GNUR 699 EXAM 4 QUESTIONS WITH
ANSWERS 100% CORRECT
Which of the following best describes visceral abdominal pain?
A. Sharp, localized pain from the parietal peritoneum
B. Pain radiating to the right shoulder from cholecystitis
C. Dull, deep, and poorly localized pain due to distension or ischemia
D. Cramping pain from the muscular wall of the abdomen - ANSWER Answer: C
C. Dull, deep, and poorly localized pain due to distension or ischemia
A patient presents with sudden, severe abdominal pain and hypotension. What
diagnosis should be strongly considered based on the timing and severity?
A. Gastroenteritis
B. Ruptured abdominal aortic aneurysm
C. Acute pancreatitis
D. Peptic ulcer disease - ANSWER Answer: B
B. Ruptured abdominal aortic aneurysm
Periumbilical pain is most often associated with pathology in which of the following?
A. Stomach and pancreas
B. Large bowel and rectum
C. Small bowel and appendix
D. Gallbladder and liver - ANSWER Answer: C
C. Small bowel and appendix
In a patient with acute abdominal pain, which finding would most likely lead you to
suspect mesenteric ischemia?
,A. Gradual onset of epigastric pain
B. History of alcohol use
C. Immediate onset of severe pain
D. Lower quadrant tenderness - ANSWER Answer: C
C. Immediate onset of severe pain
Which of the following lab tests is most essential to order in a female patient of
childbearing age with acute abdominal pain?
A. Serum lipase
B. Coagulation panel
C. Liver function tests
D. Pregnancy test - ANSWER D. Pregnancy test
Answer: D
A bedside ultrasound reveals gallstones and a stone in the common bile duct. What
imaging finding confirms this diagnosis?
A. Enlarged liver with fatty infiltration
B. Free fluid in the abdomen
C. Shadowing stone visible in the common bile duct
D. Bowel wall thickening - ANSWER Answer: C
C. Shadowing stone visible in the common bile duct
Which of the following is NOT a typical component of nonoperative management for
acute abdominal issues?
A. NPO status
B. Intravenous hydration
C. Immediate surgical exploration
D. Pain control and antibiotics - ANSWER Answer: C
,C. Immediate surgical exploration
What is a key indication for using a CT scan with contrast in evaluating abdominal pain?
A. Suspected gallbladder stones in a thin patient
B. Suspected mesenteric ischemia or bleeding
C. Patient history of constipation
D. Routine imaging for all patients with nausea - ANSWER Answer: B
B. Suspected mesenteric ischemia or bleeding
What is the purpose of leaving the abdomen open with dressings and drains after an
initial surgical intervention?
A. To allow direct wound healing by secondary intention
B. To delay surgical treatment until resources are available
C. To provide temporary stabilization and allow reoperation after edema subsides
D. To reduce the cost of operative closure - ANSWER Answer: C
C. To provide temporary stabilization and allow reoperation after edema subsides
Which of the following is a postoperative complication associated with acute abdominal
problems?
A. Abdominal aortic aneurysm rupture
B. Referred shoulder pain
C. Postoperative ileus
D. Pancreatic pseudocyst - ANSWER Answer: C
C. Postoperative ileus
What is the most common cause of appendicitis?
A. Viral infection of the GI tract
B. Obstruction of the appendiceal lumen
, C. Autoimmune inflammation
D. Hemorrhagic infarction - ANSWER Answer: B
B. Obstruction of the appendiceal lumen
Which patient population is at highest risk for mortality from appendicitis?
A. Children under 10
B. Young adult females
C. Elderly adults
D. Athletes - ANSWER Answer: C
C. Elderly adults
A patient presents with vague abdominal pain that later migrates to the right lower
quadrant and becomes sharp. This pain is most likely located at:
A. Hesselbach's triangle
B. McBurney's point
C. Murphy's point
D. Rovsing's point - ANSWER Answer: B
B. McBurney's point
Which of the following signs suggests that the appendix is retrocecal in location?
A. Murphy's sign
B. Obturator sign
C. Rovsing's sign
D. Psoas sign - ANSWER Answer: D
D. Psoas sign
Which diagnostic imaging modality has the highest negative predictive value for
appendicitis?
