1. A patient complains of severe and sharp pain in the right lower abdominal quadrant.

Based on the location, what organ or structure is most likely involved? a. b. c. d. The liver The kidney The spleen The appendi

Answer! d "b#ective! 1$%& 'eference! &($ ). Because the spleen is a solid organ, the primary threat to life when it is ruptured is! a. b. c. d. blood loss. pain. infection. inflammation.

Answer! a "b#ective! 1$%1 'eference! &($ *. The pancreas is best described as a+n,! a. b. c. d. absorptive organ. hollow organ. solid organ. fluid%filled organ.

Answer! c "b#ective! 1$%& 'eference! &($ &. -hich of the following statements is most likely to be said by a patient with parietal pain? a. b. c. d. ./ feel as though / have to vomit but can0t.1 ./t seems to hurt all over my belly and back.1 ./t hurts right here.1 .The pain seems to be dull and achy.1

Answer! c "b#ective! 1$%2 'eference! 233

2. A middle aged female patient informs you that she has a bad gallbladder and that it has been increasingly bothering her. 4our assessment reveals tenderness and mild discomfort in the right upper quadrant of her abdomen. 5he also states that her right shoulder is aching. 6iven her history and complaint, you would recogni7e her shoulder pain as! a. b. c. d. referred pain. false pain. unrelated pain. muscular pain.

Answer! a "b#ective! 1$%) 'eference! 233 $. -hich of the following statements indicates that an "89 Technician understands the goal of assessing a patient with abdominal pain? a. ./t is important to determine if the liver is the cause of pain, because a liver in#ury can cause the most life%threatening conditions.1 b. ./f the patient has tenderness upon palpation of the abdomen, you should assume that bleeding is the cause.1 c. ./t is more important to recogni7e a possible abdominal emergency than to determine its e act cause.1 d. .To best treat the patient, you must identify the e act cause of any abdominal pain.1 Answer! c "b#ective! 1$%) 'eference! 23: ;. 4ou are called to aid a patient complaining of abdominal pain. -hen you arrive, you find him lying supine complaining of pain in his lower abdomen. <e is pale and has a look of distress on his face. -hich of the following actions should you take first? a. b. c. d. /nspect his abdomen. =alpate his abdomen. Assess his AB9>s. "btain a blood pressure reading.

Answer! c "b#ective! 1$%& 'eference! 23: :. A &*%year%old woman who is crying states that she has sharp abdominal pain that is locali7ed to her right lower quadrant. -hen assessing her abdomen, you would!

a. b. c. d.

start by palpating the left upper quadrant. avoid palpating the entire abdomen. start by palpating in the right lower quadrant. avoid palpating the right lower quadrant.

Answer! a "b#ective! 1$%& 'eference! 23( (. -hile providing an in%service on abdominal pain, your medical director states that there are several different categories of pain and asks if anyone can identify and describe visceral pain. -hich of the following responses is correct? a. .?isceral pain is typically described as @sharp0 and occurs when a hollow organ has become infected.1 b. .A patient can easily locate the e act site of visceral pain, which is typically associated with nausea and vomiting.1 c. .?isceral pain occurs when an infection of the peritoneum lining the abdomen causes a rapid increase in body temperature.1 d. .A patient with visceral pain typically describes the pain as @aching0 and has a difficult time identifying its e act location.1 Answer! d "b#ective! 1$%* 'eference! 233 13. -hich of the following assessment findings would increase your suspicion of gastrointestinal bleeding? a. b. c. d. 5udden onset of constipation -atery and foul%smelling diarrhea Tarry, black stool 5harp pain in the left lower quadrant

Answer! c "b#ective! 1$%) 'eference! 23& 11. Assessment of a )1%year%old woman reveals that she has severe abdominal pain locali7ed to her right upper quadrant. 5he is alert and oriented and has stable vital signs. After placing her supine on a stretcher, she quickly assumes a lateral recumbent position with her knees drawn up to her chest. -hich of the following responses from you would be appropriate?

a. ./t would be best if you stay on your back. 5taying there will help decrease the pain.1 b. .4ou can stay on your side, but / need to you to keep your legs straight to help decrease the pain.1 c. ./ need you to stay on your back and with your head up. That way, if you vomit you won0t aspirate it.1 d. .Are you more comfortable in that position? /f you are, then you should stay on your side.1 Answer! d "b#ective! 1$%2 'eference! 23( 1). 4ou are called to assist a woman complaining of abdominal pain. Assessment reveals her to be nauseated and to have pain that is locali7ed to the right lower quadrant of her abdomen. 5he states that she was not able to take her blood pressure medication this morning, and that she wants to take it now with a small glass of #uice. Antil she receives a further medical evaluation, you would encourage her to! a. b. c. d. go ahead and take the medicine with #uice. crush the medication and then mi it in a small amount of water. not take her medication or drink #uice. take the medication with water instead of #uice.

