Which clinical manifestation would most suggest acute appendicitis?
Abdominal pain that is most intense at McBurney point
Rebound tenderness
Abdominal pain that is relieved by eating
Bright red or dark red rectal bleeding
The Correct Answer is A
Choice A reason: Abdominal pain that is most intense at McBurney point is a classic sign of acute appendicitis. McBurney point is located about two-thirds of the way from the navel to the right hip bone. It is the site of the base of the appendix, where the inflammation is most severe. The pain usually starts around the navel and then shifts to the lower right abdomen. The pain may worsen with movement, coughing, or pressure.
Choice B reason: Rebound tenderness is a symptom of peritonitis, which is a complication of acute appendicitis. Peritonitis is an inflammation of the lining of the abdominal cavity, which can occur if the appendix ruptures and spills its contents. Rebound tenderness is a sharp pain that occurs when the abdomen is quickly released after being gently pressed. It indicates irritation of the peritoneum, the membrane that covers the abdominal organs.
Choice C reason: Abdominal pain that is relieved by eating is not a typical feature of acute appendicitis. In fact, appendicitis may cause loss of appetite, nausea, and vomiting. Eating may worsen the pain by stimulating the digestive tract and increasing the pressure on the appendix.
Choice D reason: Bright red or dark red rectal bleeding is not a common manifestation of acute appendicitis. It may indicate other conditions, such as hemorrhoids, anal fissures, diverticulitis, ulcerative colitis, or colon cancer. Rectal bleeding may occur in some cases of appendicitis if the inflammation affects the cecum, the first part of the colon, but it is usually not bright or dark red.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: Placing the infant in Trendelenburg position (head lower than feet) after eating is not a good suggestion to minimize reflux. This position may increase the abdominal pressure and the risk of aspiration. The infant should be placed in an upright or semi-upright position (30 to 45 degrees) for at least 30 minutes after feeding to reduce reflux and prevent regurgitation¹.
Choice B reason: Thickening the formula with rice cereal is a common and effective suggestion to minimize reflux. The rice cereal increases the viscosity and weight of the formula, making it less likely to flow back into the esophagus. The amount of rice cereal added should be about 1 teaspoon per ounce of formula, unless otherwise instructed by the health care provider².
Choice C reason: Giving continuous nasogastric tube feedings is not a necessary or desirable suggestion to minimize reflux. Nasogastric tube feedings are used for infants who have severe reflux and cannot tolerate oral feedings, or who have other medical conditions that require tube feeding. Nasogastric tube feedings may have complications such as infection, irritation, displacement, or obstruction of the tube. They may also interfere with the infant's oral development and bonding with the caregiver³.
Choice D reason: Giving larger, less frequent feedings is not a helpful suggestion to minimize reflux. Larger feedings may overfill the stomach and increase the pressure on the lower esophageal sphincter, which is the muscle that prevents reflux. Less frequent feedings may also make the infant more hungry and irritable, and cause more crying and swallowing of air. The infant should be given smaller, more frequent feedings to reduce reflux and promote digestion.
Correct Answer is D
Explanation
Choice A reason: Sodium excess (hypernatremia) is a condition in which the blood sodium level is too high. It can cause symptoms such as thirst, dry mouth, confusion, seizures, and coma. Sodium excess is usually caused by excessive intake of salt or fluids, or by loss of water due to diabetes insipidus, burns, or sweating. Sodium excess does not cause poor skin turgor, weight loss, or irritability.
Choice B reason: Calcium excess (hypercalcemia) is a condition in which the blood calcium level is too high. It can cause symptoms such as nausea, vomiting, constipation, abdominal pain, muscle weakness, bone pain, kidney stones, and cardiac arrhythmias. Calcium excess is usually caused by hyperparathyroidism, malignancy, vitamin D overdose, or prolonged immobilization. Calcium excess does not cause poor skin turgor, weight loss, or tachycardia.
Choice C reason: Overhydration (hypervolemia) is a condition in which the body has too much fluid. It can cause symptoms such as edema, weight gain, shortness of breath, cough, and hypertension. Overhydration is usually caused by excessive intake of fluids, or by retention of fluids due to heart failure, kidney failure, or liver cirrhosis. Overhydration does not cause poor skin turgor, weight loss, or irritability.
Choice D reason: Dehydration is a condition in which the body does not have enough fluid. It can cause symptoms such as poor skin turgor, weight loss, irritability, tachycardia, tachypnea, sunken eyes, dry mouth, and decreased urine output. Dehydration is usually caused by loss of fluids due to vomiting, diarrhea, fever, or excessive sweating. Dehydration is the most likely diagnosis for the infant based on the data.
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