with gluten intolerance and needs instructions on what foods to eat. The patient should be told that a gluten restricted diet includes: 4. A patient presents with symptoms of bloody stools, new onset constipation, and weight loss. These symptoms could be associated with: 5. Spider angiomas, palmar erythema, and Terry’s nails can be associated with: 6. Which is NOT a mode of transmission for hepatitis C? 7. In the abdominal assessment of a 2-year-old, which one of the following would be considered abnormal? 8. Abdominal percussion is performed to assess: 9. When assessing the liver, have the patient inhale while palpating: 10. A term used to describe the raising esophageal or gastric contents to the esophagus or mouth without nausea or retching is: 11. Peritoneal inflammation produces abdominal pain and tenderness. What technique can be used to assess a tender abdomen suspected to be secondary to peritoneal inflammation? 12. A patient complains of severe epigastric pain that radiates to the posterior trunk and entire abdomen. This type of pain can be suggestive of: 13. When performing a rectal exam, a reddish, moist, protruding mass is noted at the anal opening. This finding is most likely a(n): 14. Which of the following symptoms are indicators of dehydration in a four-year-old child? 15. An enlarged liver with a smooth tender edge may suggest: 16. Indicators of oropharyngeal dysphagia include all of the following symptoms except: 17. Stools that appear black, tarry, and sticky are referred to as: 18. A positive obturator sign would elicit pain in the: 19. A term used to describe induced vomiting without nausea is: 20. A 30 year old patient complains of frequent belching, pain in the area below the sternum mostly after eating, and increased salivation. These symptoms are often seen in patients who have: 21. Helminths can be transmitted by: 22. When percussing the right upper quadrant of the abdomen, a dull medium-pitched sound is heard. The area being percussed is probably the: 23. Bowel sounds may be increased in the presence of: 24. A feeling of constantly needing to pass stool is termed: 25. Pain of biliary tree origin may be referred to the: 26. Which of the following assessment findings is a result of the presence of a stone in the common bile duct? 27. A 55-year-old patient visits the nurse practitioner for an annual exam. Stool sample revealed hematochezia. The patient is otherwise asymptomatic. This finding could be associated with: 28. To perform deep palpation of the abdomen: 29. A patient presents with chest pain and moves his hand from the neck to the epigastrium. This gesture could be suggestive of: 30. If a patient describes his stool as thin and “pencil-like”, this could be associated with: 31. When performing a rectal exam, the examiner should: 32. What is the most commonly reported sexually transmitted disease (STD) in the United States? 33. Risk factors associated with Hepatitis A include all of the following except: 34. A 35-year-old male visits the nurse practitioner for complaints of a fullness in his lower abdomen. He states that he noticed it a few days ago when he was working out at the gym. At times it feels like a round lump in his groin. Examination reveals a protrusion under the skin near the right groin area. This finding could be suggestive of an: 35. Which one of the following procedures would confirm a the definitive medical diagnosis of Hirschsprung’s disease? 36. On examination of the abdomen, loud rumbling noises are audible without a stethoscope. These sounds are termed: 37. Pain of duodenal or pancreatic origin may be referred to the: 38. Bowel sounds may be decreased in the presence of: 39. When performing a rectal exam, a tender, swollen, bluish, ovoid mass is noted at the anal opening. This finding is most likely a(n): 40. When examining the buttocks and rectum, a small tuft of hair surrounded by a halo of erythema was observed at the sacral area. This finding is most likely: 41. Which one of the following symptoms associated with gastroesophageal reflux (GERD) is considered an alarm symptom? 42. A patient presents with right upper quadrant and upper abdominal pain. Acute cholecystitis is suspected because the pain radiates to the: 43. When there is a sudden obstruction caused by a gallstone in the common bile duct or the cystic duct, the pain is usually felt in the: 44. Which of the following food choices is the most appropriate to offer a teenager with celiac disease? 45. An enlarged liver with a firm, nontender edge may be suggestive of: 46. Examination of the abdomen reveals a small midline protrusion in the linea alba. This finding is consistent with an: 47. A 40-year-old female presents with generalized abdominal pain and nausea. During the abdominal exam she exhibits inspiratory arrest with deep palpation of the upper right quadrant of the abdomen. This maneuver exhibits a positive: 48. When examining the abdomen, which of the following symptoms would be suggestive of appendicitis? 49. When performing a digital rectal exam, a soft, pedunculated lesion is palpated. This finding is most likely: 50. Ecchymosis of the abdominal wall is usually seen in persons with: 51. Which one of the following symptoms is seen in infants with pyloric stenosis? 52. When performing an examination of the rectal area, a linear tear at the anal opening was observed. This could be indicative of: 53. During palpation of the abdomen, right lower quadrant pain is elicited by applying pressure to the left side of the abdomen. This technique elicited a positive: 54. When performing a rectal exam, if the anal sphincter presents with laxity, consider: 55. When performing a rectal exam, if the anal sphincter presents with laxity, consider a neurologic diseases, such as S2-4 cord lesions. Sphincter tightness may occur with anxiety, inflammation, or scarring.56. A 9-month-old who has been a healthy, thriving infant presents with a poor appetite, two episodes of vomiting, three bloody stools with mucus and knees drawn to the abdomen with screaming. These are clinical manifestations of: 57. Risk factors associated with Hepatitis B include all of the following except: 58. A patient presents with complaints of bright red stools over the past week. This symptom could be consistent with: 59. A patient is experiencing a dull achy pain in the epigastric area with eating. This type pain is consistent with: 60. When performing a rectal exam, a firm mass with an irregular border is palpated approximately two inches inside the rectum. This finding could be indicative of: 61. Examination of the abdomen reveals a protrusion through an operative scar. This finding may be suggestive of an: 62. Signs and symptoms associated with diabetic gastroparesis may include all of the following except: 63. Which one of the following symptoms is associated with biliary atresia in an infant? 64. Acholic stools are associated with: 65. A patient visits the nurse practitioner for complaints of passing bloody stools over the past few weeks. He denies abdominal pain or fever. Further questioning reveals that when he passes stool, he notices blood dripping in the toilet. These symptoms could be consistent with: 66. A patient was instructed to point to the location of his pain. He pointed to just below the sternoclavicular notch which likely indicates: 67. When inspecting the abdomen of a 60-year-old male, dilated veins were noted especially in the mid and upper abdomen. This condition is associated with: 68. When performing a rectal exam, a purulent bloody discharge mixed with fecal matter is oozing from the rectum. This finding is most consistent with a: 69. Which type of hepatitis is typically contracted by ingestion of contaminated food or water? 70. A general term for distress associated with eating is: 71. The most appropriate position for the patient when performing a rectal exam and one that allows for optimal examination, is the: 72. Symptoms of a child suspected of having a diagnosis of mixed failure to thrive (FTT) are usually seen in children: 73. Stools that are pencil-like in shape are most likely: 74. When performing a rectal exam, a tender, purulent, reddened mass was noted at the anal opening. This finding is most consistent with a: 75. A patient complains of an unpleasant abdominal fullness after a light meal. This complaint may be consistent with: 76. If abdominal pain persists when the patient raises his head and shoulders, the origin of the tenderness is probably: 77. Which type of hepatitis is most commonly transmitted from infected mothers to infants at the time of birth? 78. A patient presents with complaints of burning sensation in the sternal area. He states it is aggravated by alcohol, chocolate, and coffee. This finding is: 79. Which type of hepatitis virus can be acute and subside without treatment? 80. A 30-year-old male presents with generalized abdominal pain. With flexion of the legs at the hip an increase in his abdominal pain is noted. This finding elicited a positive: 81. A patient presents with complaints of black tarry stools for the last week. This symptom is seen in conditions related to the: 82. On auscultation of the abdomen, rushes of high-pitched sounds are audible and coincide with abdominal cramps. These findings are most consistent with: 83. Palpation of the liver reveals an enlargement that is firm with an irregular edge. This finding may be suggestive of: 84. Lower abdominal pain accompanied by fever or shock in older adults could be consistent with: [Show less]
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