A female patient presents to the emergency department with severe abdominal pain localized to the right lower quadrant, nausea, and a low-grade fever. After performing a physical examination and diagnostic imaging, the patient is diagnosed with acute appendicitis. What is the most appropriate initial intervention?

Administer intravenous antibiotics and observe the patient for 24 hours.

Provide the patient with oral pain medications and discharge them with a follow-up appointment.

Recommend a liquid diet and bed rest to reduce inflammation.

Prepare the patient for an appendectomy.

Answer and Explanation

The Correct Answer is D

A. Administer intravenous antibiotics and observe the patient for 24 hours: IV antibiotics may be given preoperatively, but observation without surgery is not the standard treatment for confirmed appendicitis due to the risk of rupture.

B. Provide the patient with oral pain medications and discharge them with a follow-up appointment: Oral pain medications are not appropriate as the patient needs surgical intervention. Discharging the patient without surgery could result in life-threatening complications.

C. Recommend a liquid diet and bed rest to reduce inflammation: A liquid diet and bed rest will not address the underlying issue of appendicitis, which requires surgical removal of the inflamed appendix.

D. Prepare the patient for an appendectomy. The standard treatment for acute appendicitis is an appendectomy. Delaying surgery can lead to complications such as perforation, peritonitis, or abscess formation. This is the most appropriate intervention.

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Correct Answer is B

Explanation

A. A client who has a pacemaker: Having a pacemaker is not a contraindication for renal transplantation. As long as the patient is otherwise healthy and able to tolerate surgery, a pacemaker does not preclude the procedure.

B. A client who has a history of IV drug abuse: IV drug abuse is a contraindication for renal transplant due to the potential for poor compliance with post-transplant care and higher risk for recurrent infections and complications.

C. A client who has a body mass index (BMI) of 25: A BMI of 25 is within the normal to slightly overweight range. A BMI of 30 or higher may be a concern due to increased risks during surgery, but a BMI of 25 is not a contraindication.

D. A client who is 65 years old: Age alone is not a contraindication for a renal transplant. While younger patients may have better outcomes, transplants are performed on older patients if they are otherwise good candidates and able to tolerate the surgery and long-term immunosuppressive therapy.

A. Encouraging the patient to drink ginger tea for nausea B. Applying ice packs to the abdomen C. Administering prescribed intravenous analgesics D. Advising the patient to eat small, frequent meals

Correct Answer is C

Explanation

A. Encouraging the patient to drink ginger tea for nausea: While ginger tea may help with nausea in some cases, it is not an appropriate intervention for acute cholecystitis, which requires more aggressive management.

B. Applying ice packs to the abdomen: Ice packs are not a standard treatment for acute cholecystitis and would not effectively alleviate the patient’s pain or inflammation.

C. Administering prescribed intravenous analgesics: The most appropriate intervention is to administer prescribed intravenous analgesics to relieve pain in patients with acute cholecystitis. Pain management is a priority to alleviate discomfort while awaiting further treatment, such as surgery or antibiotics.

D. Advising the patient to eat small, frequent meals: Dietary changes like eating small, frequent meals may be advised after the acute phase to prevent future attacks, but they are not appropriate for addressing acute symptoms.

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Naxlex Comprehensive Predictor Exams

A nurse is reinforcing teaching about renal transplant with a newly licensed nurse. Which of the following clients should the nurse identify as having a contraindication for this procedure?

Correct Answer is B

Explanation

A female patient presents with right upper quadrant pain, nausea and vomiting. She has been diagnosed with acute cholecystitis. What is the most appropriate nursing action to alleviate her symptoms?

Correct Answer is C

Explanation

A nurse is caring for a client who is experiencing an acute exacerbation of ulcerative colitis. The nurse should recognize that which of the following actions is the priority?

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