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Exam (elaborations)

Gnur 238 Gi/Abdominal Assessment & Nursing Care Actual Exam

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GNUR 238 GI/ABDOMINAL ASSESSMENT & NURSING CARE ACTUAL EXAM

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ESTUDYR



GNUR 238 GI/ABDOMINAL ASSESSMENT &
NURSING CARE ACTUAL EXAM
1. Question: Which question is most appropriate to ask a patient regarding their bowel
habits?
A. “When was your last bowel movement and have you noticed any changes in your
stool pattern?”
B. “Do you ever experience pain or burning when swallowing food?”
C. “Have you had any recent nosebleeds or headaches?”
D. “What medications do you take for headaches?”
Answer: A. “When was your last bowel movement and have you noticed any changes in
your stool pattern?”
Rationale: A thorough GI history includes questions about bowel habits (frequency,
consistency, pattern) . Asking about the last bowel movement and any changes helps
detect issues like constipation or diarrhea. The other options are unrelated to GI history.

2. Question: Black, tarry stools (melena) typically indicate:
A. Bleeding in the lower gastrointestinal tract (e.g. colon)
B. Bleeding in the upper gastrointestinal tract (e.g. stomach or duodenum)
C. Normal digestion of dark foods
D. Kidney failure
Answer: B. Bleeding in the upper gastrointestinal tract (e.g. stomach or duodenum)
Rationale: Melena (black, tarry stool) results from digested blood and usually signifies
an upper GI bleed (from the esophagus, stomach, or duodenum) . Fresh bright red blood
(hematochezia) rather suggests lower GI bleeding.

3. Question: Bright red blood in the stool (hematochezia) usually suggests bleeding from:
A. The upper GI tract (esophagus or stomach)
B. The lower GI tract (colon or rectum)
C. The urinary tract
D. The respiratory tract
Answer: B. The lower GI tract (colon or rectum)
Rationale: Hematochezia (bright red blood) typically comes from the lower GI tract (e.g.
colon, rectum) . This can occur with conditions like hemorrhoids or colonic lesions.
Upper GI bleeding usually leads to dark, tarry stool (melena), not bright red blood.

4. Question: What is considered a normal range for adult stool frequency?
A. Once per month

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B. Once per day
C. Three times per week to three times per day
D. Five times per day or more
Answer: C. Three times per week to three times per day
Rationale: Population studies show that normal adult stool frequency ranges between
about three times a week and three times a day . Frequencies outside this range may
indicate constipation or diarrhea.

5. Question: When obtaining a genitourinary history, which question is most relevant for a
patient with urinary concerns?
A. “Do you experience pain or burning when you urinate?”
B. “Have you been experiencing frequent headaches?”
C. “Do you have chest pain on exertion?”
D. “Do you have any known food allergies?”
Answer: A. “Do you experience pain or burning when you urinate?”
Rationale: Asking about dysuria (painful or burning urination) directly addresses urinary
tract symptoms . It is a key question in GU history. The other options are unrelated to
urinary symptoms.

6. Question: Which question would you ask to assess for urinary incontinence?
A. “Do you ever have involuntary urine leakage when you cough, sneeze, or laugh?”
B. “How many hours of sleep do you get at night?”
C. “Do you experience pain in your legs when walking?”
D. “Have you had a colonoscopy recently?”
Answer: A. “Do you ever have involuntary urine leakage when you cough, sneeze, or
laugh?”
Rationale: This question screens for stress urinary incontinence, which is leakage during
activities that increase abdominal pressure . The other questions are not directly related
to urinary incontinence.

7. Question: In taking a genitourinary history, asking “Have you noticed any blood in your
urine?” helps evaluate for:
A. Urinary tract infection only
B. Dehydration
C. Hematuria (blood in urine)
D. Liver function
Answer: C. Hematuria (blood in urine)
Rationale: Hematuria is the presence of red blood cells in the urine. Asking about blood

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in the urine identifies this symptom, which could indicate kidney stones, infection, or
other GU pathology .

8. Question: Frequent nighttime urination (nocturia) in an older male patient may suggest:
A. Diabetes insipidus
B. Benign prostatic hyperplasia (BPH) or prostate enlargement
C. Migraine headaches
D. Asthma
Answer: B. Benign prostatic hyperplasia (BPH) or prostate enlargement
Rationale: Nocturia (excessive urination at night) in older men is commonly associated
with prostate enlargement or BPH . This symptom is a classic sign of urinary outflow
obstruction due to prostate issues.

Abdominal Examination Techniques

9. Question: What is the correct sequence of steps for abdominal physical examination?
A. Inspect, Auscultate, Percuss, Palpate (Correct sequence)
B. Inspect, Palpate, Auscultate, Percuss
C. Auscultate, Inspect, Palpate, Percuss
D. Palpate, Percuss, Auscultate, Inspect
Answer: A. Inspect, Auscultate, Percuss, Palpate
Rationale: The abdomen should be examined in the order of inspection first (visualize
contour, movement, lesions), then auscultation (listen to bowel and vascular sounds),
followed by percussion (determine organ size, fluid, masses), and finally palpation . This
sequence avoids disturbing bowel sounds before they are assessed.

10. Question: Why is auscultation performed before percussion and palpation during
abdominal exam?
A. Palpation or percussion can alter bowel sounds
B. Auscultation is the most uncomfortable part
C. The stethoscope needs to warm up
D. There is no specific reason; it’s just traditional
Answer: A. Palpation or percussion can alter bowel sounds
Rationale: Manipulating the abdomen (with percussion or palpation) can stimulate or
change the bowel activity and thus alter the sounds. Therefore, auscultation is done first
to accurately assess the undisturbed bowel sounds .

11. Question: If no bowel sounds are heard in a quadrant, how long should you listen
before concluding they are absent?
A. 1 minute

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