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 attacks of pain may reveal
tenderness and cause guarding.
d. Except for instances in which blockage is incomplete, auscultatory findings
are sufficiently nonspecific that they do not assist in the evaluation of the
patient with a bowel obstruction.
2. Match each of the terms in the left column with one or more associated types of
abdominal pain in the right.
a. diffuse, poorly localized
1. visceral pain
b. hollow viscus wall tension
2. somatic pain
c. parietal peritoneum
3. referred pain
d. convergence-projection hypothesis
e. associated sweating, nausea, tachycardia
3. In 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
4. Constipation 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
5. Match each of the clinical situations in the left column with the cause of intestinal
obstruction most likely to be involved in the right column.
a. a 5-year old boy with small bowel obstruction
1. Neoplasm
b. a 68-year old man with colonic obstruction – no
2. Adhesive band
previous surgery
3. Incarcerated hernia
c. a 40-year old woman with small bowel obstruction
4. Volvulus
3 years after abdominal hysterectomy for fibroids
5. Diverticulitis
6. Match 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. Colonic obstruction with
entire small and large bowel
competent ileocecal valve
b. gaseous distension of the small bowel
2. Ileus
with no gas in the colon
3. Complete small bowel obstruction
c. gaseous distension of the small bowel
4. Partial small bowel obstruction
d. distended colon from cecum to descending
colon with no small bowel gas
7. Which of the following signs are not suggestive of an acute abdomen:
a. guarding
b. rebound
c. active bowel sounds
d. rigidity
8. Rank the following in order in which you should approach an abdominal exam:
a. auscultation
b. percussion
c. inspection
d. palpation
9. How should you approach a patient with abdominal pain:
a. the patient has pain – have the nurse give pain medication and then examine the
patient.
b. the patient has pain – examine the patient and then order pain medication.
c. order x-rays and labs and then examine the patient
d. ask the nurse to examine the patient and report back
10. How do you characterize your ability to perform an abdominal exam:
a. have no idea
b. know a few things to check
c. understand the exam but could be better
d. competent
e. I am so good I never need to order a CT scan
Abdominal Exam Pre-Test Answer Key
1. C
2.
a.
b.
c.
d.
e.
1,3
1
2
3
2
3. A, B, C, D, E
4. B, C
5.
a. 4
b.1
c.2
6.
a. 2
b. 3
c. 4
d. 1
7. C
8. C, A, B, D
9. B
ABDOMINAL EXAM - POST-TEST
1. A 38 year old female presents with a 12 hour history of epigastric and right upper
quadrant abdominal pain, anorexia, and dark colored urine. The best radiologic test
to determine the diagnosis is:
a. abdominal series
b. IVP
c. Ultrasound
d. CT scan
e. MRI
2. The most likely diagnosis of the patient described in question 1 is:
a. gastroenteritis
b. peptic ulcer disease
c. acute cholecystitis
d. appendicitis
e. pelvic inflammatory disease
3. A 91 year old female presents with mild nausea and abdominal distension. Which of
the following would be the least likely diagnosis.
a. colon cancer
b. bowel obstruction
c. ascites
d. esophageal cancer
e. perforated duodenal ulcer
4. Which of the following is usually not associated with significant pain:
a. anal fissure
b. perirectal abscess
c. internal hemorrhoids
d. external hemorrhoids
5. Which of the following physical signs most likely points to an acute abdomen:
a. pain on deep palpation
b. pain on light palpation
c. diffuse pain
d. localized pain
e. rebound
6. Which of the following are possible causes of right lower quadrant pain:
a. appendicitis
b. ovarian torsion
c. cholecystitis
d. diverticulitis
e. inflammatory bowel disease
7. A Murphy’s sign suggests:
a. appendicitis
b. ectopic pregnancy
c. metastatic gastric cancer
d. cholecystitis
e. diverticulitis
8. How should you approach a patient with abdominal pain:
a. the patient has pain – have the nurse order pain medication and then examine
the patient.
b. the patient has pain – examine the patient and then order pain medication.
c. order x-rays and labs and then examine the patient
d. ask the nurse to examine the patient and report back
9. How do you characterize your ability to perform an abdominal exam:
a. have no idea
b. know a few things to check
c. understand the exam but could be better
d. competent
e. I am so good I never need to order a CT scan
10. How would you rate today’s session:
a. a waste of my time
b. it could have been better
c. adequate
d. I enjoyed myself and learned something
e. this was the best day of medical school so far
Abdominal Exam Post-Test Answer Key
1.
C
2.
C
3.
D
4.
C
5.
B
6.
A, B, C, D, E
7.
D
8.
B