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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
Asking the client to describe the pain is the most effective way to assess the quality of pain. This approach allows the client to provide specific details about their pain experience, including the type, intensity, and characteristics, which are essential for accurate pain management.
Choice B rationale
Identifying effective pain relief measures is important but does not directly assess the quality of pain. This step is more focused on treatment rather than the initial assessment of pain quality.
Choice C rationale
Observing body language and movement can provide additional information about the pain but is not as reliable as directly asking the client. Nonverbal cues should supplement, not replace, the client's verbal report.
Choice D rationale
Providing a numeric pain scale helps quantify the intensity of pain but does not assess the quality. Quality assessment requires a descriptive approach to understand the nature of the pain fully.
Correct Answer is ["A","B","E"]
Explanation
Choice A rationale: Involving the mother in the decision-making process can help reduce caregiver stress by sharing the responsibility and ensuring that the client's preferences and needs are considered. This collaborative approach can lead to better outcomes and improved communication.
Choice B rationale: It is important to acknowledge that caregiving can be challenging and can affect emotions. Recognizing that it is okay to have complex feelings, including not always loving or liking the person being cared for, helps normalize these emotions and reduces guilt and stress.
Choice C rationale: Moving a loved one into a care facility can be a difficult decision, but it does not necessarily mean a lack of love. However, this statement is not appropriate as it may reinforce negative emotions and guilt.
Choice D rationale: Avoiding the discussion of negative situations that may occur in the future is not helpful. It is important to plan for potential challenges to be prepared and reduce stress.
Choice E rationale: Saying "no" to things involving the care of a loved one is not selfish. It is important to set boundaries and prioritize self-care to prevent caregiver burnout. However, this statement suggests the opposite and is not appropriate.
Choice F rationale: Taking time for oneself and maintaining other important relationships is essential for a caregiver's well-being. Self-care and social support can help reduce stress and improve the ability to provide care effectively.
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