Appendicitis By Rnpedia.Com

50 Questions | Total Attempts: 2473

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Appendicitis By Rnpedia.Com

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Questions and Answers
  • 1. 
    Which condition is most likely to have a nursing diagnosis of fluid volume deficit?  
    • A. 

      Appendicitis

    • B. 

      Pancreatitis

    • C. 

      Cholecystitis

    • D. 

      Gastric ulcer

  • 2. 
    When preparing a male client, age 51, for surgery to treat appendicitis, the nurse formulates a nursing diagnosis of Risk for infection related to inflammation, perforation, and surgery. What is the rationale for choosing this nursing diagnosis?  
    • A. 

      Obstruction of the appendix may increase venous drainage and cause the appendix to rupture.

    • B. 

      Obstruction of the appendix reduces arterial flow, leading to ischemia, inflammation, and rupture of the appendix.

    • C. 

      The appendix may develop gangrene and rupture, especially in a middle-aged client.

    • D. 

      Infection of the appendix diminishes necrotic arterial blood flow and increases venous drainage.

  • 3. 
    Situation : Mr. Gerald Liu, 19 y/o, is being admitted to a hospital unit complaining of severe pain in the lower abdomen. Admission vital signs reveal an oral temperature of 101.2 0F. Which of the following complications is thought to be the most common cause of appendicitis?   
    • A. 

      A fecalith

    • B. 

      Internal bowel occlusion

    • C. 

      Bowel kinking

    • D. 

      Abdominal wall swelling

  • 4. 
    Situation : Mr. Gerald Liu, 19 y/o, is being admitted to a hospital unit complaining of severe pain in the lower abdomen. Admission vital signs reveal an oral temperature of 101.2 0F. The doctor ordered for a complete blood count. After the test, Nurse Ray received the result from the laboratory. Which laboratory values will confirm the diagnosis of appendicitis?   
    • A. 

      RBC 5.5 x 106/mm3

    • B. 

      Hct 44 %

    • C. 

      WBC 13, 000/mm3

    • D. 

      Hgb 15 g/dL

  • 5. 
    Situation: Mr. Gerald Liu, 19 y/o, is being admitted to a hospital unit complaining of severe pain in the lower abdomen. Admission vital signs reveal an oral temperature of 101.2 0F. Signs and symptoms include pain in the RLQ of the abdomen that may be localize at McBurney’s point. To relieve pain, Mr. Liu should assume which  position? 
    • A. 

      Prone

    • B. 

      Supine, stretched out

    • C. 

      Sitting

    • D. 

      Lying with legs drawn up

  • 6. 
    Situation: Mr. Gerald Liu, 19 y/o, is being admitted to a hospital unit complaining of severe pain in the lower abdomen. Admission vital signs reveal an oral temperature of 101.2 0F. After a few minutes, the pain suddenly stops without any intervention. Nurse Ray might suspect that:   
    • A. 

      The appendix is still distended

    • B. 

      The appendix may have ruptured

    • C. 

      An increased in intrathoracic pressure will occur

    • D. 

      Signs and symptoms of peritonitis occur

  • 7. 
    Roxy is admitted to the hospital with a possible diagnosis of appendicitis. On physical examination, the nurse should be looking for tenderness on palpation at McBurney’s point, which is located in the   
    • A. 

      Left lower quadrant

    • B. 

      Left upper quadrant

    • C. 

      right lower quadrant

    • D. 

      right upper quadrant

  • 8. 
    Typical signs and symptoms of appendicitis include:
    • A. 

      Nausea

    • B. 

      Left lower quadrant pain

    • C. 

      Pain when pressure is applied to the right lower quadrant of the abdomen.

    • D. 

      High fever

  • 9. 
    When preparing a male client, age 51, for surgery to treat appendicitis, the nurse formulates a nursing diagnosis of Risk for infection related to inflammation, perforation, and surgery. What is the rationale for choosing this nursing diagnosis?  
    • A. 

      Obstruction of the appendix may increase venous drainage and cause the appendix to rupture.

    • B. 

      Obstruction of the appendix reduces arterial flow, leading to ischemia, inflammation, and rupture of the appendix.

    • C. 

      The appendix may develop gangrene and rupture, especially in a middle-aged client.

    • D. 

      Infection of the appendix diminishes necrotic arterial blood flow and increases venous drainage.

  • 10. 
     Jerry has diagnosed with appendicitis. He develops a fever, hypotension and tachycardia. The nurse suspects which of the following complications?
    • A. 

      Intestinal obstruction

    • B. 

      Peritonitis

    • C. 

      Bowel ischemia

    • D. 

      Deficient fluid volume

  • 11. 
    Situation: A 20 year old college student was rushed to the ER of PGH after he fainted during their ROTC drill. Complained of severe right iliac pain. Upon palpation of his abdomen, Ernie jerks even on slight pressure. Blood test was ordered. Diagnosis is acute appendicitis. Which result of the lab test will be significant to the diagnosis?   
    • A. 

      RBC : 4.5 TO 5 Million / cu. mm.

