Detailed guide on advanced abdominal assessment in
nursing, covering types of pain, physical exam
techniques, and diagnostic findings. Includes clinical
scenarios, signs of gastrointestinal disorders, and
interpretation of symptoms for accurate patient
evaluation.
Updated Exam Study Guide Latest Updated
2025/2026
100% Certified Questions and Answers.
1. The nurse admits a client with intermittent colicky pain at the left lower quadrant of the
abdomen. Which type of pain is the client referring to?
a. Muscular pain
b. Visceral pain
c. Referred pain
d. Parietal pain - ansAns: (B)
Visceral pain occurs when hollow abdominal organs such as the intestine or biliary tree
contract unusually forcefully or are distended or stretched. Solid organs such as the liver can
also become painful when their capsules are stretched. Visceral pain may be difficult to
localize. It is typically palpable near the midline at levels that vary according to the structure
involved. Visceral pain varies in quality and may be gnawing, burning, cramping, or aching.
When it becomes severe, it may be associated with sweating, pallor, nausea, vomiting, and
restlessness.
1. A client with chest pain tells the nurse that he also feels the pain on the jaw and the
shoulder. The nurse understands that this type of pain is called
a. Referred pain
b. Parietal pain
c. Muscular pain
d. Visceral pain - ansAns: (A)
Referred pain is felt in more distant sites that share the same innervations as the source of
pain. Referred pain often develops as the initial pain becomes more intense and thus seems to
radiate or travel from the initial site. It may be felt superficially or deeply but is usually well
localized.
1. The nurse is doing the history of a patient with pain that ifs felt in the epigastric area.
Which of the following cluster of client manifestations are considered "alarm symptoms" for
gastric cancer?
a. Dysphagia, odynophagia, coffee ground emesis
b. Weight loss, diarrhea, dehydration
c. Recurrent vomiting, 2cm x 2cm lump on the upper right quadrant, fever
d. Hematochezia, hematemesis, epistaxis - ansAns: (A)
Red flags or alarm symptoms for gastric cancer include: difficulty swallowing (dysphagia),
pain with swallowing (odynophagia), recurrent vomiting, and evidence of gastrointestinal
bleeding (coffee ground emesis), weight loss and anemia.
1. A 21-year old woman is being seen at the emergency department due to right lower
abdominal pain. She has missed her period for two consecutive months. She feels weak and
dizzy. The nurse knows to prioritize which of the following nursing actions?
a. Continue assessing by palpating the abdomen
,Detailed guide on advanced abdominal assessment in
nursing, covering types of pain, physical exam
techniques, and diagnostic findings. Includes clinical
scenarios, signs of gastrointestinal disorders, and
interpretation of symptoms for accurate patient
evaluation.
Updated Exam Study Guide Latest Updated
2025/2026
100% Certified Questions and Answers.
b. Perform a pregnancy test
c. Apply hot compress to the affected area.
d. Inspect the abdomen for ascites - ansAns: (B)
With the given findings of lower abdominal pain and missed periods, the nurse suspects
ectopic pregnancy especially if accompanied by other symptoms like rigidity of abdominal
muscles, weakness and dizziness. Palpating the abdomen is contraindicated as the risk of
rupturing the fallopian tube is high.
1. A nurse is reviewing the client's records from an earlier shift and notes that the result of the
barium enema revealed "apple core" lesions on the sigmoid colon. The client is passing
pencil-like stools. Which disorder is the nurse most likely considering?
a. Gastric cancer
b. Colon cancer
c. Diverticulitis
d. Chron disease - ansAns: (B)
Thin, pencil-like stool occurs in an obstructing "apple core" lesion of the sigmoid colon. The
nurse considers colon cancer if the above are accompanied by the following: melena,
hematochezia, diarrhea, constipation, feeling of incomplete bowel emptying, bloating, cramps
weight loss and fatigue.
1. The nurse is doing a health teaching on a client with colon cancer. She is explaining the
different types of bleeding manifestations. Of particular interest to her is the type of bleeding
associated with colon cancer and that is passing of fresh blood or maroon-colored stool. The
client understands the teaching if he replies with which answer?
a. Hematemesis
b. Steatorrhea
c. Hematochezia
d. Melena - ansAns: (C)
Hematochezia is passing of blood-streaked stools, stools that are bright or dark red in color.
