Question 1

Your 74 year old patient complains of a sudden, sharp pain in his upper abdomen. He rates the pain a 9 out of 10 on the pain scale. You suspect

Accepted Answer

The sudden onset of severe (sharp) pain in the upper abdomen in an elderly patient raises the suspicion of an abdominal aortic aneurysm, especially considering the age and the nature of the pain described. Acute gastritis, peptic ulcer flare-ups, and acute appendicitis typically present with different patterns of pain and symptoms.

Question 2

Your patient has nausea, vomiting, and a burning pressure in her left upper quadrant of the abdomen and back that she says gets worse a few hours after she eats. You suspect

Accepted Answer

The symptoms described, including nausea, vomiting, and burning pressure in the left upper quadrant that worsens after eating, are indicative of a peptic ulcer. Peptic ulcers are sores that develop on the lining of the stomach, small intestine, or esophagus and can cause pain that is often exacerbated by eating.

Question 3

Which of the following conditions can be caused by tumors, esophagitis, and esophageal varices?

Accepted Answer

Upper GI bleeding can be caused by tumors, esophagitis, and esophageal varices. These conditions can lead to bleeding in the upper gastrointestinal tract, which includes the esophagus, stomach, and the first part of the small intestine.

Question 4

Your patient is reporting rectal bleeding, increased frequency of bowel movement, and a cramping pain in his abdomen. You suspect

Accepted Answer

The symptoms of rectal bleeding, increased frequency of bowel movement, and cramping abdominal pain are indicative of lower gastrointestinal issues, suggesting lower gastrointestinal bleeding as the most likely diagnosis among the provided options.

Question 5

Your patient is vomiting bright red blood. Her husband tells you that she has been fatigued and complaining of shortness of breath for the past few days. She also fainted the previous day but attributed it to hypoglycemia. You suspect

Accepted Answer

Vomiting bright red blood is a classic sign of upper gastrointestinal bleeding. The symptoms of fatigue and shortness of breath could be related to anemia from ongoing blood loss.

Question 6

When using the OPQRST tool on a patient with abdominal discomfort, the "P" reminds you to assess provocation, palliation, and

Accepted Answer

The "P" in the OPQRST mnemonic stands for Provocation/Palliation, which involves asking what makes the patient's symptoms better or worse. This includes understanding if certain positions alleviate or exacerbate the discomfort, hence "position" is the correct answer.

Question 7

You are working at a marathon. One of the runners comes to the first aid tent complaining of tearing pain in his upper abdomen. He says that it began 10 minutes ago. He wants you to assess him quickly so that he can continue the race. You should

Accepted Answer

The sudden onset of tearing pain in the upper abdomen could indicate a serious condition such as an aortic dissection or other acute abdominal emergencies. Immediate medical evaluation and transportation to a hospital are necessary.

Question 8

Your patient complains of abdominal pain, says she hasn't had a bowel movement in several days, and her vomit smells like feces. You are having trouble assessing her because she is rocking back and forth in an attempt to find a comfortable position. You suspect

Accepted Answer

The symptoms described, including abdominal pain, lack of bowel movements, and fecal-smelling vomit, are indicative of an intestinal obstruction. This condition prevents the normal passage of contents through the intestine, leading to these specific symptoms.

Question 9

Your patient is reporting nausea and vomiting, a loss of appetite over the past week, abdominal tenderness and intermittent cramping, decreased passage of stool, and a fever. You suspect

Accepted Answer

The symptoms described, such as nausea and vomiting, loss of appetite, abdominal tenderness and intermittent cramping, decreased passage of stool, and a fever, are indicative of an intestinal obstruction. These symptoms align with the clinical presentation of an obstruction in the intestines, where the normal flow of contents through the gastrointestinal tract is hindered.

Question 10

Your assessment finds that your patient is experiencing moderate to severe pain under the right side of her rib cage. She is also nauseous, has vomited several times, and reports a lot of burping and belching recently. You suspect

Accepted Answer

The symptoms described, including moderate to severe pain under the right side of the rib cage, nausea, vomiting, and excessive burping or belching, are indicative of gallbladder disease, such as gallstones or cholecystitis.

Question 11

Your male patient complains of nausea, vomiting, and blood in his urine. He is sweaty and complains of lower abdominal pain that radiates to his groin. You suspect

Accepted Answer

The symptoms described, such as nausea, vomiting, blood in the urine, sweating, and lower abdominal pain radiating to the groin, are classic signs of kidney stones. These symptoms occur as the stones move through the urinary tract, causing pain and irritation.

Question 12

Your patient is complaining of abdominal pain. She has unequal femoral and pedal pulses. Her skin is cold, pale, and moist. Her breathing is shallow and her pupils are dilated. Her blood pressure dropped dramatically during your assessment. You suspect

Accepted Answer

The symptoms described, including abdominal pain, unequal femoral and pedal pulses, cold, pale, and moist skin, shallow breathing, dilated pupils, and a dramatic drop in blood pressure, are indicative of an abdominal aortic aneurysm (AAA). These symptoms suggest a vascular issue, with the unequal pulses and hypotension pointing towards a possible rupture or impending rupture of an AAA, which is a life-threatening emergency.

Question 13

Your patient is reporting pain in his genitalia and the lateral areas of the abdomen. His pain could be referred from the

Accepted Answer

The kidneys are located in the retroperitoneal space in the abdomen and can refer pain to the genitalia and lateral areas of the abdomen. This is due to the shared nerve pathways that the kidneys and these areas have.

Question 14

Your patient is running a high fever, has been vomiting, and reports pain that began around her umbilicus but has shifted to the lower right area of her abdomen. You suspect

Accepted Answer

The symptoms described are classic for appendicitis, especially the migration of pain from the umbilical area to the lower right quadrant of the abdomen, along with fever and vomiting.

Quiz 23: Abdominal and Gastrointestinal Disorders