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22) You arrive on the scene to find an approximately 60-year-old male patient writhing on the
floor. He is complaining of a tearing pain radiating to his lower back. He has absent femoral
pulses and has a pulsatile mass just superior to his umbilicus. You suspect which of the following
conditions?
A) Myocardial infarction
B) Abdominal aortic aneurysm
C) Acute pancreatitis
D) Ruptured appendix
Objective: 22.5
23) The detection of a bulging mass through the belly button that is not pulsating should make
the EMT suspicious that the patient may be suffering from which of the following?
A) Hernia
B) Ulcer
C) Gastroenteritis
D) Abdominal aortic aneurysm
Objective: 22.5
11
24) You respond, along with fire department Emergency Medical Responders, to a 48-year-old
female having a syncope episode in the bathroom. You find the patient sitting on the commode
vomiting into the trash can. The vomitus appears to look like coffee grounds and has a foul
smell. The patient is pale and has n weak for the past few days. She has:
A) peritonitis.
B) abdominal aortic aneurysm.
C) hernia.
D) GI bleeding.
Objective: 22.5
25) You are called to the scene of a 16-year-old female patient complaining of severe lower
quadrant abdominal pain. The patient states she is sexually active. Upon palpation, you observe
rebound tenderness in the right lower quadrant. You suspect:
A) appendicitis.
B) ectopic pregnancy.
C) cholecystitis.
D) renal colic.
Objective: 22.5
12
26) You are called to the scene of a patient with abdominal pain. Upon arrival, you find a 38-
year-old Asian man on the floor next to his desk writhing in pain. He is complaining of severe
right-sided flank pain. His blood pressure is 140/90, pulse 100, and his skin is ashen and
diaphoretic. You suspect:
A) cholecystitis.
B) Mittelschmerz.
C) renal colic.
D) myocardial infarction.
Objective: 22.5
27) You respond to a 65-year-old patient complaining of abdominal pain. Your physical exam
reveals a nonpulsating mass in the lower left quadrant. You suspect:
A) aortic abdominal aneurysm.
B) appendicitis.
C) splenic rupture.
D) hernia.
Objective: 22.5
13
28) You respond to a 75-year-old female who is complaining of epigastric pain that feels like
heartburn. The pain radiates to the right shoulder. Her vital signs are stable and she has a
previous history of a myocardial infarction. She has prescription nitroglycerin tablets. She is
most likely suffering from:
A) cholecystitis.
B) abdominal aortic aneurysm.
C) Mittelschmerz.
D) renal colic.
Objective: 22.5
29) Which of the following is NOT a cause of abdominal pain?
A) Stroke
B) Food poisoning
C) Heart attack
D) Diabetes
Objective: 22.5
14
30) Pain felt in the epigastric region of the abdomen is of concern because of the possibility of
which of the following?
A) Influenza
B) Extreme diarrhea with dehydration
C) Myocardial infarction
D) Kidney stones
Objective: 22.6
31) You are responding to a 52-year-old male patient complaining of heartburn with epigastric
pain. The patient's vital signs are stable and he does not have any pain upon palpation. He has a
history of reflux disease and is on several medications for heartburn and acid reflux. What is
your greatest concern with this patient?
A) He will aspirate on vomit.
B) He will develop peritonitis.
C) His appendix will rupture.
D) He is suffering from a myocardial infarction.
Objective: 22.6
15
32) Your patient is a 60-year-old male who is complaining of severe epigastric abdominal pain
and difficulty breathing. He is pale, sweaty, and pleads with you, "Don't let me die, I think I'm
going to die." Which of the following measures is NOT part of your initial treatment of this
patient?
A) Giving 15 lpm of oxygen by nonrebreather mask
B) Applying the defibrillator pads to his chest
C) Determining whether you should assist the patient in taking nitroglycerin
D) Placing the patient in a position of comfort
Objective: 22.6
33) You are called to a nursing home for an 85-year-old patient complaining of abdominal pain.
The patient has a history of dementia and cannot describe the pain to you. The nurse states the
patient has n vomiting dark coffee ground emesis for about an hour. His blood pressure is 90/40,
pulse 100, and respiratory rate of 24. Aside from the airway, what is your greatest concern?
A) The patient will go into hypovolemic shock.
B) The patient will have a myocardial infarction.
C) The patient will have a stroke.
D) The patient will become combative.
Objective: 22.7
16
34) Which of the following is the main focus of the EMT's assessment and history taking of the
patient with abdominal pain?
A) Determining the possible need for immediate surgery
B) Determining if the patient meets criteria to refuse treatment and transport
C) Determining the cause of the pain
D) Determining the presence of shock
Objective: 22.7
35) Which of the following is a concern when caring for the patient with abdominal pain?
A) Shock
B) Patient comfort
C) Airway management
D) All of the above
Objective: 22.7
17
36) Your patient is a 40-year-old female who has n experiencing abdominal pain and vomiting
for 2 days. She is now responsive to verbal stimulus; has cool, dry skin; a heart rate of 116;
respirations of 24; and a blood pressure of 100/70. Which of the following is the BEST position
for transporting this patient?
A) Supine with the knees bent
B) Left lateral recumbent with the legs bent
C) Sitting up at a 90-degree angle
D) Sitting up at a 45-degree angle
Objective: 22.7
37) Your patient is a 34-year-old male complaining of pain "in his right side." He is pale and
diaphoretic with a heart rate of 90 beats per minute, a respiratory rate of 28 breaths per minute,
and a blood pressure of 132/80 mmHg. The patient is very agitated and anxious. Which approach
is most appropriate?
A) Try to determine the cause of his pain.
B) Tell the patient that you cannot transport him unless he calms down and lies still.
C) Insert an oropharyngeal airway.
D) Reassure him that you will make him as comfortable as possible and get him to the hospital
for additional care.
Objective: 22.7
18
