NR 509 Advanced Physical Assessment
Abdominal Pain (Esther Park Shadow Health)
Study Guide, 2026/2027 – 75-Question
Examination with Verified Solutions
ESTHER PARK: CASE BACKGROUND
Patient Attribute Details
Age 78 years
Ethnicity Asian
Chief Complaint Abdominal pain, difficulty with bowel movements
Duration Pain for 5 days, worsened over past 2-3 days
Pain Characteristics Dull and crampy, 6/10, lower abdomen (LLQ)
Bowel History No bowel movement for 5 days; mild diarrhea 3 days ago
Past Surgeries Cholecystectomy (age 42), Cesarean section (age 40)
Medical History Hypertension (diagnosed age 54)
Medications Accupril 10 mg daily
Allergies Latex (contact dermatitis)
Physical Findings LLQ mass, tenderness with guarding, distension; fecal mass on recta
,Patient Attribute Details
exam
PART 1: SUBJECTIVE DATA COLLECTION
(Questions 1-35)
1. When obtaining the chief complaint from Esther Park, what
question should the nurse ask FIRST?
A) "On a scale of 0 to 10, how would you rate your pain?"
B) "What brings you to the clinic today?"
C) "When did your pain start?"
D) "Have you tried anything to relieve your pain?"
Correct Answer: B
Rationale: The chief complaint is the reason for the patient's visit, expressed
in the patient's own words. Asking "What brings you to the clinic today?" is
the standard opening question that allows the patient to describe their
primary concern before the provider asks more specific follow-up questions.
2. Ms. Park reports that her abdominal pain started 5 days ago.
What follow-up question is MOST appropriate to assess pain onset
and progression?
A) "Has the pain changed since it started?"
B) "Do you have a history of abdominal pain?"
C) "Is the pain sharp or dull?"
D) "Does anyone in your family have similar pain?"
Correct Answer: A
Rationale: After establishing the onset, asking about changes in the pain
over time helps characterize its progression. Ms. Park reports that the pain
worsened intensely 2-3 days ago, indicating a progressive condition.
3. What is Ms. Park's current pain rating on a scale of 0-10, and
what has been the worst rating?
, A) Current 4/10; worst 6/10
B) Current 2/10; worst 8/10
C) Current 6/10; worst 10/10
D) Current 0/10; worst 5/10
Correct Answer: B
Rationale: Ms. Park rates her current pain as 2/10, with the lowest being
2/10 and the worst at 8/10. This fluctuation in severity helps assess the
acute nature of the condition.
4. A 6/10 pain rating indicates:
A) Mild pain
B) Moderate pain
C) Severe pain
D) No pain
Correct Answer: B
Rationale: On a 0-10 scale, 1-3 is mild, 4-6 is moderate, and 7-10 is severe.
A 6/10 indicates moderate pain that is interfering with Ms. Park's daily
activities, as she reports "not being able to go about her normal daily
activities due to the pain".
5. Ms. Park reports that her abdominal pain is located in the lower
abdomen. On further questioning, she identifies the left lower
quadrant (LLQ) as the primary location. Which of the following
structures is located in the LLQ?
A) Appendix
B) Gallbladder
C) Sigmoid colon
D) Liver
Correct Answer: C
Rationale: The sigmoid colon is located in the left lower quadrant. The
appendix and cecum are in the right lower quadrant. The gallbladder and
liver are in the right upper quadrant.
6. Ms. Park reports she has not had a bowel movement in 5 days but
had a single episode of watery diarrhea 3 days ago. This pattern is
known as:
A) Overflow diarrhea
B) Paradoxical diarrhea
C) Osmotic diarrhea
D) Secretory diarrhea
Abdominal Pain (Esther Park Shadow Health)
Study Guide, 2026/2027 – 75-Question
Examination with Verified Solutions
ESTHER PARK: CASE BACKGROUND
Patient Attribute Details
Age 78 years
Ethnicity Asian
Chief Complaint Abdominal pain, difficulty with bowel movements
Duration Pain for 5 days, worsened over past 2-3 days
Pain Characteristics Dull and crampy, 6/10, lower abdomen (LLQ)
Bowel History No bowel movement for 5 days; mild diarrhea 3 days ago
Past Surgeries Cholecystectomy (age 42), Cesarean section (age 40)
Medical History Hypertension (diagnosed age 54)
Medications Accupril 10 mg daily
Allergies Latex (contact dermatitis)
Physical Findings LLQ mass, tenderness with guarding, distension; fecal mass on recta
,Patient Attribute Details
exam
PART 1: SUBJECTIVE DATA COLLECTION
(Questions 1-35)
1. When obtaining the chief complaint from Esther Park, what
question should the nurse ask FIRST?
A) "On a scale of 0 to 10, how would you rate your pain?"
B) "What brings you to the clinic today?"
C) "When did your pain start?"
D) "Have you tried anything to relieve your pain?"
Correct Answer: B
Rationale: The chief complaint is the reason for the patient's visit, expressed
in the patient's own words. Asking "What brings you to the clinic today?" is
the standard opening question that allows the patient to describe their
primary concern before the provider asks more specific follow-up questions.
2. Ms. Park reports that her abdominal pain started 5 days ago.
What follow-up question is MOST appropriate to assess pain onset
and progression?
A) "Has the pain changed since it started?"
B) "Do you have a history of abdominal pain?"
C) "Is the pain sharp or dull?"
D) "Does anyone in your family have similar pain?"
Correct Answer: A
Rationale: After establishing the onset, asking about changes in the pain
over time helps characterize its progression. Ms. Park reports that the pain
worsened intensely 2-3 days ago, indicating a progressive condition.
3. What is Ms. Park's current pain rating on a scale of 0-10, and
what has been the worst rating?
, A) Current 4/10; worst 6/10
B) Current 2/10; worst 8/10
C) Current 6/10; worst 10/10
D) Current 0/10; worst 5/10
Correct Answer: B
Rationale: Ms. Park rates her current pain as 2/10, with the lowest being
2/10 and the worst at 8/10. This fluctuation in severity helps assess the
acute nature of the condition.
4. A 6/10 pain rating indicates:
A) Mild pain
B) Moderate pain
C) Severe pain
D) No pain
Correct Answer: B
Rationale: On a 0-10 scale, 1-3 is mild, 4-6 is moderate, and 7-10 is severe.
A 6/10 indicates moderate pain that is interfering with Ms. Park's daily
activities, as she reports "not being able to go about her normal daily
activities due to the pain".
5. Ms. Park reports that her abdominal pain is located in the lower
abdomen. On further questioning, she identifies the left lower
quadrant (LLQ) as the primary location. Which of the following
structures is located in the LLQ?
A) Appendix
B) Gallbladder
C) Sigmoid colon
D) Liver
Correct Answer: C
Rationale: The sigmoid colon is located in the left lower quadrant. The
appendix and cecum are in the right lower quadrant. The gallbladder and
liver are in the right upper quadrant.
6. Ms. Park reports she has not had a bowel movement in 5 days but
had a single episode of watery diarrhea 3 days ago. This pattern is
known as:
A) Overflow diarrhea
B) Paradoxical diarrhea
C) Osmotic diarrhea
D) Secretory diarrhea
