A 20-year-old client presents to the emergency department with abdominal pain. Which assessment finding is most indicative of acute appendicitis?

Pain that radiates to the left shoulder and worsens with deep breathing

Generalized abdominal pain that improves with eating

Left lower quadrant pain with rebound tenderness

Right lower quadrant pain at McBurney's point with rebound tenderness

Answer and Explanation

The Correct Answer is D

Rationale:
A. Pain radiating to the left shoulder and worsening with deep breathing (Kehr’s sign) is more indicative of splenic injury, not appendicitis.
B. Pain from appendicitis typically worsens with movement and does not improve with eating; improvement with food is more characteristic of peptic ulcer disease.
C. Left lower quadrant pain is more consistent with diverticulitis, not appendicitis.
D. Right lower quadrant pain at McBurney's point with rebound tenderness is a hallmark sign of acute appendicitis, making this the most indicative finding.

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Correct Answer is A

Explanation

Rationale:
A. Anticoagulant therapy for a pulmonary embolism is typically continued for 3–6 months, and sometimes up to 12 months or longer, depending on risk factors and medical history. This is correct and should be part of discharge teaching.
B. Vitamin K can interfere with warfarin’s effectiveness; clients should avoid supplements with high vitamin K unless advised otherwise by their provider.
C. Warfarin does not dissolve existing clots; it prevents new clots from forming and existing ones from growing. The body gradually breaks down the clot on its own.
D. Taking warfarin with aspirin increases bleeding risk unless specifically prescribed; clients should be cautioned against using other blood-thinning medications without provider approval.

A. Elevated hemoglobin level B. Decreased bone mineral density C. Bradycardia and hypotension D. Increased gastric acid production

Correct Answer is B

Explanation

Rationale:
A. Elevated hemoglobin is not a known complication of long-term pantoprazole use.
B. Long-term use of proton pump inhibitors (PPIs) like pantoprazole can lead to decreased calcium absorption, increasing the risk for decreased bone mineral density and fractures. This is a recognized potential complication.
C. Bradycardia and hypotension are not common side effects associated with pantoprazole.
D. Pantoprazole reduces gastric acid production; it does not increase it. Rebound acid hypersecretion may occur after stopping the drug abruptly, but not during its use.

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A 20-year-old client presents to the emergency department with abdominal pain. Which assessment finding is most indicative of acute appendicitis?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is providing discharge teaching for a client who developed a pulmonary embolism after total knee surgery. The client has been converted from heparin to sodium warfarin (Coumadin) anticoagulant therapy. What should the nurse teach the client?

Correct Answer is A

Explanation

A nurse is reviewing the chart of a client who has been taking pantoprazole (Protonix) daily for over a year. Which of the following findings should the nurse recognize as a potential complication of long-term therapy?

Correct Answer is B

Explanation

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