NR 509: Abdominal Pain Assessment – Original
Practice Exam
Esther Park Case Focus | Shadow Health Style | With
Detailed Rationales
Question 1
A 28-year-old female presents with abdominal pain. When using the OLDCARTS
mnemonic to assess her pain, which question best evaluates the "R" (Radiation)
component?
A) "Can you point to where the pain started?"
B) "Does the pain move to any other area, like your back or shoulder?"
C) "On a scale of 0-10, how would you rate your pain right now?"
D) "What were you doing when the pain first began?"
✅ Correct Answer: B
Rationale: The "R" in OLDCARTS stands for Radiation/Region. Asking if pain moves to
other areas (e.g., back, shoulder, groin) helps identify patterns suggestive of specific
conditions (e.g., cholecystitis radiating to right scapula, pancreatitis to back). Option A
assesses Region/Onset, C assesses Severity, and D assesses Onset/Provocation.
Understanding radiation patterns is critical for differential diagnosis.
Question 2
During the subjective interview with Esther Park, she reports, "My stomach has been
hurting for 3 days, and it gets worse after I eat." Which follow-up question is the
PRIORITY to assess for potential red flags?
A) "Have you noticed any changes in your bowel habits?"
B) "Are you experiencing fever, chills, or vomiting?"
C) "What types of food make the pain worse?"
, D) "Have you tried any over-the-counter medications?"
✅ Correct Answer: B
Rationale: Assessing for systemic symptoms (fever, chills, vomiting) is priority to
identify signs of infection, obstruction, or acute surgical conditions (e.g., appendicitis,
cholecystitis). While options A, C, and D provide useful data, identifying "red flag"
symptoms that suggest urgent pathology aligns with safety and prioritization
frameworks (ABCs, acute vs. chronic). Missing systemic signs could delay critical
intervention.
Question 3
A patient states, "The pain is sharp and only hurts right here." When documenting the
location using anatomical landmarks, the nurse should:
A) Record "patient points to epigastric area"
B) Use the nine-region abdominal map to document precise location
C) Note "localized pain in lower right quadrant"
D) Document "pain at McBurney's point"
✅ Correct Answer: B
Rationale: Using the nine-region abdominal map provides standardized, precise
documentation that facilitates communication among providers and supports clinical
reasoning. While options A, C, and D may be accurate in specific cases, they assume
interpretation before full assessment. The nine-region approach (right/left
hypochondriac, epigastric, lumbar, umbilical, iliac, hypogastric) ensures
comprehensive, objective documentation regardless of suspected diagnosis.
Question 4
Which question best assesses for associated symptoms that may indicate
gastrointestinal bleeding in a patient with abdominal pain?
A) "Have you noticed your stools are black or tarry?"
B) "Do you feel nauseated after eating?"
Practice Exam
Esther Park Case Focus | Shadow Health Style | With
Detailed Rationales
Question 1
A 28-year-old female presents with abdominal pain. When using the OLDCARTS
mnemonic to assess her pain, which question best evaluates the "R" (Radiation)
component?
A) "Can you point to where the pain started?"
B) "Does the pain move to any other area, like your back or shoulder?"
C) "On a scale of 0-10, how would you rate your pain right now?"
D) "What were you doing when the pain first began?"
✅ Correct Answer: B
Rationale: The "R" in OLDCARTS stands for Radiation/Region. Asking if pain moves to
other areas (e.g., back, shoulder, groin) helps identify patterns suggestive of specific
conditions (e.g., cholecystitis radiating to right scapula, pancreatitis to back). Option A
assesses Region/Onset, C assesses Severity, and D assesses Onset/Provocation.
Understanding radiation patterns is critical for differential diagnosis.
Question 2
During the subjective interview with Esther Park, she reports, "My stomach has been
hurting for 3 days, and it gets worse after I eat." Which follow-up question is the
PRIORITY to assess for potential red flags?
A) "Have you noticed any changes in your bowel habits?"
B) "Are you experiencing fever, chills, or vomiting?"
C) "What types of food make the pain worse?"
, D) "Have you tried any over-the-counter medications?"
✅ Correct Answer: B
Rationale: Assessing for systemic symptoms (fever, chills, vomiting) is priority to
identify signs of infection, obstruction, or acute surgical conditions (e.g., appendicitis,
cholecystitis). While options A, C, and D provide useful data, identifying "red flag"
symptoms that suggest urgent pathology aligns with safety and prioritization
frameworks (ABCs, acute vs. chronic). Missing systemic signs could delay critical
intervention.
Question 3
A patient states, "The pain is sharp and only hurts right here." When documenting the
location using anatomical landmarks, the nurse should:
A) Record "patient points to epigastric area"
B) Use the nine-region abdominal map to document precise location
C) Note "localized pain in lower right quadrant"
D) Document "pain at McBurney's point"
✅ Correct Answer: B
Rationale: Using the nine-region abdominal map provides standardized, precise
documentation that facilitates communication among providers and supports clinical
reasoning. While options A, C, and D may be accurate in specific cases, they assume
interpretation before full assessment. The nine-region approach (right/left
hypochondriac, epigastric, lumbar, umbilical, iliac, hypogastric) ensures
comprehensive, objective documentation regardless of suspected diagnosis.
Question 4
Which question best assesses for associated symptoms that may indicate
gastrointestinal bleeding in a patient with abdominal pain?
A) "Have you noticed your stools are black or tarry?"
B) "Do you feel nauseated after eating?"