ANSWERS 100% CORRECT
Which of the following best describes visceral abdominal pain?
A. Sharp, localized pain from the parietal peritoneum
B. Pain radiating to the right shoulder from cholecystitis
C. Dull, deep, and poorly localized pain due to distension or ischemia
D. Cramping pain from the muscular wall of the abdomen - ANSWER Answer: C
C. Dull, deep, and poorly localized pain due to distension or ischemia
A patient presents with sudden, severe abdominal pain and hypotension. What
diagnosis should be strongly considered based on the timing and severity?
A. Gastroenteritis
B. Ruptured abdominal aortic aneurysm
C. Acute pancreatitis
D. Peptic ulcer disease - ANSWER Answer: B
B. Ruptured abdominal aortic aneurysm
Periumbilical pain is most often associated with pathology in which of the following?
A. Stomach and pancreas
B. Large bowel and rectum
C. Small bowel and appendix
D. Gallbladder and liver - ANSWER Answer: C
C. Small bowel and appendix
In a patient with acute abdominal pain, which finding would most likely lead you to
suspect mesenteric ischemia?
,A. Gradual onset of epigastric pain
B. History of alcohol use
C. Immediate onset of severe pain
D. Lower quadrant tenderness - ANSWER Answer: C
C. Immediate onset of severe pain
Which of the following lab tests is most essential to order in a female patient of
childbearing age with acute abdominal pain?
A. Serum lipase
B. Coagulation panel
C. Liver function tests
D. Pregnancy test - ANSWER D. Pregnancy test
Answer: D
A bedside ultrasound reveals gallstones and a stone in the common bile duct. What
imaging finding confirms this diagnosis?
A. Enlarged liver with fatty infiltration
B. Free fluid in the abdomen
C. Shadowing stone visible in the common bile duct
D. Bowel wall thickening - ANSWER Answer: C
C. Shadowing stone visible in the common bile duct
Which of the following is NOT a typical component of nonoperative management for
acute abdominal issues?
A. NPO status
B. Intravenous hydration
C. Immediate surgical exploration
D. Pain control and antibiotics - ANSWER Answer: C
,C. Immediate surgical exploration
What is a key indication for using a CT scan with contrast in evaluating abdominal pain?
A. Suspected gallbladder stones in a thin patient
B. Suspected mesenteric ischemia or bleeding
C. Patient history of constipation
D. Routine imaging for all patients with nausea - ANSWER Answer: B
B. Suspected mesenteric ischemia or bleeding
What is the purpose of leaving the abdomen open with dressings and drains after an
initial surgical intervention?
A. To allow direct wound healing by secondary intention
B. To delay surgical treatment until resources are available
C. To provide temporary stabilization and allow reoperation after edema subsides
D. To reduce the cost of operative closure - ANSWER Answer: C
C. To provide temporary stabilization and allow reoperation after edema subsides
Which of the following is a postoperative complication associated with acute abdominal
problems?
A. Abdominal aortic aneurysm rupture
B. Referred shoulder pain
C. Postoperative ileus
D. Pancreatic pseudocyst - ANSWER Answer: C
C. Postoperative ileus
What is the most common cause of appendicitis?
A. Viral infection of the GI tract
B. Obstruction of the appendiceal lumen
, C. Autoimmune inflammation
D. Hemorrhagic infarction - ANSWER Answer: B
B. Obstruction of the appendiceal lumen
Which patient population is at highest risk for mortality from appendicitis?
A. Children under 10
B. Young adult females
C. Elderly adults
D. Athletes - ANSWER Answer: C
C. Elderly adults
A patient presents with vague abdominal pain that later migrates to the right lower
quadrant and becomes sharp. This pain is most likely located at:
A. Hesselbach's triangle
B. McBurney's point
C. Murphy's point
D. Rovsing's point - ANSWER Answer: B
B. McBurney's point
Which of the following signs suggests that the appendix is retrocecal in location?
A. Murphy's sign
B. Obturator sign
C. Rovsing's sign
D. Psoas sign - ANSWER Answer: D
D. Psoas sign
Which diagnostic imaging modality has the highest negative predictive value for
appendicitis?