This is caused by lower gastrointestinal bleeding. Hematemesis is vomiting of fresh blood or
of occult blood of 'coffee-grounds' consistency. Steatorrhea is passing of fatty malodorous
stools. Melena is presence of occult blood in the stool.
1. A client with hepatitis is asking the nurse why his skin turned yellow. Which response is
the most accurate to explain why jaundice happens?
a. Decreased production of bilirubin
b. Increased uptake of bilirubin by the hepatocytes
c. Increased ability of the liver to conjugate bilirubin
d. Decreased excretion of bilirubin into the bile, resulting in absorption of conjugated
bilirubin back into the blood - ansAns: (D)
,Detailed guide on advanced abdominal assessment in
nursing, covering types of pain, physical exam
techniques, and diagnostic findings. Includes clinical
scenarios, signs of gastrointestinal disorders, and
interpretation of symptoms for accurate patient
evaluation.
Updated Exam Study Guide Latest Updated
2025/2026
100% Certified Questions and Answers.
Jaundice or the yellowing of the skin is caused by several factors: increased production of
bilirubin, decreased uptake of bilirubin by the hepatocytes, decreased ability of the liver to
conjugate bilirubin, decreased excretion of bilirubin into the bile, resulting in absorption of
conjugated bilirubin back into the blood
1. A client presenting with upper right quadrant steady pain is getting frantic about his stools
that has turned grey. Which of the following nursing response will correctly address the
client's concern?
a. "Your body cannot digest food properly because it lacks the enzymes that turn stools
brownish or greenish"
b. "Bile, the substance in your gallbladder that gives color to the stool, has been totally
blocked from flowing to your intestines"
c. "The bacteria that are causing your infection have spread to affect your bowels as well."
d. "You are deficient in an important mineral that is affected by your disorder." - ansAns: (B)
When excretion of bile into the intestine is completely obstructed, the stools become gray or
light colored, or acholic, without bile.
1. The nurse is asking this series of questions to assess a client: "Do you have trouble starting
your stream? Do you have to stand closer to the toilet to void? Is there a change in the force
or size of your stream, or straining to void? Do you hesitate or stop in the middle of voiding?"
The nurse is eliciting information about which disorder?
a. Pyelonephritis
b. Colon cancer
c. Benign prostatic hypertrophy
d. Urethritis - ansAns: (C)
Benign prostatic hypertrophy is the enlargement of the prostrate that surrounds the urethra
that results to hesitancy in urination, decrease in size and force of urine, and dribbling urine.
1. The nurse is examining a patient who reported dull pain in the upper right quadrant of the
abdomen. The nurse also notes that the client has an enlarged abdomen and does percussion if
the enlargement is due to ascites or to bloating. Which of the following assessment findings
are true?
a. If the client sits upright, percussion reveals tympany over the entire upper abdomen and
dullness on the lower abdomen
b. If the client turns to the left while lying on the examining table, dullness shifts to the more
dependent side, and tympany shifts to the top.
c. If the patient lies prone on the table, the tympany is noted on the client's right side only
d. If the patient lies prone, the dullness is felt over the entire back - ansAns: (B)
, Detailed guide on advanced abdominal assessment in
nursing, covering types of pain, physical exam
techniques, and diagnostic findings. Includes clinical
scenarios, signs of gastrointestinal disorders, and
interpretation of symptoms for accurate patient
evaluation.
Updated Exam Study Guide Latest Updated
2025/2026
100% Certified Questions and Answers.
Ascitic fluid characteristically sinks with gravity, whereas gas-filled loops of bowel float to
the top. Percussion gives a dull note in dependent areas of the abdomen. In a person without
ascites, the borders between tympany and dullness usually stay relatively constant.
1. A patient comes to the emergency department in a wheelchair because of pain in the
abdomen. He is bent down with arms hugging his abdomen. The nurse suspects appendicitis.