    • B. 

      Hgb : 13 to 14 gm/dl.

    • C. 

      Platelets : 250,000 to 500,000 cu.mm.

    • D. 

      WBC : 12,000 to 13,000/cu.mm

  • 12. 
    Situation: A 20 year old college student was rushed to the ER of PGH after he fainted during their ROTC drill. Complained of severe right iliac pain. Upon palpation of his abdomen, Ernie jerks even on slight pressure. Blood test was ordered. Diagnosis is acute appendicitis. Stat appendectomy was indicated. Pre op care would include all of the following except? [1]  
    • A. 

      Consent signed by the father

    • B. 

      Enema STAT

    • C. 

      Skin prep of the area including the pubis

    • D. 

      Remove the jewelries

  • 13. 
    Situation: A 20 year old college student was rushed to the ER of PGH after he fainted during their ROTC drill. Complained of severe right iliac pain. Upon palpation of his abdomen, Ernie jerks even on slight pressure. Blood test was ordered. Diagnosis is acute appendicitis. Pre-anesthetic med of Demerol and atrophine sulfate were ordered to :
    • A. 

      Allay anxiety and apprehension

    • B. 

      Reduce pain

    • C. 

      Prevent vomiting

    • D. 

      Relax abdominal muscle

  • 14. 
    Common anesthesia for appendectomy is   
    • A. 

      Spinal

    • B. 

      General

    • C. 

      Caudal

    • D. 

      Hypnosis

  • 15. 
    Post op care for appendectomy include the following except   
    • A. 

      Early ambulation

    • B. 

      Diet as tolerated after fully conscious

    • C. 

      Nasogastric tube connect to suction

    • D. 

      Deep breathing and leg exercise

  • 16. 
    Peritonitis may occur in ruptured appendix and may cause serious problems which are  1. Hypovolemia, electrolyte imbalance 2. Elevated temperature, weakness and diaphoresis 3. Nausea and vomiting, rigidity of the abdominal wall 4. Pallor and eventually shock  
    • A. 

      1 and 2

    • B. 

      2 and 3

    • C. 

      1,2,3

    • D. 

      All of the above

  • 17. 
     If after surgery the patient’s abdomen becomes distended and no bowel sounds appreciated, what would be the most suspected complication? [1]  
    • A. 

      Intussusception

    • B. 

      Paralytic Ileus

    • C. 

      Hemorrhage

    • D. 

      Ruptured colon

  • 18. 
    During defecation, movement of feces into the rectum initiates (click all that apply)
    • A. 

      Rectoanal inhibitory reflex

    • B. 

      Voluntary relaxation of the pelvic floor and external sphincter mechanism

    • C. 

      Voluntary increase in intra-abdominal pressure

    • D. 

      Voluntary contraction of external sphincter

  • 19. 
    What percentage of people have appendicitis in their lifetime?
    • A. 

      10%

    • B. 

      20%

    • C. 

      30%

    • D. 

      50%

  • 20. 
    What are diagnostic features of acute appendicitis? click all that apply
    • A. 

      Low grade fever less than 100.4F/38C

    • B. 

      Moderate leukocytosis (10,000-20,000)

    • C. 

      Ultrasound

    • D. 

      CT (with contrast depending on body habitus)

    • E. 

      CT (helpful if perforation is suspected to diagnose periappendiceal abscess)

  • 21. 
    What best explains what happens to the appendix when it is obstructed?
    • A. 

      The inflamed tissue becomes infected and dies from lack of blood supply and eventually bursts

    • B. 

      The inflamed tissue dies from lack of blood supply causing the appendix to burst

    • C. 

      The obstruction causes pressure to build up and eventually causes the appendix to burst

    • D. 

      The obstruction hardens the appendix eventually causing it to burst

  • 22. 
    What is the primary cause of appendicitis?
    • A. 

      Obstruction of the lumen between the cecum and appendix

    • B. 

      Inflammation due to an immune response

    • C. 

      Constipation

    • D. 

      Overuse of antibiotics

  • 23. 
    During the rectoanal inhibitory reflex, the internal sphincter ________  allowing the contents into the anal canal, then the external sphincter ____________ and contents are pushed back into the rectum. This occurs up to 7 times daily.
    • A. 

      Relaxes, relaxes

    • B. 

      Contracts, contracts

    • C. 

      Relaxes, contracts

    • D. 

      Contracts, relaxes

  • 24. 
    What stimulates the contraction of propulsive waves that move stool distally from the cecum?
    • A. 

      Distention of the colonic wall

    • B. 

      Distention of the small intestinal wall

    • C. 

      The fermenting vat located in the cecum

    • D. 

      Distention of the cecum wall

  • 25. 
    What part of the colon propels retrograde waves of contraction to allow the cecum to retain liquid feces and act as a 'fermenting vat'?
    • A. 

      Mid-transverse colon

    • B. 

      Entire transverse colon

    • C. 

      Ascending colon

    • D. 

      Descending colon

    • E. 

      Ileum

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