NR 511 final exam with answers
mesenteric infarction - CORRECT ANSWERS ✔✔Patient presents with mid
epigastric pain, LUQ radiating to back, mild to very severe pain. Also has associated
nausea and vomiting diaphoresis, pain is worse with lying supine. Physical
assessment shows diminished bowel sounds and abdominal arteriogram.
Urinary stones/kidney stones - CORRECT ANSWERS ✔✔Patient presents with a
colicky flank pain progressing to constant and severe radiating to the groin in both
lower quadrant, patient has associated nausea vomiting fever chills and abdominal
distention. Costovertebral angle tenderness hematuria; do urinalysis IVP and US
intestinal perforation - CORRECT ANSWERS ✔✔Patient presents with severe,
parietal, diffuse pain; has associated guarding, rebound tenderness, pain is relieved
while lying still. Physical exam shows decreased bowel sounds, guarding, rebound
tenderness; get abdominal x-ray
intestinal obstruction - CORRECT ANSWERS ✔✔Patient presents with colicky right
lower quadrant and left lower quadrant pain; has associated nausea vomiting,
Anorexia, obstipation; physical exam shows hyperactive high-pitched bowel sounds
are hypo active bowel sounds, get an abdominal x-ray
Pancreatitis - CORRECT ANSWERS ✔✔Patient presents with severe, visceral, diffuse
pain. Has associated hypotension tachycardia; pain is relieved by leaning forward.
Physical exam shows abdominal distention, diminished bowel sounds, diffuse
rebound tenderness; will have elevated amylase levels
, ectopic pregnancy - CORRECT ANSWERS ✔✔Patient will present with persistent
right lower quadrant pain or left lower quadrant pain. May have vaginal bleeding.
Physical exam will show tender adnexal mass and will have a positive hCG test.
Dissection or Rupture of Aortic Aneurysm - CORRECT ANSWERS ✔✔Patient will
present with ripping, tearing, intense pain in chest, abdomen, lower back. Will have
associated hypotension, feelings of doom, shock. Physical exam will show shock,
diminished femoral pulses; get x-ray and CT scan
Peptic Ulcer Disease (PUD) - CORRECT ANSWERS ✔✔Patient presents with
annoying pain in epigastric region radiating to the back, right shoulder, or side.
Associated nausea, hunger; worse with empty stomach, alcohol, NSAIDs, ASA;
relieved with food and antacids. Will have epigastric tenderness to palpation. Studies
done is endoscopy and barium swallow
gastroesophageal reflux disease (GERD) - CORRECT ANSWERS ✔✔Patient will
present with epigastric, retrosternal pain. This pain will be intermittent. Patient may
have sour taste, low-grade bleeding, hoarseness, pharyngitis; worse with bending at
the waist, NSAIDs, ASA, alcohol, caffeine, recumbency; relieved with antacids. Test
are barium swallow, upper G.I., esophageal endoscopy with biopsy
gastritis - CORRECT ANSWERS ✔✔Patient will present with epigastric pain that is
constant. May have associated nausea, vomiting, diarrhea, fever, hemorrhage; worse
with alcohol, NSAIDs, aspirin; is rarely worse with food
salpingitis - CORRECT ANSWERS ✔✔Patient will present with right lower quadrant
and or left lower quadrant pain. Pain will be worse around menstruation and when
ascending stairs. There will be cervical motion and adnexal tenderness
mesenteric infarction - CORRECT ANSWERS ✔✔Patient presents with mid
epigastric pain, LUQ radiating to back, mild to very severe pain. Also has associated
nausea and vomiting diaphoresis, pain is worse with lying supine. Physical
assessment shows diminished bowel sounds and abdominal arteriogram.
Urinary stones/kidney stones - CORRECT ANSWERS ✔✔Patient presents with a
colicky flank pain progressing to constant and severe radiating to the groin in both
lower quadrant, patient has associated nausea vomiting fever chills and abdominal
distention. Costovertebral angle tenderness hematuria; do urinalysis IVP and US
intestinal perforation - CORRECT ANSWERS ✔✔Patient presents with severe,
parietal, diffuse pain; has associated guarding, rebound tenderness, pain is relieved
while lying still. Physical exam shows decreased bowel sounds, guarding, rebound
tenderness; get abdominal x-ray
intestinal obstruction - CORRECT ANSWERS ✔✔Patient presents with colicky right
lower quadrant and left lower quadrant pain; has associated nausea vomiting,
Anorexia, obstipation; physical exam shows hyperactive high-pitched bowel sounds
are hypo active bowel sounds, get an abdominal x-ray
Pancreatitis - CORRECT ANSWERS ✔✔Patient presents with severe, visceral, diffuse
pain. Has associated hypotension tachycardia; pain is relieved by leaning forward.
Physical exam shows abdominal distention, diminished bowel sounds, diffuse
rebound tenderness; will have elevated amylase levels
, ectopic pregnancy - CORRECT ANSWERS ✔✔Patient will present with persistent
right lower quadrant pain or left lower quadrant pain. May have vaginal bleeding.
Physical exam will show tender adnexal mass and will have a positive hCG test.
Dissection or Rupture of Aortic Aneurysm - CORRECT ANSWERS ✔✔Patient will
present with ripping, tearing, intense pain in chest, abdomen, lower back. Will have
associated hypotension, feelings of doom, shock. Physical exam will show shock,
diminished femoral pulses; get x-ray and CT scan
Peptic Ulcer Disease (PUD) - CORRECT ANSWERS ✔✔Patient presents with
annoying pain in epigastric region radiating to the back, right shoulder, or side.
Associated nausea, hunger; worse with empty stomach, alcohol, NSAIDs, ASA;
relieved with food and antacids. Will have epigastric tenderness to palpation. Studies
done is endoscopy and barium swallow
gastroesophageal reflux disease (GERD) - CORRECT ANSWERS ✔✔Patient will
present with epigastric, retrosternal pain. This pain will be intermittent. Patient may
have sour taste, low-grade bleeding, hoarseness, pharyngitis; worse with bending at
the waist, NSAIDs, ASA, alcohol, caffeine, recumbency; relieved with antacids. Test
are barium swallow, upper G.I., esophageal endoscopy with biopsy
gastritis - CORRECT ANSWERS ✔✔Patient will present with epigastric pain that is
constant. May have associated nausea, vomiting, diarrhea, fever, hemorrhage; worse
with alcohol, NSAIDs, aspirin; is rarely worse with food
salpingitis - CORRECT ANSWERS ✔✔Patient will present with right lower quadrant
and or left lower quadrant pain. Pain will be worse around menstruation and when
ascending stairs. There will be cervical motion and adnexal tenderness
