Chapter 18: Abdomen
Ball: Seidel’s Guide to Physical Examination, 9th Edition
MULTIPLE CHOICE
1. Mrs. James is 7 months’ pregnant and states that she has developed a problem with
constipation. She eats a well-balanced diet and is usually regular. You should explain that
constipation is common during pregnancy because of changes in the colorectal areas, such as:
a. decreased movement through the colon and increased water absorption from the
stool.
b. increased movement through the colon and increased salt taken from foods.
c. looser anal sphincter and fewer nutrients taken from foods.
d. tighter anal sphincter and less iron eliminated in the stool.
ANS: A
Constipation and flatus are more common during pregnancy because the colon is displaced,
peristalsis is decreased, and water absorption is increased. Movement through the colon is
decreased during pregnancy. The colon does not absorb nutrients. A tighter sphincter tone is not
related to pregnancy.
DIF: Cognitive Level: Applying (Application)
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
2. The family history of a patient with diarrhea and abdominal pain should include inquiry about
cystic fibrosis because it is:
a. a common genetic disorder.
b. one cause of malabsorption syndrome.
c. a curable condition with medical intervention.
d. the most frequent cause of diarrhea in general practice.
ANS: B
Cystic fibrosis is an uncommon, chronic genetic disorder affecting multiple systems. In the
gastrointestinal tract, it causes malabsorption syndrome because of pancreatic lipase deficiency.
Steatorrhea and abdominal pain from increased gas production are frequent complaints.
DIF: Cognitive Level: Applying (Application)
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
3. When assessing abdominal pain in a college-age woman, one must include:
a. history of interstate travel.
b. food likes and dislikes.
c. age at completion of toilet training.
d. the first day of the last menstrual period.
ANS: D
Exploring abdominal pain complaints in a young woman can reveal multiple causes related to the
menstrual cycle, including menstrual pain, ovulation discomfort, and abnormal menses. Asking
the patient to tell you the first day of her last menstrual period can help discriminate among these
factors. History of international travel and traveler’s diarrhea can be related to abdominal pain,
, but interstate travel usually does not. Food preferences and age at completion of toilet training
are not relevant.
DIF: Cognitive Level: Applying (Application)
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
4. Infants born weighing less than 1500 g are at higher risk for:
a. hepatitis A.
b. necrotizing enterocolitis.
c. urinary urgency.
d. pancreatitis.
ANS: B
Necrotizing enterocolitis is a gastrointestinal disease that mostly affects premature infants. It
involves infection and inflammation that cause destruction of the bowel, and it becomes more
apparent after feedings.
DIF: Cognitive Level: Analyzing (Analysis)
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
5. You are completing a general physical examination on Mr. Rock, a 39-year-old man with
complaints of constipation. When examining a patient with tense abdominal musculature, a
helpful technique is to have the patient:
a. hold his or her breath.
b. sit upright.
c. flex his or her knees.
d. raise his or her head off the pillow.
ANS: C
To help relax the abdominal musculature, it is helpful to place a small pillow under the patient’s
head and under slightly flexed knees. The other techniques are not helpful because they increase
muscle flexion.
DIF: Cognitive Level: Applying (Application)
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
6. Mrs. Little is a 44-year-old patient who presents to the office with abdominal pain and fever.
During your examination, you ask the patient to raise her head and shoulders while she lies in a
supine position. A midline abdominal ridge rises. You document this observation as a(n):
a. small inguinal hernia.
b. large epigastric hernia.
c. abdominal lipoma.
d. diastasis recti.
ANS: D
A diastasis recti occurs when the abdominal contents bulge between two abdominal muscles to
form a midline ridge as the head is lifted. It has little clinical significance and usually occurs in
women who have had repeated pregnancies and in obese patients.
