This type of pain can be suggestive of:
appendicitis.
stomach cancer.
acute pancreatitis.
biliary colic.
Question:
When performing a rectal exam, a reddish, moist, protruding mass is noted at the anal opening. This finding is most likely a(n):
a prolapsed internal hemorrhoid.
an external hemorrhoid.
a rectal polyp.
an anal abscess.
Question:
Which of the following symptoms are indicators of dehydration in a four-year-old child?
Weight gain and absence of tears
Thirst and urine specific gravity of 1.038
Heart rate of 120 bpm and sunken fontanels
Urine specific gravity of 1.010 and clear, yellow urine
Question:
An enlarged liver with a smooth tender edge may suggest:
cirrhosis.
right-sided heart failure.
hepatocellular carcinoma.
hematochromatosis.
Question:
Indicators of oropharyngeal dysphagia include all of the following symptoms except:
drooling.
nasopharyngeal regurgitation.
cough.
vomiting.
Question:
Stools that appear black, tarry, and sticky are referred to as:
acholic.
melena.
hematochezia.
steatorrhea.
Question:
A positive obturator sign would elicit pain in the:
right hypogastric area.
left lower quadrant.
flank area.
right lower quadrant.
Question:
A term used to describe induced vomiting without nausea is:
regurgitation.
retching.
bulimia.
indigestion.
Question:
A 30 year old patient complains of frequent belching, pain in the area below the sternum mostly after eating, and increased salivation. These symptoms are often seen in patients who have:
peptic ulcers.
cancer of the stomach.
esophageal varices.
gastroesophageal reflux.
Question:
Helminths can be transmitted by:
the bite of a blood-sucking insect.
venom injected through a stinger.
casual contact.
body fluids.
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When percussing the right upper quadrant of the abdomen, a dull medium-pitched sound is heard. The area being percussed is probably the:
spleen.
liver.
right kidney.
bladder.
Question:
Bowel sounds may be increased in the presence of:
an adynamic ileus.
early intestinal obstruction.
peritonitis.
constipation.
Question:
A feeling of constantly needing to pass stool is termed:
constipation.
tenesmus.
obstipation.
acholic.
Question:
Pain of biliary tree origin may be referred to the:
right shoulder.
retrosternal area.
left posterior chest.
back.
Question:
Which of the following assessment findings is a result of the presence of a stone in the common bile duct?
Elevated cholesterol levels
Right upper quadrant pain
Steatorrhea
Jaundice
Question:
A 55-year-old patient visits the nurse practitioner for an annual exam. Stool sample revealed hematochezia. The patient is otherwise asymptomatic. This finding could be associated with:
hemorrhoids.
pancreatic cancer.
ischemic colitis.
adenomatous polyps.
Question:
To perform deep palpation of the abdomen:
palpate with a light, gentle dipping motion.
use the palmar surfaces of the fingers.
use a dipping motion and press about an inch into the abdomen.
palpate for relaxation of the abdominal muscles.
Question:
A patient presents with chest pain and moves his hand from the neck to the epigastrium. This gesture could be suggestive of:
costochondritis.
angina pectoris.
gastroesophageal reflux.
bronchitis.
Question:
If a patient describes his stool as thin and "pencil-like", this could be associated with:
constipation.
a lesion in the sigmoid colon.
hemorrhoids.
Crohn's disease.
Question:
When performing a rectal exam, the examiner should:
instruct the patient to lie flat on his back.
inform the patient that the exam may stimulate a bowel movement immediately.
use a lubricated glove.
ask the patient not to strain prior to inspection of the anus.
Question:
What is the most commonly reported sexually transmitted disease (STD) in the United States?
Human immunodeficiency virus (HIV)
Syphilis
Chlamydia
Gonorrhea
Question:
Risk factors associated with Hepatitis A include all of the following except:
travelers to endemic areas.
male-male partners.
persons with chronic liver disease.
exposure to needlesticks.
Question:
A 35-year-old male visits the nurse practitioner for complaints of a fullness in his lower abdomen. He states that he noticed it a few days ago when he was working out at the gym. At times it feels like a round lump in his groin. Examination reveals a protrusion under the skin near the right groin area. This finding could be suggestive of an:
incisional hernia.
epigastric hernia.
umbilical hernia.
inguinal hernia.
Question:
Which one of the following procedures would confirm a the definitive medical diagnosis of Hirschsprung's disease?
A barium enema
A barium swallow
A rectal biopsy
An X-ray of the upper GI tract
Question:
On examination of the abdomen, loud rumbling noises are audible without a stethoscope. These sounds are termed:
abnormal.
hyperactive bowel sounds.
hypoactive bowel sounds.
borborygmus.
Question:
Pain of duodenal or pancreatic origin may be referred to the:
right shoulder.
retrosternal area.
right posterior chest.
back.
