Chapter 47: Appendicitis Flashcards
A 25-year-old male presents with right lower quadrant abdominal pain, nausea, and a fever of 101°F. Upon palpation, the nurse notes tenderness at McBurney’s point. What is the most likely diagnosis?
A. Cholecystitis
B. Gastroenteritis
C. Appendicitis
D. Diverticulitis
C. Appendicitis
Rationale: Right lower quadrant pain, fever, and tenderness at McBurney’s point are classic signs of appendicitis.
A patient with suspected appendicitis is asked to perform a physical assessment maneuver. The nurse notes pain in the right lower quadrant when the patient coughs. What is this sign called?
A. Rovsing’s sign
B. McBurney’s point
C. Psoas sign
D. Blumberg’s sign
D. Blumberg’s sign
Rationale: Blumberg’s sign, or rebound tenderness, occurs when pain is felt upon release of pressure, indicating peritoneal irritation, commonly seen in appendicitis.
Which of the following is the most common diagnostic test used to confirm a diagnosis of appendicitis?
A. Abdominal ultrasound
B. CT scan of the abdomen and pelvis
C. Colonoscopy
D. Upper GI series
B. CT scan of the abdomen and pelvis
Rationale: A CT scan is the most reliable diagnostic test for appendicitis in adults.
A 16-year-old patient presents with complaints of nausea, vomiting, and right lower quadrant abdominal pain. The nurse suspects appendicitis. Which laboratory finding would most likely be elevated?
A. Hemoglobin
B. Serum glucose
C. White blood cell count
D. Serum sodium
C. White blood cell count
Rationale: An elevated white blood cell count is a common finding in appendicitis due to the inflammatory response.
A nurse is preparing a patient for an appendectomy. Which of the following interventions is most important in the preoperative period?
A. Administering antibiotics as prescribed
B. Preparing the patient for a bowel prep
C. Instructing the patient to fast for 48 hours
D. Encouraging early ambulation
A. Administering antibiotics as prescribed
Rationale: Antibiotics are commonly administered preoperatively to reduce the risk of infection.
A client has had an appendectomy. Which of the following actions should the nurse take to prevent complications in the postoperative period?
A. Maintain the patient in a supine position for the first 24 hours
B. Encourage deep breathing and coughing to prevent atelectasis
C. Administer a high-protein diet immediately after surgery
D. Restrict oral fluids for 72 hours
B. Encourage deep breathing and coughing to prevent atelectasis
Rationale: Deep breathing and coughing exercises are important for preventing respiratory complications, such as atelectasis, following surgery.
A patient is post-op day 1 following an appendectomy. Which of the following findings is most concerning and should be reported to the healthcare provider immediately?
A. Mild abdominal distention
B. Presence of clear urine
C. Incision site appears clean with minimal drainage
D. Increasing abdominal pain and fever
D. Increasing abdominal pain and fever
Rationale: Increasing abdominal pain and fever postoperatively could indicate a complication such as infection or abscess formation.
A client is scheduled for an appendectomy. Which of the following is the priority nursing assessment prior to the surgery?
A. Assessing the patient’s nutritional status
B. Checking for allergies to shellfish
C. Assessing vital signs and pain level
D. Ensuring informed consent is signed
D. Ensuring informed consent is signed
Rationale: Ensuring informed consent is obtained is the priority before any surgical procedure.
A patient with suspected appendicitis presents with fever, nausea, and a positive psoas sign. Which of the following diagnostic tests is most likely to confirm the diagnosis?
A. Colonoscopy
B. X-ray of the abdomen
C. Abdominal ultrasound
D. CT scan of the abdomen and pelvis
D. CT scan of the abdomen and pelvis
Rationale: A CT scan is the most effective imaging tool for diagnosing appendicitis, especially with a positive psoas sign.
A nurse is caring for a post-operative appendectomy patient. Which of the following is the most important priority in the immediate post-operative period?
