A nurse is admitting a client who has suspected appendicitis. Which of the following findings is the nurse’s priority to report to the provider?
Distended, board-like abdomen
WBC count 15,000/mm³ (5,000 to 10,000/mm³)
Rebound tenderness over McBurney’s point
Temperature 37.3°C (99.1°F)
The Correct Answer is A
Choice A Reason:
A distended, board-like abdomen is a critical finding that can indicate peritonitis, a severe complication of appendicitis. Peritonitis occurs when the appendix ruptures, leading to infection spreading throughout the abdominal cavity. This condition requires immediate medical intervention to prevent further complications and potential sepsis.
Choice B Reason:
A WBC count of 15,000/mm³ is elevated and suggests an infection, which is common in appendicitis. However, it is not as immediately critical as signs of peritonitis. Elevated WBC counts are expected in cases of appendicitis but do not necessarily indicate a life-threatening emergency.
Choice C Reason:
Rebound tenderness over McBurney’s point is a classic sign of appendicitis and indicates localized inflammation. While it is an important diagnostic sign, it does not require immediate reporting compared to signs of peritonitis.
Choice D Reason:
A temperature of 37.3°C (99.1°F) is only slightly elevated and does not indicate a severe infection or complication. Fever is a common symptom of appendicitis but is not as critical as a distended, board-like abdomen.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A Reason
Increased erythrocyte sedimentation rate (ESR) is a marker of inflammation and is commonly elevated in conditions like rheumatoid arthritis. However, it is not a direct adverse effect of NSAID therapy. NSAIDs are more likely to cause gastrointestinal issues, such as bleeding, which would be detected by a fecal occult blood test.
Choice B Reason
Elevated creatinine clearance is not typically associated with NSAID use. In fact, NSAIDs can potentially reduce kidney function, leading to decreased creatinine clearance. Therefore, this option is incorrect.
Choice C Reason
Increased serum potassium levels can occur with NSAID use, especially in patients with compromised kidney function. However, this is less common compared to gastrointestinal bleeding, which is a more direct and frequent adverse effect of NSAID therapy.
Choice D Reason
Positive fecal occult blood test is the correct answer. NSAIDs can cause gastrointestinal bleeding, which can be detected through a fecal occult blood test. This is a well-documented adverse effect of NSAID therapy and is a significant concern for patients on long-term NSAID treatment.
Correct Answer is A
Explanation
Choice A Reason
Expressive aphasia is a common symptom of a left-hemisphere stroke. This condition, also known as Broca’s aphasia, affects the ability to produce language, making it difficult for the patient to speak fluently. The patient may understand speech but struggle to form coherent sentences, often speaking in short, choppy phrases.
Choice B Reason
Poor impulse control is more commonly associated with right-hemisphere strokes. The right hemisphere of the brain is responsible for controlling impulsive behavior and emotional regulation. Therefore, this symptom is less likely to be observed in a patient with a left-hemisphere stroke.
Choice C Reason
Left hemiparesis refers to weakness on the left side of the body. Since the left hemisphere of the brain controls the right side of the body, a left-hemisphere stroke typically results in right-sided weakness or paralysis. Therefore, left hemiparesis is not a typical finding in this scenario.
Choice D Reason
Disorientation to place can occur after a stroke, but it is not specifically associated with left-hemisphere strokes. Disorientation is a general symptom that can result from various types of brain injuries and is not exclusive to strokes affecting the left hemisphere.
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