NSG 507 Week 5 Abdomen Test Bank

Student Name

University of Phoenix

NSG/507 Social Justice and Information Systems for Population Health

Prof. Name

Date

NSG 507 Week 5 – Abdomen Test Bank

Question 1: Liver Percussion

Question: While percussing the 7th right intercostal space along the midclavicular line, what percussion note is expected?

Options

• A. Dullness ✅

• B. Tympany

• C. Resonance

• D. Hyperresonance

Correct Answer

A

High-Yield Points

• The liver is a solid organ, so percussion produces dullness.

• Located in the right upper quadrant (RUQ).

Question 2: Left Lower Quadrant (LLQ)

Question: Which structure is located in the LLQ?

Options

• A. Liver

• B. Duodenum

• C. Gallbladder

• D. Sigmoid colon ✅

Correct Answer

D

High-Yield Points

LLQ structures include:

• Sigmoid colon

• Descending colon

• Left ovary & tube

• Left ureter

Question 3: Difficulty Swallowing

Question: Difficulty swallowing food and medications is called:

Options

• A. Aphasia

• B. Dysphasia

• C. Dysphagia ✅

• D. Anorexia

Correct Answer

C

High-Yield Points

• Dysphagia = impaired swallowing

• Aphasia/Dysphasia = language disorders

• Anorexia = loss of appetite

Question 4: Bladder Distention

Question: Best assessment for suspected urinary bladder distention?

Options

• A. Lumbar area

• B. Epigastric region

• C. Inguinal region

• D. Midline above the pubic bone ✅

Correct Answer

D

High-Yield Points

Assess the suprapubic (hypogastric) region:

• Percussion → Dullness

• Palpation → Firm, rounded bladder

Question 5: Aging GI Changes

Question: Which GI change occurs with aging?

Options

• A. Increased saliva

• B. Enlarged liver

• C. Faster esophageal emptying

• D. Reduced gastric acid secretion ✅

Correct Answer

D

High-Yield Points

Older adults commonly have:

• ↓ Gastric acid

• ↓ Saliva

• ↓ Liver size

• Slower esophageal emptying

Question 6: Splenic Injury

Question: What should the nurse do if the spleen is enlarged?

Options

• A. Trauma commonly enlarges spleen

• B. Spleen is normally palpable

• C. Palpate thoroughly

• D. Stop palpating—risk of rupture ✅

Correct Answer

D

High-Yield Points

• Normal spleen is not palpable.

• Enlarged spleen is fragile.

• Further palpation may cause rupture.

Question 7: Protuberant Abdomen

Question: Rounded, protruding abdomen is documented as:

Options

• A. Obese

• B. Herniated

• C. Scaphoid

• D. Protuberant ✅

Correct Answer

D

High-Yield Points

• Protuberant = rounded outward

• Scaphoid = sunken inward

Question 8: Scaphoid Abdomen

Question: A scaphoid abdomen appears:

Options

• A. Flat

• B. Convex

• C. Bulging

• D. Concave ✅

Correct Answer

D

High-Yield Points

• Scaphoid abdomen = concave/sunken

• Often associated with thin individuals or malnutrition.

Question 9: Abdominal Pulsation

Question: Visible pulsation between xiphoid and umbilicus indicates:

Options

• A. Renal artery

• B. Inferior vena cava

• C. Normal abdominal aorta ✅

• D. Increased peristalsis

Correct Answer

C

High-Yield Points

Normal finding in:

• Thin adults

• Relaxed abdominal muscles

Question 10: Hypoactive Bowel Sounds

Question: Hypoactive bowel sounds suggest:

Options

• A. Diarrhea

• B. Peritonitis ✅

• C. Laxative use

• D. Gastroenteritis

Correct Answer

B

High-Yield Points

Hypoactive/absent sounds occur with:

• Peritonitis

• Paralytic ileus

• Late bowel obstruction

Question 11: Why Auscultate First?

Options

• A. Find tender areas

• B. Percussion/palpation alter bowel sounds ✅

• C. Help patient relax

• D. Prevent vascular changes

Correct Answer

B

High-Yield Points

Abdominal assessment order:

1. Inspection

2. Auscultation

3. Percussion

4. Palpation

Question 12: Normal Bowel Sounds

Options

• A. Loud tinkling

• B. Irregular high-pitched gurgles ✅

• C. Friction rub

• D. Large intestine sounds

Correct Answer

B

High-Yield Points

Normal bowel sounds:

• High-pitched

• Gurgling

• 5–30/min

• Mainly from the small intestine

Question 13: Borborygmi

Options

• A. Vascular hum

• B. Friction rub

• C. Reduced bowel activity

• D. Increased bowel activity ✅

Correct Answer

D

High-Yield Points

Borborygmi =

• Loud stomach growling

• Hyperperistalsis

• Increased intestinal activity

Question 14: Normal Percussion Finding

Options

• A. Femoral bruit

• B. Tympany around umbilicus ✅

• C. Palpable spleen

• D. LUQ dullness

Correct Answer

B

High-Yield Points

Normal abdomen:

• Mostly tympanic

• Spleen not palpable

• Bruits absent

Question 15: Heartburn During Pregnancy

Options

• A. Diarrhea

• B. Pyrosis ✅

• C. Dysphagia

• D. Constipation

Correct Answer

B

High-Yield Points

Pyrosis = Heartburn
Cause:

• GERD

• Hormonal relaxation

• Increased abdominal pressure

Question 16: Normal Percussion Notes

Options

• A. Flatness, resonance, dullness

• B. Resonance, dullness, tympany

• C. Tympany, hyperresonance, dullness ✅

• D. Resonance, hyperresonance, flatness

Correct Answer

C

High-Yield Points

• Tympany = gas

• Hyperresonance = excess gas

• Dullness = organs/fluid/feces/bladder

Question 17: Pernicious Anemia

Options

• A. Increased gastric acid

• B. Decreased gastric acid ✅

• C. Delayed emptying

• D. Accelerated emptying

Correct Answer

B

High-Yield Points

↓ Gastric acid →

• ↓ Vitamin B12 absorption

• Pernicious anemia

• ↓ Iron & calcium absorption

Question 18: Costovertebral Angle Pain

Options

• A. Ovarian infection

• B. Enlarged liver

• C. Kidney inflammation ✅

• D. Enlarged spleen

Correct Answer

C

High-Yield Points

CVA tenderness suggests:

• Pyelonephritis

• Kidney infection

• Kidney inflammation

Question 19: Ascites

Options

• A. Fluid in peritoneal cavity ✅

• B. Fecal retention

• C. Excess gas

• D. Fibroids

Correct Answer

A

High-Yield Points

Common causes:

• Cirrhosis

• Portal hypertension

• Heart failure

• Hepatitis

• Pancreatitis

• Cancer

Question 20: Deep Palpation

Options

• A. Assess motility

• B. Detect organs and masses ✅

• C. Superficial tenderness

• D. Skin assessment

Correct Answer

B

High-Yield Points

Deep palpation assesses:

• Organ size

• Masses

• Consistency

• Mobility

• Tenderness

Question 21: Black Tarry Stool

Options

• A. Gallbladder disease

• B. Laxative use

• C. GI bleeding (Melena) ✅

• D. Hemorrhoids

Correct Answer

C

High-Yield Points

Melena =

• Upper GI bleed

• Black, tarry stool

• Bright red blood → lower GI/anorectal bleeding

Question 22: Right Lower Quadrant Tenderness

Options

• A. Spleen

• B. Sigmoid colon

• C. Appendix ✅

• D. Gallbladder

Correct Answer

C

High-Yield Points

RLQ pain → Think:

• Appendicitis

• McBurney’s point tenderness

Question 23: Aging Abdomen

Options

• A. Increased muscle tone

• B. Thinner, weaker muscles ✅

• C. More rigidity

• D. Greater pain

Correct Answer

B

High-Yield Points

Older adults:

• ↓ Muscle tone

• ↓ Rigidity

• May have severe disease with minimal pain

Question 24: Pyloric Stenosis

Options

• A. Projectile vomiting ✅

• B. Hypoactive bowel sounds

• C. Olive mass in RLQ

• D. Right-to-left peristalsis

Correct Answer

A

High-Yield Points

Classic findings:

• Projectile vomiting

• Olive-shaped mass in RUQ

• Visible peristalsis left → right

Question 25: Abdominal Aortic Aneurysm (AAA)

Options

• A. Bruit absent

• B. Strong femoral pulses

• C. Pulsatile abdominal mass ✅

• D. Below umbilicus

Correct Answer

C

High-Yield Points

AAA:

• Pulsatile upper abdominal mass

• Usually left of midline

• Bruit may be present

• Femoral pulses may be diminished

NSG 507 Week 5 Abdomen Test Bank

Q8. Most likely diagnosis (RLQ pain, McBurney’s point)

• Answer: A. Acute appendicitis

• Key Points:

  • Pain starts periumbilical → RLQ (McBurney’s point)

  • Rebound tenderness + involuntary guarding

  • Nausea/vomiting, ↓ bowel sounds

  • Bowel habits usually unchanged

Q9. Chronic diarrhea after meals

• Answer: B. Osmotic diarrhea

• Key Points:

  • Usually due to lactose intolerance

  • Watery diarrhea after dairy

  • Bloating + cramps + excessive gas

  • Improves when lactose is avoided

Q10. Sudden flank pain radiating to groin

• Answer: B. Ureteral pain caused by kidney stone

• Key Points:

  • Sudden severe colicky pain

  • CVA → groin radiation

  • Hematuria common

  • Nausea without fever

Q11. Periumbilical pain shifting to RLQ

• Answer: D. Appendicitis

• Key Points:

  • Early visceral pain around umbilicus

  • Later localized RLQ pain

  • Pain worsens with movement

Q12. Causes of epigastric pain

• Answer: D. All of the above

• Includes:

  • Peptic ulcer disease

  • Pancreatitis

  • Myocardial ischemia

  • (Also gallbladder disease & pneumonia)

Q13. Pain relieved by defecation

• Answer: D. Irritable bowel syndrome (IBS)

• Key Points:

  • Pain improves after bowel movement

  • Change in stool frequency/consistency

  • Often triggered by stress or food

Q14. Coffee-ground vomiting

• Answer: B. Peptic ulcer bleeding

• Key Points:

  • Indicates upper GI bleeding

  • Blood altered by gastric acid

  • May also cause melena

Q15. Daycare worker with jaundice

• Answer: A. Hepatitis A

• Key Points:

  • Fecal-oral transmission

  • Common in daycare workers

  • Hepatitis A vaccine recommended

Q16. Pain RUQ → flank → RLQ

• Answer: C. Ureteral stone

• Key Points:

  • Pain migrates downward toward groin

  • Often associated with hematuria

Q17. Sudden urge then urine leakage

• Answer: B. Urge incontinence

• Key Points:

  • Detrusor overactivity

  • Strong urge followed by leakage

Q18. Correct abdominal exam order

• Answer: C. Inspection → Auscultation → Percussion → Palpation (IAPP)

• Mnemonic: I APP

• Auscultate before touching abdomen to avoid changing bowel sounds.

Q19. Resistant hypertension

• Answer: D. Carefully auscultate abdomen

• Key Points:

  • Listen for renal artery bruit

  • Suggests renal artery stenosis

Q20. Palpable liver edge

• Answer: C. Measure liver span by percussion

• Key Points:

  • Palpable liver ≠ hepatomegaly

  • Normal liver span: 6–12 cm (MCL)

Q21. Grating sound over spleen

• Answer: A. Splenic friction rub

• Key Points:

  • Indicates splenic inflammation/infarction

Q22. Small abdominal mass

• Answer: B. Repeat exam with abdominal muscles contracted

• Key Points:

  • Distinguishes abdominal wall vs intra-abdominal mass

Q23. Castell’s sign

• Answer: B. Suggests possible splenic enlargement

• Key Points:

  • Inspiratory dullness at left lower anterior axillary line

  • Seen in infectious mononucleosis

Q24. Kidney vs spleen enlargement

• Answer: C. Tympany remains over mass

• Key Points:

  • Kidney lies behind bowel → tympany persists

  • Enlarged spleen produces dullness

Q25. Midline suprapubic dull mass

• Answer: D. Distended urinary bladder

• Key Points:

  • Smooth midline mass

  • Dull to percussion

  • Common with BPH

Q26. Pulsatile abdominal mass

• Answer: A. Arrange abdominal ultrasound

• Key Points:

  • Suspect AAA

  • Ultrasound confirms size

  • 4 cm increases rupture risk

Q27. Finding consistent with ascites

• Answer: D. Shifting tympany

• Key Points:

  • Positive shifting dullness

  • Fluid wave may also be present

Q28. Obturator sign

• Answer: B. RLQ pain with flexed hip internally rotated

• Remember:

  • Obturator: Internal rotation

  • Psoas: Hip extension/resisted flexion

  • Murphy: RUQ pain on inspiration

  • Rovsing: RLQ pain when LLQ palpated

Q29. Severe pain with minimal tenderness

• Answer: C. Mesenteric ischemia

• Classic Feature:

  • Pain out of proportion to physical findings

Chapter 19

Q6. Situs inversus finding

• Answer: A. Tympany in RUQ + liver dullness in LUQ

• Key Point:

  • Mirror-image organ placement

Q7. Strongest sign of appendicitis

• Answer: B. Rebound tenderness

• Key Points:

  • Indicates peritoneal irritation

  • Suggests appendicitis with peritonitis

Q8. Chronic pancreatitis pathology

• Answer: E. Fibrosis of pancreas

• Key Points:

  • Chronic alcohol use

  • Epigastric pain → back

  • Chronic diarrhea

  • Weight loss

  • Diabetes

Q9. Most suggestive of biliary colic

• Answer: E. Pain radiating to right shoulder

• Key Points:

  • Gallbladder pain refers to right shoulder/scapula

  • Due to phrenic nerve irritation