A nurse is assessing a child diagnosed with appendicitis.
Which finding requires immediate intervention?
High elevation in white blood cell count.
Guarding and rebound tenderness.
Sudden relief of pain followed by rigid abdomen and fever.
Abdominal tenderness in the right lower quadrant.
The Correct Answer is C
Choice A rationale
A high elevation in the white blood cell count, or leukocytosis, is an expected inflammatory response in appendicitis. While an elevated WBC count (normal range typically 4,500 to 11,000 cells/mcL) indicates infection or inflammation, it does not necessarily signal immediate, life-threatening complications requiring immediate intervention.
Choice B rationale
Guarding, which is the tensing of abdominal muscles upon palpation, and rebound tenderness, pain that worsens when pressure is released, are classic signs of peritoneal irritation associated with appendicitis. These findings suggest inflammation of the peritoneum but do not indicate an immediate, critical emergency in the same way as sudden pain relief.
Choice C rationale
Sudden relief of pain in a child with appendicitis, followed by a rigid abdomen and fever, is a critical sign of a ruptured appendix and subsequent peritonitis. The rupture releases the pressure causing the initial pain, but the spillage of bowel contents leads to widespread inflammation of the peritoneum, a serious and potentially life-threatening condition requiring immediate surgical intervention to prevent sepsis and other complications.
Choice D rationale
Abdominal tenderness in the right lower quadrant (RLQ), often referred to as McBurney's point, is a characteristic finding in appendicitis due to the inflammation of the appendix in this anatomical location. While it warrants investigation and treatment, localized tenderness alone does not indicate an immediate, life-threatening complication.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
A first-degree burn involves only the epidermis, the outermost layer of the skin. It is characterized by redness (erythema), pain, and dryness, without the formation of blisters. The superficial damage affects the outer layer of epithelial cells, causing vasodilation and inflammation, leading to the observed redness and discomfort.
Choice B rationale
A second-degree burn involves the epidermis and a portion of the dermis, the layer beneath the epidermis. These burns are characterized by blisters, significant pain, redness, and swelling. The damage extends deeper into the skin, affecting nerve endings and blood vessels, leading to fluid leakage and blister formation.
Choice C rationale
A third-degree burn involves the destruction of the epidermis and the entire dermis, potentially extending into the subcutaneous tissue. These burns appear white or charred, are often painless initially due to nerve damage, and lack blisters. The full thickness destruction of skin layers impairs sensation and requires significant medical intervention, often including skin grafting.
Choice D rationale
Full-thickness burn is another term for a third-degree burn, indicating that all layers of the skin have been destroyed. This type of burn extends through the epidermis and dermis and may involve underlying subcutaneous tissue, muscle, or bone. The appearance is typically dry, leathery, and may be white, charred, or waxy.
Correct Answer is ["A","B","C","D"]
Explanation
Choice A rationale
Type 2 diabetes in pediatric patients can sometimes be managed effectively through lifestyle modifications alone, particularly in the early stages. These changes include dietary adjustments to reduce sugar and processed foods, increased physical activity to improve insulin sensitivity, and weight management.
Choice B rationale
Insulin resistance is a key pathophysiological feature of type 2 diabetes. In this condition, the body's cells do not respond effectively to insulin, leading to elevated blood glucose levels as glucose cannot enter the cells for energy. The pancreas initially produces more insulin to compensate, but eventually, it may not be able to keep up.
Choice C rationale
Type 1 diabetes is more commonly diagnosed in younger children and adolescents, often presenting with acute symptoms. It results from the autoimmune destruction of insulin-producing beta cells in the pancreas, leading to an absolute deficiency of insulin.
Choice D rationale
Type 1 diabetes is an autoimmune disease where the body's immune system mistakenly attacks and destroys the pancreatic beta cells that produce insulin. This autoimmune process is often triggered by genetic predisposition and environmental factors but is not directly caused by lifestyle.
Choice E rationale
Obesity is a significant risk factor for the development of type 2 diabetes due to its association with increased insulin resistance. While individuals with type 1 diabetes can also be obese, obesity is not the primary cause of type 1 diabetes.
Choice F rationale
Type 1 diabetes cannot be cured with lifestyle changes alone because it involves the permanent destruction of insulin-producing cells. Individuals with type 1 diabetes require lifelong insulin therapy to survive.
Choice G rationale
Type 1 diabetes cannot be prevented with healthy eating or other lifestyle modifications because it is an autoimmune condition. The onset is not directly linked to dietary habits or physical activity levels.
Choice H rationale
Type 2 diabetes is less common in infants and toddlers and is more frequently diagnosed in older children, adolescents, and adults, often associated with factors like obesity, family history, and sedentary lifestyle.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.