A nurse is caring for a 24-year-old female client in the emergency department (ED).
What is the most likely diagnosis for this client, based on the history, physical exam, and diagnostic results?
Acute appendicitis
Ectopic pregnancy
Ovarian cyst rupture
Acute gastritis
The Correct Answer is A
Choice A rationale: Acute appendicitis is most likely based on the history of sudden onset of severe abdominal pain localized to the right lower quadrant, nausea, vomiting with green bile, and tenderness on physical examination. The ultrasound findings of right lower quadrant tenderness further support this diagnosis. The client's vital signs, including tachycardia and tachypnea, are consistent with the stress and pain caused by acute appendicitis.
Choice B rationale: Ectopic pregnancy is less likely as the client has a negative pregnancy test and reports regular menstrual cycles with her last period occurring one week ago. Additionally, her symptoms are more typical of appendicitis.
Choice C rationale: Ovarian cyst rupture would typically present with sudden onset of pelvic pain, often associated with menstrual irregularities or a history of ovarian cysts. However, the client's presentation and diagnostic results strongly point towards acute appendicitis.
Choice D rationale: Acute gastritis generally presents with epigastric pain, nausea, and vomiting. However, the localization of pain to the right lower quadrant and the ultrasound findings make appendicitis a more likely diagnosis in this case.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale
While asking the client's family to return may provide additional support, it is not a viable long-term solution as family members may have other responsibilities and commitments. It also places undue pressure on the family.
Choice B rationale
Hiring a private nurse could be a solution, but it may not be financially feasible for all clients. It also does not address the need for a comprehensive plan for both the client and her husband.
Choice C rationale
Social services can assist in arranging respite care for the client's husband, ensuring he receives the necessary care while the client recovers. Respite care is a practical solution for temporary relief for caregivers.
Choice D rationale
A case management evaluation can help assess the client's home environment and identify any potential needs or risks. However, it does not directly address the immediate concern of providing care for the husband.
Correct Answer is D
Explanation
Choice A rationale
Asking the mother about usual care practices might provide useful information, but it is not the best immediate intervention for addressing the child's dry and cracked lips and nares. Immediate action should be taken to provide relief.
Choice B rationale
Using a topical lidocaine analgesic is not appropriate for treating dryness and cracking of the lips and nares. Lidocaine is an anesthetic, not a moisturizing agent, and could cause additional irritation or adverse reactions if used improperly.
Choice C rationale
Applying petroleum jelly to the child's nose and lips is not recommended as it poses a risk of aspiration, especially in young children. Inhaling petroleum jelly can lead to respiratory issues and is therefore not a safe option.
Choice D rationale
Using a water-soluble lubricant is the best option for moisturizing and protecting the child's dry and cracked lips and nares. Water-soluble lubricants are safe for use on mucous membranes and provide effective relief without the risk of aspiration.
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