Which interventions can reduce the incidence of pressure injuries in hospitalized clients? (Select all that apply)

Choice A reason: Rebound tenderness at McBurney’s point, located in the right lower quadrant, is a classic sign of appendicitis. It occurs due to peritoneal irritation from an inflamed appendix, causing pain when pressure is released. This reflects localized inflammation and is a key diagnostic finding, often accompanied by guarding and fever.

Choice B reason: Hyperactive bowel sounds are not typical in appendicitis. Early in the condition, bowel sounds may be normal, but as inflammation progresses, paralytic ileus develops, leading to hypoactive or absent bowel sounds. Hyperactive sounds suggest other conditions, like gastroenteritis or obstruction, not the peritoneal irritation characteristic of appendicitis.

Choice C reason: Increased urinary output is not associated with appendicitis. Inflammation may cause systemic effects, but the kidneys typically reduce urine output (oliguria) in response to stress or hypovolemia from fluid shifts. Appendicitis does not directly affect renal function to increase urine production, making this an unlikely finding.

Choice D reason: A soft, non-tender abdomen is not expected in appendicitis. The condition causes localized tenderness, guarding, and rigidity in the right lower quadrant due to inflammation. A soft abdomen suggests no significant peritoneal irritation, which contradicts the pathophysiology of appendicitis, where pain and muscle guarding are prominent features.

Choice A reason: Nuchal rigidity, or neck stiffness, is a hallmark of bacterial meningitis due to meningeal inflammation irritating the spinal nerves and muscles. This causes resistance to neck flexion, often accompanied by fever, headache, and photophobia. It reflects the inflammatory response to bacterial invasion of the meninges, a critical diagnostic sign.

Choice B reason: Hypoactive deep tendon reflexes are not typical in bacterial meningitis. The condition causes central nervous system irritation, often leading to hyperactive reflexes due to meningeal inflammation. Hypoactive reflexes may occur in peripheral neuropathies or late-stage neurological diseases, not in acute meningitis, where irritability and hyperreflexia are more common.

Choice C reason: Bradycardia is not expected in bacterial meningitis. The systemic inflammatory response and fever typically cause tachycardia as the body compensates for infection and increased metabolic demand. Bradycardia may occur in late stages with increased intracranial pressure, but it is not a primary or early finding in meningitis.

Choice D reason: Increased appetite is not associated with bacterial meningitis. The condition causes systemic symptoms like fever, headache, and nausea, often leading to anorexia due to inflammation and discomfort. Increased metabolic demand exists, but patients typically experience reduced appetite, making this an unlikely finding in acute bacterial meningitis.