Which of the following is an accurate manifestation of appendicitis?
a. (+) Rovsing sign - increased abdominal pain when the patient is asked to raise his thigh
against the nurse's hand positioned above the knee
b. (+) psoas sign - Pain in the right lower quadrant during left-sided pressure
c. (+) obturator sign - pain in the right hypogastric area when the client is asked to flex thigh
at the hip and the knee bent and rotated internally
d. (-) cutaneous hyperesthesia - localized pain as the nurse pinches the abdomen - ansAns:
(C)
In appendicitis, pain in the right lower quadrant during left-sided pressure suggests
appendicitis (a positive Rovsing sign). There is also - increased abdominal pain when the
patient is asked to raise his thigh against the nurse's hand positioned above the knee (psoas
sign). If the client is asked to flex thigh at the hip and bend the knee and rotate it internally,
and pain is felt in the hypogastric are, the client is positive for obturator sign. The client
should also be able to localize pain over the lower left quadrant if the nurse pinches skin in
different areas of the abdomen (cutaneous hyperesthesia).
1. A patient with acute cholecystitis has just been admitted to the unit. The nurse wants to
assess the client for murphy sign. Which of the following maneuver is correct in eliciting
murphy sign?
a. the patient is asked to raise his thigh against the nurse's hand positioned above the knee
b. the nurse exerts downward pressure on the lower left quadrant of the abdomen
c. the client is asked to flex thigh at the hip and the knee bent and rotated internally
d. hooking the fingers of the right hand on the client's right costal margin and asking him to
breathe deeply - ansAns: (D)
The nurse hooks her left thumb or the fingers of her right hand under the costal margin at the
point where the lateral border of the rectus muscle intersects with the costal margin. Or if the
liver is enlarged, the nurse hooks thumb or fingers under the liver edge at a comparable point
below then asks the patient to take a deep breath. A sharp increase in tenderness with a
sudden stop in inspiratory effort constitutes a positive Murphy sign of acute cholecystitis.
1. The nurse is taking the history of a client with suspected colorectal cancer. Which of the
following is NOT an indication of high risk for colorectal cancer?
a. History of appendicitis in the recent 3 years
b. History of inflammatory bowel disease
nursing, covering types of pain, physical exam
techniques, and diagnostic findings. Includes clinical
scenarios, signs of gastrointestinal disorders, and
interpretation of symptoms for accurate patient
evaluation.
Updated Exam Study Guide Latest Updated
2025/2026
100% Certified Questions and Answers.
1. The nurse admits a client with intermittent colicky pain at the left lower quadrant of the
abdomen. Which type of pain is the client referring to?
a. Muscular pain
b. Visceral pain
c. Referred pain
d. Parietal pain - ansAns: (B)
Visceral pain occurs when hollow abdominal organs such as the intestine or biliary tree
contract unusually forcefully or are distended or stretched. Solid organs such as the liver can
also become painful when their capsules are stretched. Visceral pain may be difficult to
localize. It is typically palpable near the midline at levels that vary according to the structure
involved. Visceral pain varies in quality and may be gnawing, burning, cramping, or aching.
When it becomes severe, it may be associated with sweating, pallor, nausea, vomiting, and
restlessness.
1. A client with chest pain tells the nurse that he also feels the pain on the jaw and the
shoulder. The nurse understands that this type of pain is called
a. Referred pain
b. Parietal pain
c. Muscular pain
d. Visceral pain - ansAns: (A)
Referred pain is felt in more distant sites that share the same innervations as the source of
pain. Referred pain often develops as the initial pain becomes more intense and thus seems to
radiate or travel from the initial site. It may be felt superficially or deeply but is usually well
localized.
1. The nurse is doing the history of a patient with pain that ifs felt in the epigastric area.
Which of the following cluster of client manifestations are considered "alarm symptoms" for
gastric cancer?
a. Dysphagia, odynophagia, coffee ground emesis
b. Weight loss, diarrhea, dehydration
c. Recurrent vomiting, 2cm x 2cm lump on the upper right quadrant, fever
d. Hematochezia, hematemesis, epistaxis - ansAns: (A)
Red flags or alarm symptoms for gastric cancer include: difficulty swallowing (dysphagia),
pain with swallowing (odynophagia), recurrent vomiting, and evidence of gastrointestinal
bleeding (coffee ground emesis), weight loss and anemia.
1. A 21-year old woman is being seen at the emergency department due to right lower
abdominal pain. She has missed her period for two consecutive months. She feels weak and
dizzy. The nurse knows to prioritize which of the following nursing actions?
a. Continue assessing by palpating the abdomen
,Detailed guide on advanced abdominal assessment in
nursing, covering types of pain, physical exam
techniques, and diagnostic findings. Includes clinical
scenarios, signs of gastrointestinal disorders, and
interpretation of symptoms for accurate patient
evaluation.
Updated Exam Study Guide Latest Updated
2025/2026
100% Certified Questions and Answers.
b. Perform a pregnancy test
c. Apply hot compress to the affected area.
d. Inspect the abdomen for ascites - ansAns: (B)
With the given findings of lower abdominal pain and missed periods, the nurse suspects
ectopic pregnancy especially if accompanied by other symptoms like rigidity of abdominal
muscles, weakness and dizziness. Palpating the abdomen is contraindicated as the risk of
rupturing the fallopian tube is high.
1. A nurse is reviewing the client's records from an earlier shift and notes that the result of the
barium enema revealed "apple core" lesions on the sigmoid colon. The client is passing
pencil-like stools. Which disorder is the nurse most likely considering?
a. Gastric cancer
b. Colon cancer
c. Diverticulitis
d. Chron disease - ansAns: (B)
Thin, pencil-like stool occurs in an obstructing "apple core" lesion of the sigmoid colon. The
nurse considers colon cancer if the above are accompanied by the following: melena,
hematochezia, diarrhea, constipation, feeling of incomplete bowel emptying, bloating, cramps
weight loss and fatigue.
1. The nurse is doing a health teaching on a client with colon cancer. She is explaining the
different types of bleeding manifestations. Of particular interest to her is the type of bleeding
associated with colon cancer and that is passing of fresh blood or maroon-colored stool. The
client understands the teaching if he replies with which answer?
a. Hematemesis
b. Steatorrhea
c. Hematochezia
d. Melena - ansAns: (C)
Hematochezia is passing of blood-streaked stools, stools that are bright or dark red in color.
This is caused by lower gastrointestinal bleeding. Hematemesis is vomiting of fresh blood or
of occult blood of 'coffee-grounds' consistency. Steatorrhea is passing of fatty malodorous
stools. Melena is presence of occult blood in the stool.
1. A client with hepatitis is asking the nurse why his skin turned yellow. Which response is
the most accurate to explain why jaundice happens?
a. Decreased production of bilirubin
b. Increased uptake of bilirubin by the hepatocytes
c. Increased ability of the liver to conjugate bilirubin
d. Decreased excretion of bilirubin into the bile, resulting in absorption of conjugated
bilirubin back into the blood - ansAns: (D)
,Detailed guide on advanced abdominal assessment in
nursing, covering types of pain, physical exam
techniques, and diagnostic findings. Includes clinical
scenarios, signs of gastrointestinal disorders, and
interpretation of symptoms for accurate patient
evaluation.
Updated Exam Study Guide Latest Updated
2025/2026
100% Certified Questions and Answers.
Jaundice or the yellowing of the skin is caused by several factors: increased production of
bilirubin, decreased uptake of bilirubin by the hepatocytes, decreased ability of the liver to
conjugate bilirubin, decreased excretion of bilirubin into the bile, resulting in absorption of
conjugated bilirubin back into the blood
1. A client presenting with upper right quadrant steady pain is getting frantic about his stools
that has turned grey. Which of the following nursing response will correctly address the
client's concern?
a. "Your body cannot digest food properly because it lacks the enzymes that turn stools
brownish or greenish"
b. "Bile, the substance in your gallbladder that gives color to the stool, has been totally
blocked from flowing to your intestines"
c. "The bacteria that are causing your infection have spread to affect your bowels as well."
d. "You are deficient in an important mineral that is affected by your disorder." - ansAns: (B)
When excretion of bile into the intestine is completely obstructed, the stools become gray or
light colored, or acholic, without bile.
