AGNP BOARD EXAM QUESTIONS Assessment of Gastroenterology (84 Questions)
Question:
When percussing a protuberant abdomen, tympany is audible. This is consistent with all of the
following conditions except:
intestinal obstruction.
increased intestinal gas production.
a large solid tumor. Correct
a paralytic ileus.
Explanation:
A protuberant abdomen that is tympanic throughout when percussed can suggest intestinal
obstruction, increased gas production, or a paralytic ileus. A solid mass gives a dull sound on
percussion.
Question:
Stool that appears bloody, mucoid, or with pus, may indicate:
constipation.
a lesion in the sigmoid colon.
hemorrhoids.
Crohn's disease. Correct
Explanation:
Crohn's disease usually presents with blood, mucus, or pus in the stool. Thin, pencil-like stool
occurs in an obstructing “apple-core” lesion of the sigmoid colon. Constipation produces hard,
dry stool. In the presence of hemorrhoids, the stool may appear blood streaked.
Question:
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. Correct
wheat.
barley.
rye.
Explanation:
,A gluten-free diet is a diet that excludes the protein gluten. Gluten is found in grains such as
wheat, barley, rye and triticale (a cross between wheat and rye). Corn and rice, and soybean
products are allowed but processed foods are not.
Question:
A patient presents with symptoms of bloody stools, new onset constipation, and weight loss.
These symptoms could be associated with:
hemorrhoids.
colon cancer. Correct
ischemic colitis.
adenomatous polyps.
Explanation:
Colon cancer can cause bloody stools but usually presents with changes in bowel habits and
weight loss. Lower abdominal pain accompanied by fever or shock in older adults could be
consistent with ischemic colitis. Generally, the abdomen is soft on palpation. Hemorrhoids
typically present with noticeable blood on the tissue paper, surface of stool, or dripping in the
toilet. Blood in the stool is usually the only symptom seen with adenomatous polyps.
Question:
Spider angiomas, palmar erythema, and Terry's nails can be associated with:
chronic renal failure.
leukemia.
liver disease. Correct
infective endocarditis.
Explanation:
Jaundice, spider angiomas and other telangiectasias, palmar erythema, Terry’s nails, pruritus,
purpura, and caput medusae are skin conditions associated with liver disease. These skin
conditions are not seen in patients who have chronic renal failure, leukemia, or infective carditis.
Question:
Which is NOT a mode of transmission for hepatitis C?
Intravenous (IV) drug use
Transfusion of unscreened blood
Sexual intercourse
, Breast milk Correct
Explanation:
Hepatitis C is not spread through breast milk, food, water or by casual contact such as hugging,
kissing and sharing food or drinks with an infected person. Hepatitis C is transmitted by
intravenous drug use, sexual intercourse, and transfusion of unscreened contaminated blood.
Question:
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). Correct
A palpable spleen 2 cm below the left costal margin (LCM).
Explanation:
The normal findings for a 2-year-old are a pot belly, spleen located 2 cm below the LCM, and
tinkling sounds heard every 10-30 seconds. The liver should be approximately 1-3 cm palpable
below the RCM; 4 cm is considered abnormal.
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. Correct
Explanation:
If an abdominal aneurysm is suspected, percussion of the abdomen could cause the aneurysm to
rupture, a catastrophic event. The finding of a pulsatile mass in the center of the abdomen is
highly suspicious of an abdominal aneurysm. Listening with a stethoscope may also reveal a
bruit produced by turbulent blood flow within the aneurysm. Percussion is not a contraindication
for the other choices.
Question:
Abdominal percussion is performed to assess:
local inflammation.
, generalized tenderness.
density of tissues and organs. Correct
size and placement of the kidneys.
Explanation:
Indirect percussion can be performed to evaluate borders and sizes of abdominal organs and
masses. Because percussion produces sounds of varying loudness and pitch, these sounds can
also assist in identifying density of tissues and organs. Percussion could assess the size but
palpation determines the position.
Question:
When assessing the liver, have the patient inhale while palpating:
approximately 3 cm below the right costal region in the midclavicular line. Correct
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.
Explanation:
If the patient inhales, the liver can be palpated about 3 cm below the right costal margin in the
midclavicular line. The liver is not palpated posterior or on the left side of the body.
Question:
A term used to describe the raising esophageal or gastric contents to the esophagus or mouth
without nausea or retching is:
regurgitation. Correct
retching.
bulimia.
indigestion.
Explanation:
Raising esophageal or gastric contents to the esophagus or mouth without nausea or retching is
regurgitation. Induced vomiting without nausea is characteristic of anorexia/bulimia. Retching
describes involuntary spasm of the stomach, diaphragm, and esophagus that precedes and
culminates in vomiting. Indigestion is a general term for distress associated with eating.