A. Monitoring for signs of infection
B. Ensuring adequate fluid intake
C. Managing pain and preventing complications
D. Encouraging early ambulation
C. Managing pain and preventing complications
Rationale: Effective pain management and preventing complications such as infection or bleeding are critical in the immediate post-operative period.
A nurse is caring for a postoperative appendectomy patient. Which of the following is an expected finding in the first 24 hours post-surgery?
A. Decreased bowel sounds and abdominal distension
B. Sudden onset of nausea and vomiting
C. Bright red blood at the surgical site
D. Severe abdominal pain unrelieved by medication
A. Decreased bowel sounds and abdominal distension
Rationale: Decreased bowel sounds and mild abdominal distension are expected after abdominal surgery, due to temporary ileus.
A 40-year-old patient presents with severe abdominal pain, nausea, vomiting, and fever. The nurse suspects appendicitis. What is the most appropriate initial intervention?
A. Administer pain medication
B. Obtain an abdominal x-ray
C. Assess for peritonitis
D. Prepare for immediate surgery
C. Assess for peritonitis
Rationale: Assessing for peritonitis is important because it may indicate the appendix has ruptured, requiring urgent surgical intervention.
A patient diagnosed with appendicitis is experiencing acute pain. Which of the following interventions would best help alleviate the patient’s discomfort?
A. Applying a warm compress to the abdomen
B. Providing an antacid to reduce gastric irritation
C. Administering prescribed pain medication
D. Encouraging oral fluids
C. Administering prescribed pain medication
Rationale: Administering pain medication as prescribed is the best intervention to manage acute pain associated with appendicitis.
Which of the following would most likely occur if a patient’s appendicitis goes untreated?
A. Development of peritonitis
B. Acute pancreatitis
C. Gastrointestinal bleeding
D. Gallbladder rupture
A. Development of peritonitis
Rationale: If left untreated, appendicitis can lead to the rupture of the appendix, causing peritonitis, a life-threatening infection.
A post-operative appendectomy patient develops a sudden increase in pain and fever on the third day after surgery. What is the nurse’s most appropriate action?
A. Administer additional pain medication
B. Reassess the surgical site for signs of infection or abscess
C. Encourage the patient to take deep breaths
D. Apply ice to the incision site
B. Reassess the surgical site for signs of infection or abscess
Rationale: A sudden increase in pain and fever may indicate infection or an abscess at the surgical site, requiring immediate evaluation.
Which of the following is a typical complication after an appendectomy that requires monitoring in the post-operative period?
A. Paralytic ileus
B. Pericarditis
C. Biliary colic
D. Gastric reflux
A. Paralytic ileus
Rationale: Paralytic ileus, or temporary cessation of bowel movement, is a common complication after abdominal surgery like appendectomy.
A patient is experiencing pain in the right lower quadrant, nausea, and a positive Rovsing’s sign. Which of the following interventions is the nurse likely to implement first?
A. Administer pain medication as prescribed
B. Obtain an abdominal ultrasound
C. Prepare the patient for surgery
D. Start an IV line for fluid resuscitation
D. Start an IV line for fluid resuscitation
Rationale: IV fluids are important for maintaining hydration and blood pressure in a patient with suspected appendicitis, especially before surgery.
In a patient with appendicitis, which of the following clinical findings would indicate the progression to a ruptured appendix?
A. Decrease in fever
B. Sudden relief of pain
C. Increase in white blood cell count
D. Worsening abdominal distension
B. Sudden relief of pain
Rationale: Sudden relief of pain could indicate that the appendix has ruptured, releasing contents into the abdominal cavity.
A nurse is preparing a 10-year-old patient for an appendectomy. Which of the following should be included in preoperative teaching?
A. The patient may have a large abdominal incision
B. The procedure will require a blood transfusion
C. The patient will be able to eat immediately after surgery
D. The patient will need to wear a compression garment post-surgery
A. The patient may have a large abdominal incision
Rationale: Preoperative teaching should include potential surgical site details, including the size of the incision, to prepare the patient and family.
