WEEK 6 [ADN260] APPENDICITIS,
GALLBLADDER DISEASE,
INFLAMMATION, NEPHRITIS EXAM
QUESTIONS AND ANSWERS
During a physical assessment, the nurse becomes concerned that 75-year-old Hattie
Jackson is experiencing acute appendicitis. Which assessment finding supports this
diagnosis? - Answer-Confusion
The mother of 7-year-old Peyton Henderson is upset because the child has not been
given any medication for abdominal pain caused by acute appendicitis. Which
explanation about the administration of pain medication is most appropriate? -
Answer-"Pain medication will mask the change in pain if the appendix ruptures."
The nurse identifies the potential for impaired gas exchange as a potential problem for
68-year-old Jorge Dominiquez, who is recovering from an appendectomy. Which
intervention should the nurse select to support this client's oxygenation needs? -
Answer-Splinting the incision when coughing
Mrs. Darby is a 26-year-old woman who is seeing the healthcare provider because of
severe upper right quadrant and right shoulder pain lasting for "hours at a time." The
healthcare provider indicates she believes it might be gallbladder disease but needs to
complete some tests. Mrs. Darby states, "That can't be. I'm too young. That's a disease
of old people." What is your best response? - Answer-"There are many risk factors for
gallbladder disease."
Ms. Atchison is a 50-year-old woman who has been diagnosed with gallstones. She is
preparing to have laboratory and diagnostic testing done. The healthcare provider
explained the need for testing. She is scheduled for an ultrasound, complete blood
count, and serum bilirubin. She asks why she is having an ultrasound instead of an x-
ray. She is concerned that insurance will not cover it. What is your best response? -
Answer-"An x-ray just shows the presence of gallstones, but an ultrasound also shows if
the gallbladder is emptying."
Mrs. Reyes is a 53-year-old woman who has just had a cholecystectomy with T-tube
placement. She is 12 hours postsurgery. She is in semi-Fowler position and is NPO with
a nasogastric (NG) tube in place after surgery. Her T-tube is connected to a sterile
container. Orders include routine vital signs and pain medications per protocol, or as
tolerated, minimal ice chips, and measuring T-tube drainage. You are completing a
head-to-toe assessment. Which assessment finding would require notification of the
healthcare provider? - Answer-Vomiting after administration of ordered antiemetic
,The mother of 4-year-old Kerry Washington asks why the nurse is concerned about the
client's breathing after she was stung by a bee. Which response by the nurse is the
most appropriate? - Answer-"Bee stings can cause a release of inflammatory
substances that can lead to airway obstruction."
Manny Domingo, a 45-year-old gardener is being treated for severe inflammation of the
right lower leg. Why should the nurse teach Manny infection control techniques prior to
being discharged? - Answer-Pathogens could cause the inflammatory process to
become worse.
The nurse is reviewing the blood test results conducted on Carmen Pataglia, a 68-year-
old female with rheumatoid arthritis. On which laboratory value should the nurse focus
to determine the presence of chronic inflammation in Ms.Pataglia? - Answer-Monocytes
10%
The nurse is caring for Shanelle Hamilton, a 35-year-old African American female being
treated for exacerbation of systemic lupus erythematosus. What should the nurse teach
Ms. Hamilton about the prescribed medication dexamethasone? - Answer-Do not stop
taking this medication.
Alicia Meritt, a 22-year-old woman with complaints of fatigue and persistent diarrhea, is
suspected of having Crohn disease and is scheduled to have a colonoscopy. Which
finding would Alicia's nurse expect to see from the colonoscopy if Alicia has Crohn
disease? - Answer-Cobblestone appearance of bowel
Danae Jacobs is a 35-year-old woman with a history of Crohn disease, which
manifested itself when she was 21 years old. For the last 2 years, she has been on
numerous antibiotics and steroids with less than desirable effects. After a recent
colonoscopy, the surgeon has told Danae that strictures have formed in her bowel and
he suggested surgery. What surgery does Danae's nurse anticipate Danae needing? -
Answer-Strictureplasty
Eli Schwartz is a 15-year-old boy who was recently diagnosed with ulcerative colitis and
is admitted to the hospital with severe diarrhea. Which nursing intervention would Eli's
nurse provide for Eli? - Answer-Infuse intravenous fluids as prescribed
A nurse is caring for Taraj Singh, a 5-year-old child who was recently diagnosed with
strep throat and treated. However, a week after Taraj's strep throat diagnosis, Taraj
began complaining of a severe headache and Taraj's mother noticed Taraj had a
swollen face. Taraj's healthcare provider has diagnosed Taraj with acute postinfection
glomerulonephritis. Which additional manifestation will Taraj's nurse expect to find upon
physical assessment? - Answer-Hematuria
A nurse is caring for Samuel McMurray, a 68-year-old man with rapidly progressive
glomerulonephritis (RPGN). Mr. McMurray's past medical history includes diabetes
mellitus and hypertension. His current blood pressure is 142/92 and his nurse notes 3+
, pedal edema to both of Mr. McMurray's legs. Mr. McMurray's healthcare provider has
ordered antihypertensive and immunosuppressive medications, as well as
plasmapheresis. Mr. McMurray asks his nurse, "What is plasmapheresis?" Which
response by the nurse is the most appropriate? - Answer-"This therapy removes
damaging antibodies from your blood."
A nurse is caring for Maria Lopez, a 68-year-old female who presents to the hospital in
a hypertensive crisis. Ms. Lopez's healthcare provider has ruled out a neurological
cause for her symptoms and now suspects that Ms. Lopez may be suffering from
nephritis. Ms. Lopez's nurse is performing a focused exam and is now performing Ms.
Lopez's health history intake. Which factor would the nurse suspect as being related to
the possible diagnosis of nephritis? - Answer-History of a nonhealing skin infection
A nurse is caring for William Sanders, a 65-year-old male with a history of peptic ulcer
disease (PUD), who presents to the emergency department via ambulance gurney. Mr.
Sanders called first responders to his house when he developed severe upper
abdominal pain that radiated to his right shoulder. Mr. Sanders's heart rate is 114 and
blood pressure is 90/55. Mr. Sanders's nurse notes that his skin is cool and clammy, his
abdomen is hard, and no bowel sounds can be auscultated. What complication
associated with PUD does the nurse suspect that Mr. Sanders has? - Answer-
Perforation
A nurse is caring for Mohammed Hassad, a 34-year-old man who has a 20-pack-year
history of smoking and works as an construction worker. Recently, Mohammed has
been complaining of hungerlike pain in his upper abdomen that occurs in the middle of
the night but seems to subside once he eats. Mr. Hassad's healthcare provider has
ordered an upper GI series to aid in diagnosing his condition. What instruction will Mr.
Hassad's nurse provide to Mohammed regarding this diagnostic test? - Answer-"This
procedure is a type of x-ray that uses contrast."
A nurse is planning care for Peter Carroll, a 55-year-old man who was recently
diagnosed with peptic ulcer disease (PUD). Peter is hospitalized after several days of
nausea and vomiting in addition to complaining of epigastric pain. When planning care
for Mr. Carroll, which nursing diagnosis takes priority? - Answer-risk of deficient fluid
volume
Case Study: Appendicitis
The nurse, caring for an 11-year-old child recovering from an appendectomy, is
preparing to help the family ambulate the child for the first time after surgery. Which
non-pharmacological nursing strategies would be appropriate for this child? - Answer-A
splint pillow against the abdomen when moving or coughing
The nurse is conducting an assessment on a client who is 36 hours postoperative
following an appendectomy. During the assessment, the nurse is unable to hear any
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