Question:
Bowel sounds may be decreased in the presence of:
diarrhea.
early intestinal obstruction.
peritonitis.
ulcerative colitis.
Question:
When performing a rectal exam, a tender, swollen, bluish, ovoid mass is noted at the anal opening. This finding is most likely a(n):
internal hemorrhoid.
external hemorrhoid.
rectal polyp.
anal abscess.
Question:
When examining the buttocks and rectum, a small tuft of hair surrounded by a halo of erythema was observed at the sacral area. This finding is most likely:
an external hemorrhoid.
a pilonidal cyst.
a genital wart.
a normal finding.
Question:
Which one of the following symptoms associated with gastroesophageal reflux (GERD) is considered an alarm symptom?
bloating.
aerophagia.
odynophagia.
dyspepsia.
Question:
A patient presents with right upper quadrant and upper abdominal pain. Acute cholecystitis is suspected because the pain radiates to the:
epigastric area.
lower abdomen.
back.
right scapula area.
Question:
When there is a sudden obstruction caused by a gallstone in the common bile duct or the cystic duct, the pain is usually felt in the:
epigastric area with radiation to the back.
the periumbilical area with radiation to the right lower quadrant.
epigastric or right upper quadrant with radiation to the right scapula and shoulder.
left lower quadrant.
Question:
Which of the following food choices is the most appropriate to offer a teenager with celiac disease?
Peanut butter and banana sandwich on whole wheat bread
Oatmeal raisin cookies and low-fat milk
Oven-baked potato chips with salsa and lemonade
Rye crackers with cheese and fruit juice
Question:
An enlarged liver with a firm, nontender edge may be suggestive of:
cirrhosis.
right-sided heart failure.
hepatocellular carcinoma.
hepatitis.
Question:
Examination of the abdomen reveals a small midline protrusion in the linea alba. This finding is consistent with an:
incisional hernia.
epigastric hernia.
umbilical hernia.
inguinal hernia.
Question:
A 40-year-old female presents with generalized abdominal pain and nausea. During the abdominal exam she exhibits inspiratory arrest with deep palpation of the upper right quadrant of the abdomen. This maneuver exhibits a positive:
psoas sign.
Rovsing's sign.
Murphy's sign.
obturator sign.
Question:
When examining the abdomen, which of the following symptoms would be suggestive of appendicitis?
Pain localized halfway between the umbilicus and the right iliac crest
Pain in the left lower quadrant
Presence of borborygmus sounds
Pain radiating from the mid abdomen to the back
Question:
When performing a digital rectal exam, a soft, pedunculated lesion is palpated. This finding is most likely:
a prolapsed internal hemorrhoid.
an external hemorrhoid.
a rectal polyp.
an anal abscess.
Question:
Ecchymosis of the abdominal wall is usually seen in persons with:
Cushing's disease.
hepatic cirrhosis.
colorectal cancer.
intraperitoneal hemorrhage.
Question:
Which one of the following symptoms is seen in infants with pyloric stenosis?
Gross distension of the abdomen
Distended superficial veins
Ascites
Visible peristalsis
Question:
When performing an examination of the rectal area, a linear tear at the anal opening was observed. This could be indicative of:
a hemorrhoid.
an anal fissure.
a syphilitic chancre.
a genital wart.
Question:
During palpation of the abdomen, right lower quadrant pain is elicited by applying pressure to the left side of the abdomen. This technique elicited a positive:
psoas sign.
Rovsing's sign.
Murphy's sign.
obturator sign.
Question:
When performing a rectal exam, if the anal sphincter presents with laxity, consider:
patient anxiety.
a neurologic disease.
anal inflammation.
anal scarring.
Question:
A 9-month-old who has been a healthy, thriving infant presents with a poor appetite, two episodes of vomiting, three bloody stools with mucus and knees drawn to the abdomen with screaming. These are clinical manifestations of:
celiac disease.
intussusception.
pyloric stenosis.
intestinal parasites.
Question:
Risk factors associated with Hepatitis B include all of the following except:
having multiple sex partners.
body piercing with unclean equipment.
travelers to endemic areas.
being incarcerated.
Question:
A patient presents with complaints of bright red stools over the past week. This symptom could be consistent with:
cancer of the ascending colon.
cancer of the sigmoid colon.
gastric ulcers.
small bowel obstruction.
Question:
A patient is experiencing a dull achy pain in the epigastric area with eating. This type pain is consistent with:
a gastric ulcer.
a duodenal ulcer.
pancreatitis.
dumping syndrome.
Question:
When performing a rectal exam, a firm mass with an irregular border is palpated approximately two inches inside the rectum. This finding could be indicative of:
rectal carcinoma.
a syphilitic chancre.
rectal abscess.
genital wart.
