NR509 FINAL EXAM NEWEST 2026 TEST BANK
AND STUDY GUIDE EXAM QUESTIONS AND
CORRECT VERIFIED ANSWERS (GRADED A+)
While performing a physical examination on male patients, it is possible to
palpate multiple structures in relation to the inguinal canal and related
hernias. Which of the following is not palpable during an external
examination of the abdominal wall or inguinal region?
a. External inguinal ring
b. Internal inguinal ring
c. Pubic tubercle
d. Anterior superior iliac spine
e. Direct inguinal hernia - VERIFIED ANSWER - b. Internal inguinal ring
An overweight 26-year-old public servant presents to the Emergency
Department with 12 hours of intense abdominal pain, light-headedness,
and a fainting episode that finally prompted her to seek medical attention.
She has a strong family history of gallstones and is concerned about this
possibility. She has not had any vomiting or diarrhea. She had a normal
bowel movement this morning. Her β-human chorionic gonadotropin (β-
hCG) is positive at triage. She reports that her last period was 10 weeks
,ago. Her vital signs at triage are pulse, 118; blood pressure, 86/68;
respiratory rate, 20/min; oxygen saturation, 99%; and temperature,
37.3ºC orally. The clinician performs an abdominal exam prior to her
pelvic exam and, on palpation of her abdomen, finds involuntary rigidity
and rebound tenderness. What is the most likely diagnosis?
a. Ruptured tubal (or ectopic) pregnancy
b. Acute cholecystitis
c. Ruptured appendix
d. Per - VERIFIED ANSWER - a. Ruptured tubal (or ectopic) pregnancy
An otherwise healthy 31-year-old accountant presents to an outpatient
clinic with a 3-year history of recurrent crampy abdominal pain that lasts
for about 1-2 weeks each episode and is associated with onset of
constipation. She describes infrequent, small hard stool that she finds
very difficult to pass. She has tried to increase dietary fiber and water
intake, but usually this is not sufficient and she resorts to over-the-
counter laxatives, which she finds upset her stomach but do resolve the
constipation. Symptoms typically gradually resolve with bowel
movements. Which of the following is the most likely physiological
mechanism for her constipation?
a. A large, firm fecal mass in the rectum
b. Decreased fecal bulk
,c. Functional change in bowel movement
d. Spasm of the external sphincter
e. Impairment of autonomic innervations - VERIFIED ANSWER - c.
Functional change in bowel movement
An otherwise healthy 28-year-old lawyer presents to the Emergency
Department with a 1-day history of severe abdominal pain. The emergency
physician suspects appendicitis and general surgery is consulted. The
resident believes the patient has signs of peritonitis on exam. Which of
the following physical exam findings supports peritonitis?
a. Voluntary contraction of the abdominal wall that persists over several
examinations
b. Pressing down onto the abdomen firmly and slowly and withdrawing the
hand quickly produces pain
c. Abdominal pain that increases with hip flexion
d. Localized pain over McBurney point, which lies 2 inches from the
anterior superior iliac spinous process on a line drawn from the
umbilicus
e. Pain with internal rotation of the right hip - VERIFIED ANSWER - b.
Pressing down onto the abdomen firmly and slowly and withdrawing the
hand quickly produces pain
, A 58-year-old man with a history of diabetes and alcohol addiction has
been sober for the last 10 months. He presents with a 4-month history of
increasing weakness, recurrent epigastric pain radiating to his back,
chronic diarrhea with stools 6-8 times daily, and weight loss of 18 lb over
4 months. What is the mechanism of his most likely diagnosis?
a. Helicobacter pylori infection
b. Inflammation of the gallbladder
c. Inflammation of colonic diverticulum
d. Reduced blood supply to the bowel
e. Fibrosis of the pancreas - VERIFIED ANSWER - e. Fibrosis of the
pancreas
A 46-year-old executive who is obese and otherwise healthy presents to a
family medicine clinic with a 3-month course of recurrent severe
abdominal pain that usually resolves on its own after a few hours. Her last
episode was prolonged lasting 6 hours, and she is frustrated that she has
had to leave or miss work on three separate occasions. She would like a
diagnosis and the problem fixed. Which symptoms or signs would be most
suggestive of a diagnosis of biliary colic?
