A teenager is admitted with an acute onset of right lower quadrant pain at McBurney point. Appendicitis is suspected. For which clinical indicator should the nurse assess the client to determine if the pain is secondary to appendicitis?
Urine retention
Increased lower bowel motility.
Gastric hyperacidity
Rebound tenderness.
The Correct Answer is D
A. Urine retention is not typically associated with appendicitis. While urinary issues may occur with abdominal pain due to other reasons, they do not specifically indicate appendicitis. Therefore, this option is not relevant.
B. Increased lower bowel motility can be seen in various gastrointestinal conditions, but it is not a specific indicator of appendicitis. In fact, appendicitis may lead to decreased bowel motility due to inflammation. Thus, this option is not indicative of appendicitis.
C. Gastric hyperacidity refers to increased stomach acid production and is associated with conditions like gastritis or peptic ulcers, but it is not a clinical indicator of appendicitis. Therefore, this option is not relevant to the diagnosis of appendicitis.
D. Rebound tenderness is a classic sign of appendicitis. It occurs when pressure is applied to the abdomen and then released, causing pain. This indicator suggests irritation of the peritoneum, which can occur with appendicitis.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. While constipation is a common side effect of gastric bypass surgery, docusate may not be necessary for all clients. The need for stool softeners should be individualized based on the client's symptoms.
B. While gastric bypass surgery can help with weight loss, it does not eliminate the risk of high cholesterol. Clients should still monitor their cholesterol levels and take appropriate measures to manage it.
C. This statement reflects an understanding of the need for ongoing medical monitoring following gastric bypass surgery. Patients are at risk for nutritional deficiencies, including electrolyte imbalances, due to changes in absorption and dietary intake. Regular checks are necessary to prevent complications.
D. While gastric bypass surgery can increase the risk of developing diabetes, not all clients will need to monitor their blood sugar daily. The need for blood sugar monitoring should be determined by the client's individual risk factors and medical history.
Correct Answer is D
Explanation
A. Urine retention is not typically associated with appendicitis. While urinary issues may occur with abdominal pain due to other reasons, they do not specifically indicate appendicitis. Therefore, this option is not relevant.
B. Increased lower bowel motility can be seen in various gastrointestinal conditions, but it is not a specific indicator of appendicitis. In fact, appendicitis may lead to decreased bowel motility due to inflammation. Thus, this option is not indicative of appendicitis.
C. Gastric hyperacidity refers to increased stomach acid production and is associated with conditions like gastritis or peptic ulcers, but it is not a clinical indicator of appendicitis. Therefore, this option is not relevant to the diagnosis of appendicitis.
D. Rebound tenderness is a classic sign of appendicitis. It occurs when pressure is applied to the abdomen and then released, causing pain. This indicator suggests irritation of the peritoneum, which can occur with appendicitis.
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