A client you are assigned is experiencing arrhythmia. What sign is the client exhibiting?

Choice A reason: Rebound tenderness in the right lower quadrant, often at McBurney’s point, is a hallmark of appendicitis, indicating peritoneal irritation from an inflamed appendix. This sign, elicited by releasing pressure during palpation, suggests localized inflammation, requiring urgent surgical evaluation to prevent rupture and peritonitis.

Choice B reason: Pancreatitis typically presents with epigastric or left upper quadrant pain, radiating to the back, not right lower quadrant rebound tenderness. It involves pancreatic inflammation, often due to gallstones or alcohol, and is assessed via serum amylase and lipase, not RLQ findings, making this incorrect.

Choice C reason: Cholecystitis causes right upper quadrant pain and tenderness, often with Murphy’s sign, due to gallbladder inflammation. Rebound tenderness in the right lower quadrant is not characteristic, as cholecystitis affects the upper abdomen, making this choice misaligned with the clinical finding.

Choice D reason: Diverticulitis typically causes left lower quadrant pain, as diverticula are common in the sigmoid colon. Right lower quadrant rebound tenderness is not a typical finding, as it suggests appendicitis instead, making this choice incorrect for the described gastrointestinal assessment finding.

Choice A reason: Smoking history is relevant for vascular or lung issues but not directly for unilateral arm edema, which suggests localized causes like lymphedema. Breast surgery history is more pertinent. Assuming smoking is key risks missing lymphatic causes, delaying diagnosis and management of edema in affected patients.

Choice B reason: Left arm edema may indicate lymphedema from breast surgery, like mastectomy, which disrupts lymphatic drainage. Asking about surgery history is critical to identify causes, guiding interventions like compression therapy. This targeted question ensures accurate diagnosis, preventing complications like chronic swelling or infection in patients with post-surgical edema.

Choice C reason: Recent weight gain may cause generalized edema but is less likely for unilateral arm edema, which points to localized issues like post-surgical lymphedema. Assuming weight gain is key risks overlooking specific causes, delaying targeted treatments critical for managing localized edema and improving patient comfort and function.

Choice D reason: Extra nipples (supernumerary nipples) are anatomical variants, unrelated to arm edema, which likely stems from lymphatic or vascular issues. Assuming this is relevant misdirects assessment, risking neglect of surgical history, critical for diagnosing lymphedema and implementing appropriate interventions like lymphatic drainage or compression.