Answer! c "b#ective! 1$%2 'eference! 213 1*. 4ou suspect that a man e periencing right lower quadrant pain has appendicitis. <e states that he has no health insurance and wants to refuse care. <e asks you what can happen if he has appendicitis but does not go to the hospital. -hich of the following statements would you make in reply? a. .4our appendi could rupture, causing a ma#or infection, shock, and possible death.1 b. .The inflammation of the appendi will gradually subside, but in the meantime the pain can be terrible.1 c. ./f you do not get care, blood may clot in your intestine and cause an obstruction.1 d. .Take an antacid, and if the pain does not subside in an hour or two, then you should go to the hospital.1 Answer! a "b#ective! 1$%2 'eference! 233

1&. -hich of the following statements regarding abdominal pain would lead you to suspect appendicitis? a. .The stabbing pain started in the right side of my belly and spread up to my stomach.1 b. ./ had back pain for about a week, and now the pain is all throughout my belly.1 c. .The pain started around my belly button and slowly spread down to the right side of my belly.1 d. .The pain comes and goes and is more noticeable on the left side of my stomach.1 Answer! c "b#ective! 1$%) 'eference! 233 12. -hen you are obtaining information for a medical history, which of the following items would be significant for a patient with suspected cholecystitis? a. b. c. d. The patient started taking a new medication for high blood pressure. The patient e perienced a recent une plained weight loss. The patient has abstained from drinking alcohol over the past month. The patient ate fried chicken and potato salad for dinner.

Answer! d "b#ective! 1$%) 'eference! 23) 1$. A 1&%year%old girl sitting in the lodge is complaining of severe abdominal and flank pain. 5he tells you that her symptoms started a couple of days ago but have worsened over the last few hours. 5he has chills and thinks she might have a fever. Based on her complaints, you are concerned that she may have! a. b. c. d. cholecystitis. pyelonephritis. hepatitis. nephrolithiasis.

Answer! b "b#ective! 1$%1 'eference! 23) 1;. -hich of the following statements is false? a. Assessing abdominal complaints can be difficult because the nerve pathways for the gastrointestinal, urinary, and reproductive systems are in relative pro imity to each other.

b. =roblems affecting the organs in one system can seriously affect organs in another system. c. Assessment of abdominal complaints is straightforward because the organs are specifically located and easily palpated. d. "ne of the problems encountered when assessing abdominal complaints is a patient0s reluctance to allow the e am due to embarrassment or pain. Answer! c "b#ective! 1$%& 'eference! &(( 1:. 9olic is best described as! a. intermittent severe abdominal pain caused by the obstruction and distension of a hollow organ. b. an inflammatory condition involving the lining of the stomach. c. a violent contraction of the stomach muscles due to no ious stimuli. d. bloody stool. Answer! a "b#ective! 1$%1 'eference! 23$ 1(. -hich of the following statements regarding acute abdomen is false? a. "89 Technicians need to be able to pinpoint the source of an acute abdomen. b. =hysicians accurately diagnose the source of an acute abdomen on first e amination only about 23 percent of the time. c. "89 Technicians need only be able to recogni7e that the patient is very ill and needs to go the hospital. d. An acute abdomen can rapidly spiral into septic or hypovolemic shock. Answer! a "b#ective! 1$%) 'eference! &(( )3. 'ebound tenderness is best described as! a. a very useful finding for diagnosing a problem in a prehospital environment. b. severe pain that occurs after the sudden release of abdominal palpation pressure during an e amination of the abdomen. c. a type of pain that is initially relieved by vomiting but returns within a short period of time. d. pain that radiates into an area other than the site of the affected organ. Answer! b

"b#ective! 1$%) 'eference! 23( )1. A conscious patient with a 6/B6A complaint is most often comfortable in! a. b. c. d. a supine position with the knees slightly fle ed. the recovery position. the Trendelenburg position. a supine position with the feet elevated 1)C1: inches.

Answer! a "b#ective! 1$%2 'eference! 213 )). An infection involving one or both kidneys and ureters is called! a. b. c. d. a perforated bowel. a bowel obstruction. pyelonephritis. melena.

Answer! c "b#ective! 1$%1 'eference! 23) )*. Abdominal aortic aneurysm +AAA, is a true emergency because it can lead to! a. b. c. d. sudden death. severe pain. moderate blood loss. vomiting.

Answer! a "b#ective! 1$%1 'eference! 23& )&. The most common 6/ problem that "89 Technicians encounter is! a. b. c. d. constipation. indigestion. colic. gastroenteritis.

Answer! d "b#ective! 1$%1 'eference! 232