A nurse is caring for a client with peritonitis and observes a rigid, board-like abdomen upon palpation. The nurse recognizes this finding as:
Rebound tenderness
Paralytic ileus
Abdominal compartment syndrome
Guarding
The Correct Answer is D
Choice A reason:
Rebound tenderness refers to increased pain upon release of pressure during palpation and is not related to the finding of a rigid, board-like abdomen.
Choice B reason:
Paralytic ileus refers to a condition in which the intestines stop functioning, causing a lack of bowel sounds and distension, but it is not directly related to the rigid abdomen finding.
Choice C reason:
Abdominal compartment syndrome may cause abdominal distension and increased intra-abdominal pressure, but it does not necessarily result in a rigid, board-like abdomen.
Choice D reason:
The finding of a rigid, board-like abdomen upon palpation is known as guarding, which is a protective response of the abdominal muscles in peritonitis to minimize movement and protect the inflamed peritoneum.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason:
Chest pain is not a typical symptom of peritonitis, as the condition primarily affects the abdomen.
Choice B reason:
A severe headache is not a characteristic symptom of peritonitis.
Choice C reason:
Abdominal pain and tenderness are hallmark symptoms of peritonitis, resulting from inflammation of the peritoneum lining the abdominal cavity.
Choice D reason:
Shortness of breath is not a common symptom of peritonitis unless there is an associated respiratory complication.
Correct Answer is D
Explanation
Choice A reason:
An electrocardiogram (ECG) is used to assess the electrical activity of the heart and is not specific to diagnosing peritonitis.
Choice B reason:
A complete blood count (CBC) may reveal elevated white blood cell count and inflammatory markers, but it alone cannot confirm the diagnosis of peritonitis.
Choice C reason:
A chest X-ray may be performed to rule out other conditions, but it is not the primary diagnostic test for peritonitis.
Choice D reason:
An abdominal computed tomography (CT) scan is a valuable diagnostic tool for identifying signs of inflammation and infection in the peritoneal cavity, aiding in the confirmation of peritonitis.
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