Question:
Examination of the abdomen reveals a protrusion through an operative scar. This finding may be suggestive of an:
incisional hernia.
epigastric hernia.
umbilical hernia.
inguinal hernia.
Question:
Signs and symptoms associated with diabetic gastroparesis may include all of the following except:
vomiting of undigested food.
weight loss.
diarrhea.
erratic glucose levels.
Question:
Which one of the following symptoms is associated with biliary atresia in an infant?
Bilious vomitus
Acholic stools
Hematuria
Weight gain
Question:
Acholic stools are associated with:
pancreatic carcinoma.
obstructive jaundice.
viral hepatitis.
inflammatory bowel disease.
Question:
A patient visits the nurse practitioner for complaints of passing bloody stools over the past few weeks. He denies abdominal pain or fever. Further questioning reveals that when he passes stool, he notices blood dripping in the toilet. These symptoms could be consistent with:
hemorrhoids.
colon cancer.
ischemic colitis.
adenomatous polyps.
Question:
A patient was instructed to point to the location of his pain. He pointed to just below the sternoclavicular notch which likely indicates:
diabetic gastroparesis.
esophageal dysphagia.
oropharyngeal dysphagia.
esophageal varices.
Question:
When inspecting the abdomen of a 60-year-old male, dilated veins were noted especially in the mid and upper abdomen. This condition is associated with:
Cushing's disease.
hepatic cirrhosis.
colorectal cancer.
intraperitoneal hemorrhage.
Question:
When performing a rectal exam, a purulent bloody discharge mixed with fecal matter is oozing from the rectum. This finding is most consistent with a:
rectal carcinoma.
anorectal fistula.
anal abscess.
genital wart.
Question:
Which type of hepatitis is typically contracted by ingestion of contaminated food or water?
Hepatitis A
Hepatitis B
Hepatitis C
Hepatitis D
Question:
A general term for distress associated with eating is:
regurgitation.
retching.
bulimia.
indigestion.
Question:
The most appropriate position for the patient when performing a rectal exam and one that allows for optimal examination, is the:
knee-chest position.
lateral decubitus position.
right side lying position.
supine position.
Question:
Symptoms of a child suspected of having a diagnosis of mixed failure to thrive (FTT) are usually seen in children:
with congenital heart defects (CHD).
whose mothers are experiencing postpartal depression.
with cerebral palsy who are receiving nutritional supplements through feeding tubes.
who have cleft palates or lips and the caretaker is insecure in his/her feeding abilities.
Question:
Stools that are pencil-like in shape are most likely:
normal.
an early sign of colon cancer.
a sign of Crohn's disease.
a rectal polyp.
the anal opening. This finding is most consistent with a:
rectal carcinoma.
anorectal fistula.
anal abscess.
genital wart.
Question:
A patient complains of an unpleasant abdominal fullness after a light meal. This complaint may be consistent with:
diabetic gastroparesis.
peptic ulcer.
gastritis.
gastrocolic fistula.
Question:
If abdominal pain persists when the patient raises his head and shoulders, the origin of the tenderness is probably:
in the abdominal wall.
deep within the abdomen.
from the pleural cavity.
in the pancreas.
Question:
Which type of hepatitis is most commonly transmitted from infected mothers to infants at the time of birth?
Hepatitis A
Hepatitis B
Hepatitis C
Hepatitis D
Question:
A patient presents with complaints of burning sensation in the sternal area. He states it is aggravated by alcohol, chocolate, and coffee. This finding is:
odynophagia.
dyspepsia.
dysphagia.
heartburn.
Question:
Which type of hepatitis virus can be acute and subside without treatment?
Hepatitis A
Hepatitis B
Hepatitis C
Hepatitis D
Question:
A 30-year-old male presents with generalized abdominal pain. With flexion of the legs at the hip an increase in his abdominal pain is noted. This finding elicited a positive:
psoas sign.
Rovsing's sign.
Murphy's sign.
obturator sign.
Question:
A patient presents with complaints of black tarry stools for the last week. This symptom is seen in conditions related to the:
descending colon.
ascending colon.
rectum.
transverse colon.
Question:
On auscultation of the abdomen, rushes of high-pitched sounds are audible and coincide with abdominal cramps. These findings are most consistent with:
an adynamic ileus.
intestinal obstruction.
peritonitis.
ulcerative colitis.
Question:
Palpation of the liver reveals an enlargement that is firm with an irregular edge. This finding may be suggestive of:
cirrhosis.
hepatocellular carcinoma.
a normal variation in the shape of the liver.
a downward displacement of the liver by a low diaphragm.
Question:
Lower abdominal pain accompanied by fever or shock in older adults could be consistent with:
hemorrhoids.
colon cancer.
ischemic colitis.
adenomatous polyps. [Show Less]