AND STUDY GUIDE EXAM QUESTIONS AND
CORRECT VERIFIED ANSWERS (GRADED A+)
While performing a physical examination on male patients, it is possible to
palpate multiple structures in relation to the inguinal canal and related
hernias. Which of the following is not palpable during an external
examination of the abdominal wall or inguinal region?
a. External inguinal ring
b. Internal inguinal ring
c. Pubic tubercle
d. Anterior superior iliac spine
e. Direct inguinal hernia - VERIFIED ANSWER - b. Internal inguinal ring
An overweight 26-year-old public servant presents to the Emergency
Department with 12 hours of intense abdominal pain, light-headedness,
and a fainting episode that finally prompted her to seek medical attention.
She has a strong family history of gallstones and is concerned about this
possibility. She has not had any vomiting or diarrhea. She had a normal
bowel movement this morning. Her β-human chorionic gonadotropin (β-
hCG) is positive at triage. She reports that her last period was 10 weeks
,ago. Her vital signs at triage are pulse, 118; blood pressure, 86/68;
respiratory rate, 20/min; oxygen saturation, 99%; and temperature,
37.3ºC orally. The clinician performs an abdominal exam prior to her
pelvic exam and, on palpation of her abdomen, finds involuntary rigidity
and rebound tenderness. What is the most likely diagnosis?
a. Ruptured tubal (or ectopic) pregnancy
b. Acute cholecystitis
c. Ruptured appendix
d. Per - VERIFIED ANSWER - a. Ruptured tubal (or ectopic) pregnancy
An otherwise healthy 31-year-old accountant presents to an outpatient
clinic with a 3-year history of recurrent crampy abdominal pain that lasts
for about 1-2 weeks each episode and is associated with onset of
constipation. She describes infrequent, small hard stool that she finds
very difficult to pass. She has tried to increase dietary fiber and water
intake, but usually this is not sufficient and she resorts to over-the-
counter laxatives, which she finds upset her stomach but do resolve the
constipation. Symptoms typically gradually resolve with bowel
movements. Which of the following is the most likely physiological
mechanism for her constipation?
a. A large, firm fecal mass in the rectum
b. Decreased fecal bulk
,c. Functional change in bowel movement
d. Spasm of the external sphincter
e. Impairment of autonomic innervations - VERIFIED ANSWER - c.
Functional change in bowel movement
An otherwise healthy 28-year-old lawyer presents to the Emergency
Department with a 1-day history of severe abdominal pain. The emergency
physician suspects appendicitis and general surgery is consulted. The
resident believes the patient has signs of peritonitis on exam. Which of
the following physical exam findings supports peritonitis?
a. Voluntary contraction of the abdominal wall that persists over several
examinations
b. Pressing down onto the abdomen firmly and slowly and withdrawing the
hand quickly produces pain
c. Abdominal pain that increases with hip flexion
d. Localized pain over McBurney point, which lies 2 inches from the
anterior superior iliac spinous process on a line drawn from the
umbilicus
e. Pain with internal rotation of the right hip - VERIFIED ANSWER - b.
Pressing down onto the abdomen firmly and slowly and withdrawing the
hand quickly produces pain
, A 58-year-old man with a history of diabetes and alcohol addiction has
been sober for the last 10 months. He presents with a 4-month history of
increasing weakness, recurrent epigastric pain radiating to his back,
chronic diarrhea with stools 6-8 times daily, and weight loss of 18 lb over
4 months. What is the mechanism of his most likely diagnosis?
a. Helicobacter pylori infection
b. Inflammation of the gallbladder
c. Inflammation of colonic diverticulum
d. Reduced blood supply to the bowel
e. Fibrosis of the pancreas - VERIFIED ANSWER - e. Fibrosis of the
pancreas
A 46-year-old executive who is obese and otherwise healthy presents to a
family medicine clinic with a 3-month course of recurrent severe
abdominal pain that usually resolves on its own after a few hours. Her last
episode was prolonged lasting 6 hours, and she is frustrated that she has
had to leave or miss work on three separate occasions. She would like a
diagnosis and the problem fixed. Which symptoms or signs would be most
suggestive of a diagnosis of biliary colic?
