NURS 807 Patho|The abdomen exam text
questions and answers graded A+ 2022 UPDATE
Bates’ Guide to Physical Examination and History Taking, 11th Edition
Chapter 11: The Abdomen
Multiple Choice
1. A 52-year-old secretary comes to your office, complaining about accidentally leaking urine
when she coughs or sneezes. She says this has been going on for about a year now. She relates
that she has not had a period for 2 years. She denies any recent illness or injuries. Her past
medical history is significant for four spontaneous vaginal deliveries. She is married and has four
children. She denies alcohol, tobacco, or drug use. During her pelvic examination you note some
atrophic vaginal tissue, but the remainder of her pelvic, abdominal, and rectal examinations are
unremarkable.
Which type of urinary incontinence does she have?
A) Stress incontinence
B) Urge incontinence
NURS 807 Patho|The abdomen exam text
questions and answers graded A+ 2022 UPDATE
, NURS 807 Patho|The abdomen exam text
questions and answers graded A+ 2022 UPDATE
C) Overflow incontinence
Ans: A
Chapter: 11
Page and Header: 418, The Health History
Feedback: Stress incontinence usually occurs when the intra-abdominal pressure goes up during
coughing, sneezing, or laughing. This is usually due to a weakness of the pelvic floor, with
inadequate muscle support of the bladder. Vaginal deliveries and pelvic surgery are often
associated with these symptoms. Usually female patients are postmenopausal when stress
incontinence begins. Kegel exercises are usually recommended to strengthen the pelvic floor
muscles.
2. A 46-year-old former salesman presents to the ER, complaining of black stools for the past
few weeks. His past medical history is significant for cirrhosis. He has gained weight recently,
especially around his abdomen. He has smoked two packs of cigarettes a day for 30 years and
has drunk approximately 10 alcoholic beverages a day for 25 years. He has used IV heroin and
smoked crack in the past. He denies any recent use. He is currently unemployed and has never
been married. On examination you find a man appearing older than his stated age. His skin has a
yellowish tint and he is thin, with a prominent abdomen. You note multiple “spider angiomas”
at the base of his neck. Otherwise, his heart and lung examinations are normal. On inspection he
NURS 807 Patho|The abdomen exam text
questions and answers graded A+ 2022 UPDATE
, NURS 807 Patho|The abdomen exam text
questions and answers graded A+ 2022 UPDATE
has dilated veins around his umbilicus. Increased bowel sounds are heard during auscultation.
Palpation reveals diffuse tenderness that is more severe in the epigastric area. His liver is small
and hard to palpation and he has a positive fluid wave. He is positive for occult blood on his
rectal examination.
What cause of black stools most likely describes his symptoms and signs?
A) Infectious diarrhea
B) Mallory-Weiss tear
C) Esophageal varices
Ans: C
Chapter: 11
Page and Header: 434, Techniques of Examination
Feedback: Varices are often found in alcoholic patients, but only when they have a diagnosis of
significant cirrhosis. This patient has symptoms of cirrhosis, including jaundice, ascites, spider
hemangiomas, and dilated veins on his abdomen (caput medusa).
3. A 21-year-old receptionist comes to your clinic, complaining of frequent diarrhea. She states
that the stools are very loose and there is some cramping beforehand. She states this has occurred
on and off since she was in high school. She denies any nausea, vomiting, or blood in her stool.
Occasionally she has periods of constipation, but that is rare. She thinks the diarrhea is much
NURS 807 Patho|The abdomen exam text
questions and answers graded A+ 2022 UPDATE
questions and answers graded A+ 2022 UPDATE
Bates’ Guide to Physical Examination and History Taking, 11th Edition
Chapter 11: The Abdomen
Multiple Choice
1. A 52-year-old secretary comes to your office, complaining about accidentally leaking urine
when she coughs or sneezes. She says this has been going on for about a year now. She relates
that she has not had a period for 2 years. She denies any recent illness or injuries. Her past
medical history is significant for four spontaneous vaginal deliveries. She is married and has four
children. She denies alcohol, tobacco, or drug use. During her pelvic examination you note some
atrophic vaginal tissue, but the remainder of her pelvic, abdominal, and rectal examinations are
unremarkable.
Which type of urinary incontinence does she have?
A) Stress incontinence
B) Urge incontinence
NURS 807 Patho|The abdomen exam text
questions and answers graded A+ 2022 UPDATE
, NURS 807 Patho|The abdomen exam text
questions and answers graded A+ 2022 UPDATE
C) Overflow incontinence
Ans: A
Chapter: 11
Page and Header: 418, The Health History
Feedback: Stress incontinence usually occurs when the intra-abdominal pressure goes up during
coughing, sneezing, or laughing. This is usually due to a weakness of the pelvic floor, with
inadequate muscle support of the bladder. Vaginal deliveries and pelvic surgery are often
associated with these symptoms. Usually female patients are postmenopausal when stress
incontinence begins. Kegel exercises are usually recommended to strengthen the pelvic floor
muscles.
2. A 46-year-old former salesman presents to the ER, complaining of black stools for the past
few weeks. His past medical history is significant for cirrhosis. He has gained weight recently,
especially around his abdomen. He has smoked two packs of cigarettes a day for 30 years and
has drunk approximately 10 alcoholic beverages a day for 25 years. He has used IV heroin and
smoked crack in the past. He denies any recent use. He is currently unemployed and has never
been married. On examination you find a man appearing older than his stated age. His skin has a
yellowish tint and he is thin, with a prominent abdomen. You note multiple “spider angiomas”
at the base of his neck. Otherwise, his heart and lung examinations are normal. On inspection he
NURS 807 Patho|The abdomen exam text
questions and answers graded A+ 2022 UPDATE
, NURS 807 Patho|The abdomen exam text
questions and answers graded A+ 2022 UPDATE
has dilated veins around his umbilicus. Increased bowel sounds are heard during auscultation.
Palpation reveals diffuse tenderness that is more severe in the epigastric area. His liver is small
and hard to palpation and he has a positive fluid wave. He is positive for occult blood on his
rectal examination.
What cause of black stools most likely describes his symptoms and signs?
A) Infectious diarrhea
B) Mallory-Weiss tear
C) Esophageal varices
Ans: C
Chapter: 11
Page and Header: 434, Techniques of Examination
Feedback: Varices are often found in alcoholic patients, but only when they have a diagnosis of
significant cirrhosis. This patient has symptoms of cirrhosis, including jaundice, ascites, spider
hemangiomas, and dilated veins on his abdomen (caput medusa).
3. A 21-year-old receptionist comes to your clinic, complaining of frequent diarrhea. She states
that the stools are very loose and there is some cramping beforehand. She states this has occurred
on and off since she was in high school. She denies any nausea, vomiting, or blood in her stool.
Occasionally she has periods of constipation, but that is rare. She thinks the diarrhea is much
NURS 807 Patho|The abdomen exam text
questions and answers graded A+ 2022 UPDATE