1. The nurse is asking this series of questions to assess a client: "Do you have trouble starting
your stream? Do you have to stand closer to the toilet to void? Is there a change in the force
or size of your stream, or straining to void? Do you hesitate or stop in the middle of voiding?"
The nurse is eliciting information about which disorder?
a. Pyelonephritis
b. Colon cancer
c. Benign prostatic hypertrophy
d. Urethritis - ansAns: (C)
Benign prostatic hypertrophy is the enlargement of the prostrate that surrounds the urethra
that results to hesitancy in urination, decrease in size and force of urine, and dribbling urine.
1. The nurse is examining a patient who reported dull pain in the upper right quadrant of the
abdomen. The nurse also notes that the client has an enlarged abdomen and does percussion if
the enlargement is due to ascites or to bloating. Which of the following assessment findings
are true?
a. If the client sits upright, percussion reveals tympany over the entire upper abdomen and
dullness on the lower abdomen
b. If the client turns to the left while lying on the examining table, dullness shifts to the more
dependent side, and tympany shifts to the top.
c. If the patient lies prone on the table, the tympany is noted on the client's right side only
d. If the patient lies prone, the dullness is felt over the entire back - ansAns: (B)
, Detailed guide on advanced abdominal assessment in
nursing, covering types of pain, physical exam
techniques, and diagnostic findings. Includes clinical
scenarios, signs of gastrointestinal disorders, and
interpretation of symptoms for accurate patient
evaluation.
Updated Exam Study Guide Latest Updated
2025/2026
100% Certified Questions and Answers.
Ascitic fluid characteristically sinks with gravity, whereas gas-filled loops of bowel float to
the top. Percussion gives a dull note in dependent areas of the abdomen. In a person without
ascites, the borders between tympany and dullness usually stay relatively constant.
1. A patient comes to the emergency department in a wheelchair because of pain in the
abdomen. He is bent down with arms hugging his abdomen. The nurse suspects appendicitis.
Which of the following is an accurate manifestation of appendicitis?
a. (+) Rovsing sign - increased abdominal pain when the patient is asked to raise his thigh
against the nurse's hand positioned above the knee
b. (+) psoas sign - Pain in the right lower quadrant during left-sided pressure
c. (+) obturator sign - pain in the right hypogastric area when the client is asked to flex thigh
at the hip and the knee bent and rotated internally
d. (-) cutaneous hyperesthesia - localized pain as the nurse pinches the abdomen - ansAns:
(C)
In appendicitis, pain in the right lower quadrant during left-sided pressure suggests
appendicitis (a positive Rovsing sign). There is also - increased abdominal pain when the
patient is asked to raise his thigh against the nurse's hand positioned above the knee (psoas
sign). If the client is asked to flex thigh at the hip and bend the knee and rotate it internally,
and pain is felt in the hypogastric are, the client is positive for obturator sign. The client
should also be able to localize pain over the lower left quadrant if the nurse pinches skin in
different areas of the abdomen (cutaneous hyperesthesia).
1. A patient with acute cholecystitis has just been admitted to the unit. The nurse wants to
assess the client for murphy sign. Which of the following maneuver is correct in eliciting
murphy sign?
a. the patient is asked to raise his thigh against the nurse's hand positioned above the knee
b. the nurse exerts downward pressure on the lower left quadrant of the abdomen
c. the client is asked to flex thigh at the hip and the knee bent and rotated internally
d. hooking the fingers of the right hand on the client's right costal margin and asking him to
breathe deeply - ansAns: (D)
The nurse hooks her left thumb or the fingers of her right hand under the costal margin at the
point where the lateral border of the rectus muscle intersects with the costal margin. Or if the
liver is enlarged, the nurse hooks thumb or fingers under the liver edge at a comparable point
below then asks the patient to take a deep breath. A sharp increase in tenderness with a
sudden stop in inspiratory effort constitutes a positive Murphy sign of acute cholecystitis.
1. The nurse is taking the history of a client with suspected colorectal cancer. Which of the
following is NOT an indication of high risk for colorectal cancer?
a. History of appendicitis in the recent 3 years
b. History of inflammatory bowel disease