Question:
Question:
When percussing a protuberant abdomen, tympany is audible. This is consistent with all of the
following conditions except:
intestinal obstruction.
increased intestinal gas production.
a large solid tumor. Correct
a paralytic ileus.
Explanation:
A protuberant abdomen that is tympanic throughout when percussed can suggest intestinal
obstruction, increased gas production, or a paralytic ileus. A solid mass gives a dull sound on
percussion.
Question:
Stool that appears bloody, mucoid, or with pus, may indicate:
constipation.
a lesion in the sigmoid colon.
hemorrhoids.
Crohn's disease. Correct
Explanation:
Crohn's disease usually presents with blood, mucus, or pus in the stool. Thin, pencil-like stool
occurs in an obstructing “apple-core” lesion of the sigmoid colon. Constipation produces hard,
dry stool. In the presence of hemorrhoids, the stool may appear blood streaked.
Question:
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. Correct
wheat.
barley.
rye.
Explanation:
,A gluten-free diet is a diet that excludes the protein gluten. Gluten is found in grains such as
wheat, barley, rye and triticale (a cross between wheat and rye). Corn and rice, and soybean
products are allowed but processed foods are not.
Question:
A patient presents with symptoms of bloody stools, new onset constipation, and weight loss.
These symptoms could be associated with:
hemorrhoids.
colon cancer. Correct
ischemic colitis.
adenomatous polyps.
Explanation:
Colon cancer can cause bloody stools but usually presents with changes in bowel habits and
weight loss. Lower abdominal pain accompanied by fever or shock in older adults could be
consistent with ischemic colitis. Generally, the abdomen is soft on palpation. Hemorrhoids
typically present with noticeable blood on the tissue paper, surface of stool, or dripping in the
toilet. Blood in the stool is usually the only symptom seen with adenomatous polyps.
Question:
Spider angiomas, palmar erythema, and Terry's nails can be associated with:
chronic renal failure.
leukemia.
liver disease. Correct
infective endocarditis.
Explanation:
Jaundice, spider angiomas and other telangiectasias, palmar erythema, Terry’s nails, pruritus,
purpura, and caput medusae are skin conditions associated with liver disease. These skin
conditions are not seen in patients who have chronic renal failure, leukemia, or infective carditis.
Question:
Which is NOT a mode of transmission for hepatitis C?
Intravenous (IV) drug use
Transfusion of unscreened blood
Sexual intercourse
, Breast milk Correct
Explanation:
Hepatitis C is not spread through breast milk, food, water or by casual contact such as hugging,
kissing and sharing food or drinks with an infected person. Hepatitis C is transmitted by
intravenous drug use, sexual intercourse, and transfusion of unscreened contaminated blood.
Question:
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). Correct
A palpable spleen 2 cm below the left costal margin (LCM).
Explanation:
The normal findings for a 2-year-old are a pot belly, spleen located 2 cm below the LCM, and
tinkling sounds heard every 10-30 seconds. The liver should be approximately 1-3 cm palpable
below the RCM; 4 cm is considered abnormal.
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. Correct
Explanation:
If an abdominal aneurysm is suspected, percussion of the abdomen could cause the aneurysm to
rupture, a catastrophic event. The finding of a pulsatile mass in the center of the abdomen is
highly suspicious of an abdominal aneurysm. Listening with a stethoscope may also reveal a
bruit produced by turbulent blood flow within the aneurysm. Percussion is not a contraindication
for the other choices.
Question:
Abdominal percussion is performed to assess:
local inflammation.
, generalized tenderness.
density of tissues and organs. Correct
size and placement of the kidneys.
Explanation:
Indirect percussion can be performed to evaluate borders and sizes of abdominal organs and
masses. Because percussion produces sounds of varying loudness and pitch, these sounds can
also assist in identifying density of tissues and organs. Percussion could assess the size but
palpation determines the position.
Question:
When assessing the liver, have the patient inhale while palpating:
approximately 3 cm below the right costal region in the midclavicular line. Correct
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.
Explanation:
If the patient inhales, the liver can be palpated about 3 cm below the right costal margin in the
midclavicular line. The liver is not palpated posterior or on the left side of the body.
Question:
A term used to describe the raising esophageal or gastric contents to the esophagus or mouth
without nausea or retching is:
regurgitation. Correct
retching.
bulimia.
indigestion.
Explanation:
Raising esophageal or gastric contents to the esophagus or mouth without nausea or retching is
regurgitation. Induced vomiting without nausea is characteristic of anorexia/bulimia. Retching
describes involuntary spasm of the stomach, diaphragm, and esophagus that precedes and
culminates in vomiting. Indigestion is a general term for distress associated with eating.
Question:
