Emergency Care, 13e (Limmer et al.)
Chapter 22 Abdominal Emergencies
1) Pain that originates in an organ, such as the intestines, is called ________ pain.
A) visceral
B) referred
C) acute
D) parietal
Objective: 22.1
2) The patient complaining of parietal abdominal pain would concern you the MOST is the one
who:
A) walks out to the ambulance informing you he has the worst “belly ache.”
B) is sitting upright in a chair, moaning in pain, and drinking antacid.
C) is rolling about on the floor complaining of pain.
D) is lying on the floor very still and quiet with his knees drawn up to his chest.
Objective: 22.1
1
3) Your patient was diagnosed with cholecystitis (gallbladder inflammation) three days ago. The
patient now presents with nausea, vomiting, and pain in the right shoulder. The pain in the
shoulder can be classified as:
A) referred pain.
B) visceral pain.
C) pancreatic pain.
D) somatic pain.
Objective: 22.1
4) Pain that the patient feels in a body part or area of the body that has nothing to do with a
diseased organ is termed:
A) epigastric pain.
B) abdominal pain.
C) retroperitoneal pain.
D) referred pain.
Objective: 22.1
2
5) Which of the following organs is located in the retroperitoneal space?
A) Liver
B) Stomach
C) Kidneys
D) Uterus
Objective: 22.2
6) Which of the following structures is (are) NOT located in the abdominal cavity?
A) Kidneys
B) Liver
C) Spleen
D) Stomach
Objective: 22.2
7) Which abdominal quadrant contains the appendix?
A) Left lower
B) Right upper
C) Right lower
D) Left upper
Objective: 22.2
3
8) Most organs of the abdomen are enclosed within the:
A) extraperitoneal.
B) peritoneum.
C) retroperitoneal.
D) midline.
Objective: 22.2
9) Organs of the right upper quadrant include:
A) pancreas, spleen, and part of the liver.
B) most of the liver, gallbladder, and part of the large intestine.
C) small intestine, stomach, and spleen.
D) most of the liver, spleen, and gallbladder.
Objective: 22.2
4
10) Which of the following is true concerning parietal pain?
A) It is often described as “crampy” or “colicky.”
B) It arises from solid organs.
C) It is usually intermittent in nature.
D) It is generally localized to a particular area.
Objective: 22.3
11) Which of the following is NOT a cause of parietal pain?
A) Muscle spasm
B) Bleeding into the abdominal cavity
C) Inflammation
D) Infection
Objective: 22.3
5
12) With the exception of the ________, most abdominal organs are not able to sense tearing
sensations.
A) aorta
B) ovaries
C) liver
D) colon
Objective: 22.3
13) Your patient is a 35-year-old female with abdominal pain. Which of the following findings
CANNOT be attributed to the patient experiencing pain?
A) Slight increase in blood pressure
B) Shallow respirations
C) Increased heart rate
D) Decreased level of consciousness
Objective: 22.3
6
14) Which patient is experiencing visceral pain?
A) 24-year-old male complaining of severe left flank pain
B) 19-year-old female complaining of severe cramps in the lower abdominal quadrants
C) 45-year-old female complaining of abdominal pain “all over”
D) 28-year-old male with rebound tenderness
Objective: 22.3
15) Which of the following is a characteristic of referred pain?
A) It is only felt in hollow organs.
B) It is felt in a location other than the organ causing it.
C) It is caused by psychological stress.
D) It is usually described as “crampy” or “colicky.”
Objective: 22.4
7
16) When the gallbladder is diseased, the pain is not only felt in the right upper quadrant (RUQ)
but also in the right shoulder. This is known as:
A) parietal pain.
B) visceral pain.
C) referred pain.
D) tearing pain.
Objective: 22.4
17) You respond to an abdominal pain call. Your partner suspects that the patient is having an
abdominal aortic aneurysm (AAA). What type of pain is the patient most likely experiencing?
A) Parietal
B) Visceral
C) Referred
D) Tearing
Objective: 22.5
8
18) You are called to a residential neighborhood at 12:30 A.M. Your patient has just finished
eating a super-sized meal of deep fried fish. He is now complaining of a “crampy” pain in the
right upper quadrant and has had two episodes of nausea and vomiting with a green emesis. What
condition do you suspect that your patient is experiencing?
A) Peptic ulcer
B) Intestinal obstruction
C) Cholecystitis
D) Appendicitis
Objective: 22.5
19) You are called to a 25-year-old male complaining of right lower quadrant (RLQ) pain. His
other symptoms are nausea and vomiting, fever, and decreasing pain in the umbilicus area. As an
EMT, you feel this patient might have:
A) appendicitis.
B) pancreatitis.
C) cholecystitis.
D) peritonitis.
Objective: 22.5
9
20) You respond to the scene of a 50-year-old male complaining of severe abdominal pain. He
has a history of alcohol and drug abuse. His vital signs are stable and he presents with epigastric
pain that radiates to the back. He has guarding and point tenderness in the upper quadrants. You
suspect:
A) cholecystitis.
B) myocardial infarction.
C) gastroesophageal reflux disease (GERD).
D) pancreatitis.
Objective: 22.5
21) You are called to a residence for a 48-year-old male patient. He is lying in bed and is
incoherent. He is unable to follow commands. His blood pressure is 80/40, pulse 136, and
respiratory rate of 36. His wife states that he had lower right abdominal pain for about two days
and it progressively worsened. He said about an hour ago he had a sudden increase in pain and
then became incoherent. The wife states the husband refused to see a doctor before, but she
finally called 911. You suspect:
A) appendicitis.
B) splenic rupture.
C) renal colic.
D) peritonitis.
Objective: 22.5
10