DIF: Cognitive Level: Applying (Application)
OBJ: Nursing process—assessment
MSC: Integrated Process: Communication and Documentation
7. Mr. Robins is a 45-year-old man who presents to the emergency department with a complaint
of constipation. During auscultation, you note borborygmi sounds. This is associated with:
Ball: Seidel’s Guide to Physical Examination, 9th Edition
MULTIPLE CHOICE
1. Mrs. James is 7 months’ pregnant and states that she has developed a problem with
constipation. She eats a well-balanced diet and is usually regular. You should explain that
constipation is common during pregnancy because of changes in the colorectal areas, such as:
a. decreased movement through the colon and increased water absorption from the
stool.
b. increased movement through the colon and increased salt taken from foods.
c. looser anal sphincter and fewer nutrients taken from foods.
d. tighter anal sphincter and less iron eliminated in the stool.
ANS: A
Constipation and flatus are more common during pregnancy because the colon is displaced,
peristalsis is decreased, and water absorption is increased. Movement through the colon is
decreased during pregnancy. The colon does not absorb nutrients. A tighter sphincter tone is not
related to pregnancy.
DIF: Cognitive Level: Applying (Application)
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
2. The family history of a patient with diarrhea and abdominal pain should include inquiry about
cystic fibrosis because it is:
a. a common genetic disorder.
b. one cause of malabsorption syndrome.
c. a curable condition with medical intervention.
d. the most frequent cause of diarrhea in general practice.
ANS: B
Cystic fibrosis is an uncommon, chronic genetic disorder affecting multiple systems. In the
gastrointestinal tract, it causes malabsorption syndrome because of pancreatic lipase deficiency.
Steatorrhea and abdominal pain from increased gas production are frequent complaints.
DIF: Cognitive Level: Applying (Application)
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
3. When assessing abdominal pain in a college-age woman, one must include:
a. history of interstate travel.
b. food likes and dislikes.
c. age at completion of toilet training.
d. the first day of the last menstrual period.
ANS: D
Exploring abdominal pain complaints in a young woman can reveal multiple causes related to the
menstrual cycle, including menstrual pain, ovulation discomfort, and abnormal menses. Asking
the patient to tell you the first day of her last menstrual period can help discriminate among these
factors. History of international travel and traveler’s diarrhea can be related to abdominal pain,
, but interstate travel usually does not. Food preferences and age at completion of toilet training
are not relevant.
DIF: Cognitive Level: Applying (Application)
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
4. Infants born weighing less than 1500 g are at higher risk for:
a. hepatitis A.
b. necrotizing enterocolitis.
c. urinary urgency.
d. pancreatitis.
ANS: B
Necrotizing enterocolitis is a gastrointestinal disease that mostly affects premature infants. It
involves infection and inflammation that cause destruction of the bowel, and it becomes more
apparent after feedings.
DIF: Cognitive Level: Analyzing (Analysis)
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
5. You are completing a general physical examination on Mr. Rock, a 39-year-old man with
complaints of constipation. When examining a patient with tense abdominal musculature, a
helpful technique is to have the patient:
a. hold his or her breath.
b. sit upright.
c. flex his or her knees.
d. raise his or her head off the pillow.
ANS: C
To help relax the abdominal musculature, it is helpful to place a small pillow under the patient’s
head and under slightly flexed knees. The other techniques are not helpful because they increase
muscle flexion.
DIF: Cognitive Level: Applying (Application)
OBJ: Nursing process—assessment MSC: Physiologic Integrity: Physiologic Adaptation
6. Mrs. Little is a 44-year-old patient who presents to the office with abdominal pain and fever.
During your examination, you ask the patient to raise her head and shoulders while she lies in a
supine position. A midline abdominal ridge rises. You document this observation as a(n):
a. small inguinal hernia.
b. large epigastric hernia.
c. abdominal lipoma.
d. diastasis recti.
ANS: D
A diastasis recti occurs when the abdominal contents bulge between two abdominal muscles to
form a midline ridge as the head is lifted. It has little clinical significance and usually occurs in
women who have had repeated pregnancies and in obese patients.
DIF: Cognitive Level: Applying (Application)
OBJ: Nursing process—assessment
MSC: Integrated Process: Communication and Documentation
7. Mr. Robins is a 45-year-old man who presents to the emergency department with a complaint
of constipation. During auscultation, you note borborygmi sounds. This is associated with:
