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NCLEX Questions Appendicitis Exam Guide Latest Update
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NCLEX Questions Appendicitis Exam Guide Latest Update
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NCLEX Questions Appendicitis ExamGuide Latest Update
A client telephones the health clinic with complaints of generalized abdominal pain
which is aggravated by moving or walking. The client has not been able to eat for a day
and is nauseated. Which advice should the nurse provide to this client?
A. "Take a warm shower and apply a heating pad to the abdomen."
B. "Rest in bed and drink warm fluids."
C. "Seek immediate medical attention."
D. "Take an over-the-counter laxative." - Answer-Answer: C
Rationale: The initial characteristic manifestation of acute appendicitis is continuous,
mild, generalized or upper abdominal pain. Over the next 4 hours, the pain intensifies
and localizes in the right lower quadrant of the abdomen. Pain associated with
appendicitis is aggravated by moving, walking, or coughing. If medical attention is not
provided, gangrene can develop within 24dash36 hours. The client should be instructed
to seek immediate medical attention. Resting in bed and drinking warm fluids is not
going to prevent the appendix from developing gangrene. When appendicitis is
suspected, the client should be instructed to avoid laxatives and not to apply heat to the
abdomen because heat could encourage the appendix to rupture.
Which clinical manifestation does the nurse expect with acute appendicitis?
A. High fever
B. Nausea and vomiting
C. Rebound tenderness
D. Pain relieved with ambulation - Answer-Answer: C
Rationale: One manifestation of acute appendicitis is localized and rebound tenderness
of McBurney point upon palpation. A high fever is a manifestation of a perforated
appendix. Nausea and vomiting are generalized symptoms and are not present
exclusively with appendicitis. Ambulation increases pain in appendicitis.
Which condition may occur if the client does not seek medication attention for acute
appendicitis within 24dash36 hours? (Select all that apply.)
A. Seizure
B. Constipation
C. Nausea
D. Peritonitis
E. Perforation - Answer-Answer: D, E
Rationale: If treatment is not initiated, tissue necrosis and gangrene result within 24-36
hours, leading to perforation (rupture). Perforation allows the contents of the
gastrointestinal (GI) tract to flow into the peritoneal space of the abdomen, resulting in
peritonitis. Appendicitis does not cause seizures, nausea, or constipation.
A teenage boy presents with suspected appendicitis. The caregiver asks, "Why did my
son get this?" Which response by the nurse is the most appropriate?
, A. "Your son has been eating too much fiber."
B. "Your son is eating too many fruits and vegetables."
C. "Your son has not been getting enough exercise."
D. "Your adolescent son is in a risk group." - Answer-Answer: D
Rationale: Adolescent boys are at greatest risk for appendicitis. Appendicitis cannot be
prevented, but certain dietary habits may reduce the risk of developing this condition.
Eating foods that contain high fiber content, such as fresh fruits and vegetables,
decreases the incidence of appendicitis.
Appendicitis almost always results from an obstruction in the appendiceal lumen. Which
problem should the nurse identify as the cause of this obstruction?
A. Monolith
B. Fecalith
C. Tonsillolith
D. Ptyalith - Answer-Answer: B
Rationale: The obstruction is often caused by a hard mass of feces (fecalith). Ptyalith is
a calculus in the salivary gland. Tonsillolith is a calculus in the tonsil. A monolith is a
large stone used in sculpture.
Which statement by a client diagnosed with acute appendicitis leads the nurse to
believe the client needs teaching about dietary interventions?
A. "I eat raw vegetables for a snack several days per week."
B. "I don't like fruits and vegetables."
C. "I prefer to have meat with each meal."
D. "I eat fruit with breakfast every day." - Answer-Answer: B
Rationale: Certain dietary habits may reduce the risk of developing acute appendicitis.
Eating foods that contain high fiber content, such as fresh fruits and vegetables,
decreases the incidence of appendicitis.
Which assessment finding leads the nurse to suspect that an older client may have
appendicitis? (Select all that apply.)
A. Pain migrating from the lower left to the upper right quadrant
B. Tenderness when pressing McBurney point
C. Confusion
D. No abdominal pain
E. Internal rotation of the left hip increases pain - Answer-Answer: B, C, E
Rationale: Fewer than 30% of older adults who have appendicitis present with classic
symptoms. Classic signs of acute appendicitis are pain that is aggravated by moving or
walking, rebound tenderness of McBurney point, and extension or internal rotation of
the right hip that increases pain and confusion. A little less than half demonstrate no
rebound or involuntary guarding. Pain typically migrates down to the lower right
quadrant in appendicitis.
A teenage girl is being assessed for the possibility of appendicitis. Which other condition
should the nurse consider? (Select all that apply.)
A. Pelvic inflammatory disease
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